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Zindel V. Segal

University of Toronto, The Scarborough Hospital

34 papers in the library · 18,240 citations · publishing 1978-2026

Papers

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A Critical Review and 10-Year Update on Prospects for a Clinical Science of Mindfulness-Based Intervention

Mindfulness July 7, 2026 Joseph J. Lévy, Sona Dimidjian, Zindel V. Segal

Abstract Objectives Over the past decade, research on mindfulness-based interventions (MBIs) has expanded exponentially. A decade ago, Dimidjian and Segal (2015) used the National Institutes of Health (NIH) Stage Model to assess the state of the science and identify key issues limiting public health impact. The present review provided a ten-year update on the field’s progress, applying the same...

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

INTRODUCTION: Around a third of patients with major depressive disorder experience persistent symptoms despite usual treatments. Identifying scalable, psychological treatment options is critical to reduce the burden associated with difficult-to-treat depression (DTD). We examined the efficacy of mindfulness-based cognitive therapy (MBCT) compared with treatment as usual (TAU) and other active...

Mindfulness-Based Cognitive Therapy for Depression, Taking It Further (MBCT-D-TiF): An Assessment of an Intervention Development Study.

Global advances in integrative medicine and health 2025 Chelsea J Siwik, Jessica M. Harrison, Willem Kuyken et al.

Mindfulness-Based Cognitive Therapy (MBCT) reduces depression relapse, yet graduates have expressed a need for structured guidance post-program to maintain mindfulness practice and sustain benefits. To address this, we created MBCT for Depression-Taking it Further (MBCT-D-TiF). To refine and pilot test feasibility and acceptability of MBCT-D-TiF. We collected qualitative focus group data to...

Mediators of change in online mindfulness-based cognitive therapy: A secondary analysis of a randomized trial of mindful mood balance.

Journal of Consulting and Clinical Psychology July 17, 2023 Sona Dimidjian, Robert Gallop, Joseph J. Lévy et al. 14 citations

OBJECTIVE: Digital delivery of mindfulness-based cognitive therapy through the Mindful Mood Balance (MMB) program is clinically effective (Segal et al., 2020); however, the mechanisms through which this program delivers its benefits have not been established. METHOD: This study investigates the differential impact of the MMB program paired with usual depression care (UDC) compared to UDC alone...

Preventing Depression Relapse: A Qualitative Study on the Need for Additional Structured Support Following Mindfulness-Based Cognitive Therapy.

Global advances in integrative medicine and health 2023 Chelsea J Siwik, Shelley R Adler, Patricia J Moran et al. 7 citations

Mindfulness-based cognitive therapy (MBCT) is an effective group intervention for reducing rates of depression relapse. However, about one-third of graduates experience relapse within 1 year of completing the course. The current study aimed to explore the need and strategies for additional support following the MBCT course. We conducted 4 focus groups via videoconferencing, two with MBCT...

Static and treatment-responsive brain biomarkers of depression relapse vulnerability following prophylactic psychotherapy: Evidence from a randomized control trial

NeuroImage Clinical 2022 Norman A. S. Farb, Philip A. Desormeau, Adam K. Anderson et al. 15 citations

BACKGROUND: Neural reactivity to dysphoric mood induction indexes the tendency for distress to promote cognitive reactivity and sensory avoidance. Linking these responses to illness prognosis following recovery from Major Depressive Disorder informs our understanding of depression vulnerability and provides engagement targets for prophylactic interventions. METHODS: A prospective fMRI...

Mindfulness-based cognitive therapy vs. a health enhancement program for the treatment of late-life depression: Study protocol for a multi-site randomized controlled trial.

Frontiers in Aging Neuroscience 2022 Magnus Bein, Myriam Lesage, Elena Dikaios et al.

Late-life depression (LLD) affects up to 18% of older adults and has been linked to elevated dementia risk. Mindfulness-based cognitive therapy (MBCT) holds promise for treating symptoms of depression and ameliorating cognitive deficits in older adults. While preliminary findings are promising, a definitive RCT investigating its effects on late life depression and cognition have not yet been...

Mindfulness-Based Stress Reduction and Mindfulness-Based Cognitive Therapy

The Oxford Handbook of Stress and Mental Health February 17, 2020 Philip A. Desormeau, Kathleen M. Walsh, Zindel V. Segal

Over the past two decades, investigations of mindfulness meditation have demonstrated considerable efficacy in reducing the symptom burden associated with a variety of medical and mental health disorders (Baer, 2003). This chapter reviews the theoretical basis for offering training in mindfulness meditation to these populations, and it outlines the structure of mindfulness-based interventions,...

