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

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.

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Abstract

Abstract Objectives Mindfulness-Based Cognitive Therapy (MBCT) reduces recurrence and current depressive symptoms in patients with major depressive disorder (MDD). To understand how and for whom MBCT works, a person-centered approach focusing on mindfulness profiles can be useful. Four mindfulness profiles, each associated differently with mental health outcomes, have previously been identified. So far, no studies have examined whether profiles change after MBCT and whether these changes are related to treatment outcome. Method Latent transition analysis (LTA) was performed on pre- and post-MBCT subscale scores of the Five Facet Mindfulness Questionnaire (FFMQ) in patients with current or remitted MDD (n=500). LTA allowed the assessment of individual changes in mindfulness profile after MBCT and the relation between profile change and corresponding changes in measures of mental health, including depressive symptoms, overall functional impairment, worry, and self-compassion. Results LTA re-established the four profiles previously identified cross-sectionally: “Very low mindfulness” (VLM), “Non-judgmentally aware” (NJA), “Judgmentally observing” (JO), and “High mindfulness” (HM). For 71 out of 168 patients with VLM profiles changed to NJA and for another 30 to HM. For 49 out of the 129 patients with NJA and for 37 out of 141 patients with JO profiles changed to HM. All 61 patients starting with HM kept HM. In general, change was related to greater than average improvement in mental health, while no change in profile was related to less than average improvement in mental health (except for HM). Conclusions Our findings indicate that changes in mindfulness profile after MBCT was differentially related to clinical change. These results from a person-centered approach offer new avenues to further elucidate the working mechanism of MBCT and improve its outcome. Preregistration This study was not preregistered.