Neural reactivity to sad mood—specifically deactivation in somatosensory brain regions—was a stable marker of depression relapse risk in remitted patients, regardless of whether they received Cognitive Therapy or Mindfulness-Based Cognitive Therapy. In contrast, reduced activation in the left lateral prefrontal cortex after treatment predicted lower relapse risk, suggesting that therapy may work by dampening cognitive control processes and enhancing sensory integration. The findings point to two distinct factors in depression vulnerability: an enduring sensory deactivation pattern that signals relapse risk, and a modifiable prefrontal response that can be targeted by prophylactic interventions.
Mindfulness meditation training reduces symptoms in medical and mental health disorders by engaging core cognitive processes that decrease ruminative and elaborative thinking, which perpetuate stress reactivity. The chapter defines mindfulness, reviews its theoretical basis, and outlines mindfulness-based interventions' structure and impact on stress and psychological health indices. It describes the mindfulness stress-buffering account (MSBA) as the dominant theoretical model explaining mindfulness's effects on stress-related disorders, highlighting how this framework can guide intervention science.
Preventing relapse of major depression may depend on developing the ability to decenter from negative thoughts, not just on managing residual symptoms. In a 24-month follow-up of remitted depressed patients who completed either cognitive therapy or mindfulness-based cognitive therapy, growth in decentering and distress tolerance occurred after treatment ended, while residual symptoms did not change. Greater practice of therapy-acquired regulatory skills after treatment boosted decentering, which in turn predicted a reduced risk of relapse or recurrence over two years. Decentering slope was a significant predictor of prophylaxis, with a hazard ratio of 0.232.