Clinical psychological science : a journal of the Association for Psychological Science
April 29, 2022
Z. Cohen, R. DeRubeis, Rachel Hayes et al.
Depression often returns even after successful treatment. Using data from 424 adults with recurrent depression, researchers built models to predict relapse over 24 months for those continuing antidepressant medication (ADM) versus switching to mindfulness-based cognitive therapy (MBCT). Only the ADM model modestly predicted relapse better than baseline severity. People with the poorest ADM prognosis who switched to MBCT had lower relapse rates (48% vs. 70%) and longer time before relapse than those who stayed on ADM. For those with moderate or good ADM prognosis, both treatments led to similar relapse likelihood. The results suggest predictive models could help tailor relapse prevention choices.
Behaviour Research and Therapy
May 25, 2021
C. Hitchcock, C. Haag, Alicia J. Smith et al.
preprint
Memory specificity—the ability to recall specific, single-incident autobiographical memories—has been thought to predict recurrent depression. This individual patient data meta-analysis examined whether mindfulness-based cognitive therapy (MBCT) improves memory specificity and whether pre-treatment memory specificity moderates treatment response. Across datasets including 880 participants, memory specificity did not significantly change from before to after treatment for either MBCT or control interventions. Baseline memory specificity did not predict treatment response, whether measured by symptom levels or relapse risk. These findings question the assumed role of memory specificity in treatments for depression.
International Journal of Clinical and Health Psychology
February 18, 2021
C. Strauss, Jenny Gu, J. Montero-Marín et al.
A randomized controlled trial assigned 234 National Health Service workers to either mindfulness-based cognitive therapy for life (MBCT-L) or a wait-list. MBCT-L reduced stress more than the wait-list, with a medium-to-large effect size, and improved well-being, depression, and anxiety. No effects were found for work-related outcomes. Mindfulness and self-compassion appeared to mediate the stress and well-being improvements. The authors suggest MBCT-L could be an effective component of a broader healthcare worker mental health strategy.
Mindfulness
December 2, 2020
R. Baer, C. Crane, J. Montero-Marín et al.
About two-thirds of schoolteachers and university students who took an 8-week mindfulness course reported unpleasant experiences linked to the practice, though most rated these as not at all or only somewhat upsetting, and some found them beneficial. The proportion reporting harm from the course ranged from 3 to 7%, and the proportion showing reliable deterioration on symptom questionnaires ranged from 2 to 7%. These groups largely did not overlap, indicating that harm may not be detected by standard symptom measures. The findings suggest mindfulness teachers should prepare participants for possible difficulties and assess harm explicitly.
Mindfulness
January 12, 2019
A. Tickell, S. Ball, P. Bernard et al.
Mindfulness-based cognitive therapy (MBCT) is delivered effectively and safely in routine mental health services, even though its use has expanded beyond the originally intended population. Across five UK mental health services with 1,554 participants, 47% entered with non-depressed scores, and 96% of those remained non-depressed after treatment. Among the 53% who entered with depressed scores, 45% recovered to non-depressed range, and overall depression severity significantly decreased. Reliable deterioration was low (3%), comparable to other psychotherapies.
Mindfulness
January 12, 2017
M. Huijbers, R. Crane, W. Kuyken et al.
In a multi-centre trial of mindfulness-based cognitive therapy (MBCT) for recurrent depression, teacher competence—assessed using the Mindfulness-Based Interventions: Teaching Assessment Criteria (MBI:TAC)—showed no significant association with patient adherence, potential mechanisms of change (rumination, cognitive reactivity, mindfulness, self-compassion), or key outcomes (depressive symptoms post-treatment and depressive relapse/recurrence over 15 months). The authors suggest several possible explanations, including the standardized delivery of MBCT, the emphasis on self-reliance in the learning process, participant-related factors, challenges in assessing teacher competence, and the limited sample of videotaped sessions. Further research is needed to explore these explanations.
Psychological Assessment
April 14, 2016
Jenny Gu, C. Strauss, C. Crane et al.
The 39-item and 15-item versions of the Five Facet Mindfulness Questionnaire (FFMQ) show different factor structures before and after mindfulness-based cognitive therapy (MBCT) in adults with remitted recurrent depression. Before MBCT, a four-factor model (excluding the Observing facet) best fit the data; after MBCT, a five-factor model fit best. Configural invariance across time was not supported, meaning the questionnaire's structure changes with intervention, which may invalidate direct pre-to-post comparisons. Both versions had adequate internal consistency and sensitivity to change and did not differ in convergent validity. Researchers should consider omitting the Observing subscale when comparing scores before and after mindfulness interventions. The FFMQ-15 is a suitable brief alternative.
The Lancet
July 4, 2015
W. Kuyken, Rachel Hayes, B. Barrett et al.
For people with a history of recurrent depression, mindfulness-based cognitive therapy combined with support to taper antidepressants is not superior to continuing maintenance antidepressants for preventing relapse over two years. In a randomized trial of 424 adults with three or more prior episodes, the time to relapse did not differ between the two groups. Both treatments were associated with enduring positive outcomes in terms of relapse, residual symptoms, and quality of life. Serious adverse events were rare and similar across groups. The findings suggest that MBCT with tapering support offers a comparable alternative to long-term antidepressant use.
Clinical Psychology Review
April 1, 2015
A. M. van der Velden, W. Kuyken, U. Wattar et al.
This systematic review examines how mindfulness-based cognitive therapy (MBCT) alleviates recurrent major depressive disorder. Of 476 articles identified, 23 met inclusion criteria. Twelve studies found that changes in mindfulness, rumination, worry, compassion, or meta-awareness were associated with, predicted, or mediated MBCT's effect on treatment outcomes. Preliminary evidence also suggests alterations in attention, memory specificity, self-discrepancy, emotional reactivity, and momentary affect may play a role. The authors conclude that MBCT may work through some theoretically predicted mechanisms but call for more rigorous designs to establish causal specificity.
Implementation Science
May 24, 2014
J. Rycroft-Malone, R. Anderson, R. Crane et al.
Mindfulness-based cognitive therapy (MBCT) is a cost-effective psychosocial program that helps people with recurrent depression stay well long-term, yet its availability across the UK is limited and inequitable. This two-phase qualitative study will interview stakeholders involved in commissioning, managing, and implementing MBCT services in all four UK countries, including areas where implementation succeeds and where it fails. In-depth case studies will identify barriers and facilitators to implementation. Findings will inform an implementation plan to promote better, more equitable access to MBCT within the UK National Health Service.