Therapeutic Mindfulness and Depression

Depression October 1, 2019 Evan Collins, Zindel V. Segal

There is growing interest in mindfulness as a therapeutic intervention for a variety of physical and mental health conditions, including depression. A major contribution has been the growing evidence base of mindfulness-based cognitive therapy (MBCT) for prevention of depressive relapse in those with recurrent unipolar depression, as well as MBCT’s application to other mood disorders, special...

Mindfulness‐based cognitive therapy for relapse prophylaxis in mood disorders

World Psychiatry September 22, 2016 Zindel V. Segal, Lê-Anh Dinh-Williams 11 citations

Relapse and recurrence are common and debilitating aspects of major depressive disorder. Furthermore, the risk of developing a chronic course of illness increases with each successive episode and, even among patients who achieve clinical remission, residual depressive symptoms are commonly reported. Maintenance antidepressant monotherapy is effective as long as it is continued, yet in practice...

Efficacy of Mindfulness-Based Cognitive Therapy in Prevention of Depressive Relapse

JAMA Psychiatry April 28, 2016 Willem Kuyken, Fiona C Warren, Rod S. Taylor et al. 815 citations

IMPORTANCE: Relapse prevention in recurrent depression is a significant public health problem, and antidepressants are the current first-line treatment approach. Identifying an equally efficacious nonpharmacological intervention would be an important development. OBJECTIVE: To conduct a meta-analysis on individual patient data to examine the efficacy of mindfulness-based cognitive therapy...

A Randomized Controlled Trial of Mindfulness-Based Cognitive Therapy for Treatment-Resistant Depression

Psychotherapy and Psychosomatics 2016 Stuart J. Eisendrath, Erin P Gillung, Kevin L. Delucchi et al. 193 citations

BACKGROUND: Due to the clinical challenges of treatment-resistant depression (TRD), we evaluated the efficacy of mindfulness-based cognitive therapy (MBCT) relative to a structurally equivalent active comparison condition as adjuncts to treatment-as-usual (TAU) pharmacotherapy in TRD. METHODS: This single-site, randomized controlled trial compared 8-week courses of MBCT and the Health...

Mindfulness-based cognitive therapy for residual depressive symptoms and relapse prophylaxis

Current Opinion in Psychiatry December 11, 2015 Zindel V. Segal, Kathleen M. Walsh 64 citations

PURPOSE OF REVIEW: The article reviews the recent evidence for mindfulness-based cognitive therapy (MBCT) for patients with residual depressive symptoms or in remitted patients at increased risk for relapse. RECENT FINDINGS: Randomized controlled trials have shifted focus from comparing MBCT with treatment-as-usual to comparing MBCT against interventions. These studies have provided evidence...

Prospects for a clinical science of mindfulness-based intervention.

American Psychologist October 1, 2015 Sona Dimidjian, Zindel V. Segal 297 citations

Mindfulness-based interventions (MBIs) are at a pivotal point in their future development. Spurred on by an ever-increasing number of studies and breadth of clinical application, the value of such approaches may appear self-evident. We contend, however, that the public health impact of MBIs can be enhanced significantly by situating this work in a broader framework of clinical psychological...

A Randomized Controlled Trial of Mindfulness Meditation for Chronic Insomnia

Sleep August 29, 2014 Jason C Ong, Rachel Manber, Zindel V. Segal et al. 338 citations

STUDY OBJECTIVES: To evaluate the efficacy of mindfulness meditation for the treatment of chronic insomnia. DESIGN: Three-arm, single-site, randomized controlled trial. SETTING: Academic medical center. PARTICIPANTS: Fifty-four adults with chronic insomnia. INTERVENTIONS: Participants were randomized to either mindfulness-based stress reduction (MBSR), mindfulness-based therapy for insomnia...

Web-Based Intervention in Mindfulness Meditation for Reducing Residual Depressive Symptoms and Relapse Prophylaxis: A Qualitative Study

Journal of Medical Internet Research March 24, 2014 Jennifer M. Boggs, Arne Beck, Jennifer N. Felder et al. 73 citations

BACKGROUND: Mindful Mood Balance (MMB) is a Web-based intervention designed to treat residual depressive symptoms and prevent relapse. MMB was designed to deliver the core concepts of mindfulness-based cognitive therapy (MBCT), a group treatment, which, despite its strong evidence base, faces a number of dissemination challenges. OBJECTIVE: The present study is a qualitative investigation of...

