Factors Associated with Attrition from Mindfulness-Based Cognitive Therapy in Patients with a History of Suicidal Depression.
Catherine Crane, J Mark G Williams
Mindfulness March 2010 DOI: 10.1007/s12671-010-0003-8 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Randomized controlled trial Peer reviewed |
|---|---|
| Sample size | 68 |
| Population | People with a history of suicidal ideation or behaviour |
| Intervention | Mindfulness-based cognitive therapy |
| Measures | Means end problem-solving task |
| Topics | Depression Meditation |
| Key findings | Dropout from MBCT was associated with younger age, not taking antidepressants, higher depressive rumination and brooding, and greater problem-solving deterioration following mood challenge; these factors did not distinguish waitlist dropouts. The authors suggest that those with high cognitive reactivity may find MBCT difficult to engage with but may benefit most if they persist. |
Abstract
We report data from a randomised controlled trial of mindfulness-based cognitive therapy to pilot procedures for people with a history of suicidal ideation or behaviour, focusing in particular on the variables that distinguish those who complete an adequate 'dose' of treatment, from those who drop out. Sixty-eight participants were randomised to either immediate treatment with mindfulness-based cognitive therapy (MBCT) (n = 33) or to the waitlist (n = 36) arm of the trial. In addition to collecting demographic and clinical information, we assessed participants' cognitive reactivity using the means end problem-solving task, completed before and after a mood induction procedure. Ten participants dropped out of treatment, and eight dropped out of the waitlist condition. Those who dropped out of MBCT were significantly younger than those who completed treatment, less likely to be on antidepressants, had higher levels of depressive rumination and brooding and showed significantly greater levels of problem-solving deterioration following mood challenge. None of these factors distinguished participants in the waiting list condition who remained in the study from those who dropped out. Our results suggest that individuals with high levels of cognitive reactivity, brooding and depressive rumination may find it particularly difficult to engage with MBCT, although paradoxically they are likely to have the most to gain from the development of mindfulness skills if they remain in class. Addressing how such patients can be best prepared for treatment and supported to remain in treatment when difficulties arise is an important challenge.