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Mira B. Cladder-Micus

5 papers in the library · 11 citations · publishing 2024-2026

Papers

Rumination and Self-Compassion Moderate Mindfulness-Based Cognitive Therapy for Patients With Recurrent and Persistent Major Depressive Disorder: A Controlled Trial.

Depression and Anxiety January 1, 2024 Jelle Lubbers, Dirk E. M. Geurts, Philip Spinhoven et al. 10 citations

Mindfulness-based cognitive therapy (MBCT) added to treatment as usual reduced depressive symptoms and overall functional impairment more than treatment as usual alone in patients with persistent or recurrent major depressive disorder, with medium and small effect sizes respectively. The therapy worked better for those who started with higher levels of rumination and perseverative thinking and lower levels of self-compassion; these traits moderated the treatment's effects. No mediators of MBCT's effects were identified, as the therapy did not change the assessed potential mediators by mid-treatment. Allocating MBCT based on patients' rumination and self-compassion levels could make symptom reduction more efficient.

Efficacy and Moderators of Mindfulness-Based Cognitive Therapy in Difficult-to-Treat Depression: A Systematic Review and Individual Participant Data Meta-Analysis

Psychotherapy and Psychosomatics June 12, 2026 Thorsten Barnhofer, Maria Niemi, Johannes Michalak et al. 1 citation

For adults with difficult-to-treat depression—those who have not responded to prior treatments, have treatment-resistant depression, or have a chronic course—mindfulness-based cognitive therapy (MBCT) is likely superior to usual care, reducing depressive symptoms by a standardized mean difference of -0.40 at post-treatment and -0.41 at medium-term follow-up. There was a 92% and 85% probability, respectively, that these benefits exceeded a minimal important difference. However, MBCT did not show clear superiority over other active psychosocial interventions, and no robust moderators of outcome were identified across baseline severity, chronicity, or comorbidity.

Change in Mindfulness Profiles After Mindfulness-Based Cognitive Therapy for Major Depressive Disorder

Mindfulness July 1, 2024 Jelle Lubbers, Philip Spinhoven, Mira B. Cladder-Micus et al.

After Mindfulness-Based Cognitive Therapy (MBCT), many patients with major depressive disorder shift toward healthier mindfulness profiles, and those who change profiles show greater improvement in mental health than those who do not. Among 500 patients, four mindfulness profiles were identified: Very low mindfulness, Non-judgmentally aware, Judgmentally observing, and High mindfulness. Of 168 patients initially in the Very low mindfulness profile, 71 moved to Non-judgmentally aware and 30 to High mindfulness. Of 129 in Non-judgmentally aware, 49 moved to High mindfulness; of 141 in Judgmentally observing, 37 moved to High mindfulness. All 61 patients already in High mindfulness remained there. Profile change was linked to above-average improvement in depressive symptoms, functional impairment, worry, and self-compassion, while no change (except staying in High mindfulness) was linked to below-average improvement.

Latent Profile Analysis of the Five Facet Mindfulness Questionnaire (FFMQ) Subscales in a Naturalistic Sample of Patients with Past or Present Major Depression: A Replication and Extension Study

Mindfulness February 1, 2024 Jelle Lubbers, Philip Spinhoven, Mira B. Cladder-Micus et al.

In patients with current or remitted major depressive disorder, four distinct mindfulness profiles were identified using latent profile analysis on questionnaire data from 754 individuals. Three profiles matched those found in previous depressed samples (very low mindfulness, high mindfulness, non-judgmentally aware), and one matched a profile from non-clinical populations (judgmentally observing). Those with high mindfulness had the best mental health—fewer depressive symptoms, less worry, less functional impairment, and more self-compassion—while those with very low mindfulness had the worst. However, mindfulness profiles did not predict how much mental health changed after Mindfulness-Based Cognitive Therapy, suggesting profiles are linked to current mental health but not to treatment response.

Mindfulness Based Cognitive Therapy (MBCT) Reduces Depression-Related Self- Referential Processing In Patients With Bipolar Disorder

Thalia D.M. Stalmeier, Jelle Lubbers, Mira B. Cladder-Micus et al.

In people with bipolar disorder, negative self-referential processing—how one attributes negative traits to oneself and remembers them—is linked to depressive symptoms. In a randomized trial, 49 participants with bipolar disorder were assigned to mindfulness-based cognitive therapy plus treatment as usual or treatment as usual alone. Those who received MBCT showed a reduction in negative self-referential memory bias over time compared to the control group, while positive and negative self-attributions did not change differently between groups. The findings suggest that MBCT may specifically reduce negative memory bias, which could play a role in preventing or treating depressive symptoms in bipolar disorder.