Mindfulness-based cognitive therapy for recurrent depression: A translational research study with 2-year follow-up

Australian & New Zealand Journal of Psychiatry March 4, 2014 Graham Meadows, Frances Shawyer, Joanne Enticott et al. 66 citations

OBJECTIVE: While mindfulness-based cognitive therapy (MBCT) has demonstrated efficacy in reducing depressive relapse/recurrence over 12-18 months, questions remain around effectiveness, longer-term outcomes, and suitability in combination with medication. The aim of this study was to investigate within a pragmatic study design the effectiveness of MBCT on depressive relapse/recurrence over 2...

Inside the Mindful Mind

Current Directions in Psychological Science December 1, 2013 Rimma Teper, Zindel V. Segal, Michael Inzlicht 557 citations

Although the psychological benefits of mindfulness training on emotion regulation are well-documented, the precise mechanisms underlying these effects remain unclear. In the present account, we propose a new linkage between mindfulness and improved emotion regulation—one that highlights the role played by executive control. Specifically, we suggest that the present-moment awareness and...

Mindfulness meditation training alters cortical representations of interoceptive attention

Social Cognitive and Affective Neuroscience June 11, 2012 Norman A. S. Farb, Zindel V. Segal, Adam K. Anderson 566 citations

One component of mindfulness training (MT) is the development of interoceptive attention (IA) to visceral bodily sensations, facilitated through daily practices such as breath monitoring. Using functional magnetic resonance imaging (fMRI), we examined experience-dependent functional plasticity in accessing interoceptive representations by comparing graduates of a Mindfulness-Based Stress...

Treatment-specific changes in decentering following mindfulness-based cognitive therapy versus antidepressant medication or placebo for prevention of depressive relapse.

Journal of Consulting and Clinical Psychology March 12, 2012 Peter Bieling, Lance L. Hawley, Richard T. Bloch et al. 239 citations

OBJECTIVE: To examine whether metacognitive psychological skills, acquired in mindfulness-based cognitive therapy (MBCT), are also present in patients receiving medication treatments for prevention of depressive relapse and whether these skills mediate MBCT's effectiveness. METHOD: This study, embedded within a randomized efficacy trial of MBCT, was the first to examine changes in mindfulness...

The Mindful Brain and Emotion Regulation in Mood Disorders

The Canadian Journal of Psychiatry February 1, 2012 Norman A. S. Farb, Adam K. Anderson, Zindel V. Segal 361 citations

Mindfulness involves nonjudgmental attention to present-moment experience. In its therapeutic forms, mindfulness interventions promote increased tolerance of negative affect and improved well-being. However, the neural mechanisms underlying mindful mood regulation are poorly understood. Mindfulness training appears to enhance focused attention, supported by the anterior cingulate cortex and the...

Collaboration in Mindfulness‐Based Cognitive Therapy

Journal of Clinical Psychology January 26, 2012 Jennifer N. Felder, Sona Dimidjian, Zindel V. Segal 55 citations

In this article, we describe the nature of therapeutic collaboration between psychotherapist and group participants in mindfulness-based cognitive therapy (MBCT), which occurs in a group format and incorporates cognitive therapy and mindfulness practices with the aim of preventing depression relapse. Collaboration is a central part of two components of MBCT: inquiry and leading mindfulness...

Mindfulness-based cognitive therapy: culture clash or creative fusion?

Contemporary Buddhism May 1, 2011 Melanie Fennell, Zindel V. Segal 31 citations

AbstractMindfulness-based cognitive therapy creates an unlikely partnership, between the ancient tradition of mindfulness meditation rooted in Buddhist thought, and the much more recent and essentially western tradition of cognitive and clinical science. This article investigates points of congruence and difference between the two traditions and concludes that, despite first appearances, this...

Minding one’s emotions: Mindfulness training alters the neural expression of sadness.

Emotion February 1, 2010 Norman A. S. Farb, Adam K. Anderson, Helen S. Mayberg et al. 523 citations

Recovery from emotional challenge and increased tolerance of negative affect are both hallmarks of mental health. Mindfulness training (MT) has been shown to facilitate these outcomes, yet little is known about its mechanisms of action. The present study employed functional MRI (fMRI) to compare neural reactivity to sadness provocation in participants completing 8 weeks of MT and waitlisted...

Mindfulness‐based stress reduction and attentional control

Clinical Psychology & Psychotherapy November 1, 2007 Nicole D. Anderson, Mark A. Lau, Zindel V. Segal et al. 326 citations

Abstract This study was designed to test the hypothesis that mindfulness involves sustained attention, attention switching, inhibition of elaborative processing and non‐directed attention. Healthy adults were tested before and after random assignment to an 8‐week Mindfulness‐Based Stress Reduction (MBSR) course ( n = 39) or a wait‐list control ( n = 33). Testing included measures of sustained...