Time-varying associations between daily skills practice and affect in a mindfulness and positive psychology-based intervention for early psychosis

Objective: Using daily life methods, the present study investigated the impact of Integrated Coping Awareness Therapy (I-CAT), which includes mindfulness and positive psychological interventions, versus treatment-as-usual (TAU) on improving daily affective well-being. Among I-CAT participants only, we also examined the time-varying effect of daily I-CAT skill practice on daily affective well-being. Methods: Data are drawn from a randomized controlled treatment trial involving 38 young adults with a schizophrenia spectrum disorder. Participants completed daily reports of positive (happiness, relaxation) and negative (stress, sadness) affect across 9 months of treatment. I-CAT recipients completed daily practice of mindfulness and positive coping skills. Results: I-CAT and TAU did not differentially impact daily affect across treatment. However, daily skill practice was associated with better daily affective outcomes in certain phases of I-CAT. We also found that increased daily practice of positive coping skills was associated with better daily affective outcomes, whereas mindfulness practice was associated with poorer affective outcomes during certain periods of the I-CAT intervention. Conclusions: In general, I-CAT did not improve daily affective outcomes compared with TAU. However, components of I-CAT, specifically the daily practice of positive coping skills, were associated with improved daily emotional well-being in young adults with psychosis. Implications of these findings are discussed.