Effectiveness of Cognitive-Behavioral and Mindfulness Intervention in Improving Life Satisfaction of Patients with Crohn’s Disease: Evaluating Stress, Interpersonal Sensitivity, and Social Support as Mechanisms of Change

Objectives: Cognitive behavioral and mindfulness interventions have been shown to promote well-being in individuals with chronic illness. However, the underlying psychological processes through which these interventions impact well-being are not fully explored. This secondary analysis study aimed to examine the role of perceived social support, interpersonal sensitivity, and perceived stress as mediators of the positive effect of individualized online Cognitive Behavioral and Mindfulness Intervention (COBMINDEX) on life satisfaction among patients with Crohn’s disease (CD). Method: Patients with mild or moderately active disease (n=142) were randomly assigned to either COBMINDEX intervention or treatment-as-usual control group. After a period of 3 months, the control group also received the COBMINDEX intervention. Complete data were collected from 120 patients (COBMINDEX=60, TAU=60). Analysis of covariance assessed group differences in post-intervention scores, controlling for baseline scores. Multiple parallel mediation analysis assessed the proposed mechanisms for the entire sample. Results: Individuals in the COBMINDEX condition reported significantly lower levels of perceived stress (F=28.06, p<0.01) and interpersonal sensitivity (F=12.78, p<0.01) than those in the control condition. The COBMINDEX group also had significantly higher levels of life satisfaction (F=9.79, p<0.01) compared to the control group. Perceived social support did not differ across groups (F=2.73, p=0.10). Analysis of indirect effects revealed significant effects of perceived stress (b=0.52, 95% CI [0.16, 1.03]) and interpersonal sensitivity (b=0.73, 95% CI [0.31, 1.35]); thus, the positive effect of COBMINDEX on life satisfaction was mediated by changes in interpersonal sensitivity and perceived stress. Conclusions: The findings highlight the importance of targeting mental processes such as interpersonal sensitivity to enhance patients’ life satisfaction. These findings suggest that practitioners might consider COBMINDEX as an adjunct intervention for patients with CD. Preregistration: The study was registered with ClinicalTrials.gov (Identifier: NCT05085925) and with the Ministry of Health in Israel (https://my.health.gov.il/CliniTrials/Pages/MOH_2020-02-24_008721.aspx).