The contributions of focused attention and open monitoring in mindfulness-based cognitive therapy for affective disturbances: A 3-armed randomized dismantling trial.
PLoS One January 12, 2021 DOI: 10.1371/journal.pone.0244838 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Randomized controlled trial Peer reviewed |
|---|---|
| Sample size | 104 |
| Population | Adults with mild to severe depression and anxiety |
| Interventions | Mindfulness-based cognitive therapy (MBCT) Open monitoring (OM) meditation |
| Duration | 8-week intervention, with follow-up to 20 weeks |
| Measures | Inventory of Depressive Symptomatology (IDS), Depression Anxiety Stress Scales (DASS), Reliable Change Index (RCI) |
| Topics | Meditation |
| Registration | NCT01831362 |
| Key findings | All three 8-week interventions produced medium-to-large improvements on most outcomes and were largely comparable at post-treatment, but differed in rapidity and durability: FA improved fastest with fewest deteriorations yet lost gains and showed lasting depression deteriorations at week 20; OM improved slowest and lost anxiety gains; MBCT showed the most favorable long-term pattern for depression. |
Abstract
Objective: Mindfulness-based cognitive therapy (MBCT) includes a combination of focused attention (FA) and open monitoring (OM) meditation practices. The aim of this study was to assess both short- and long-term between- and within-group differences in affective disturbance among FA, OM and their combination (MBCT) in the context of a randomized controlled trial.
Method: One hundred and four participants with mild to severe depression and anxiety were randomized into one of three 8-week
Interventions: MBCT (n = 32), FA (n = 36) and OM (n = 36). Outcome measures included the Inventory of Depressive Symptomatology (IDS), and the Depression Anxiety Stress Scales (DASS). Mixed effects regression models were used to assess differential treatment effects during treatment, post-treatment (8 weeks) and long-term (20 weeks). The Reliable Change Index (RCI) was used to translate statistical findings into clinically meaningful improvements or deteriorations.
Results: All treatments demonstrated medium to large improvements (ds = 0.42-1.65) for almost all outcomes. While all treatments were largely comparable in their effects at post-treatment (week 8), the treatments showed meaningful differences in rapidity of response and pattern of deteriorations. FA showed the fastest rate of improvement and the fewest deteriorations on stress, anxiety and depression during treatment, but a loss of treatment-related gains and lasting deteriorations in depression at week 20. OM showed the slowest rate of improvement and lost treatment-related gains for anxiety, resulting in higher anxiety in OM at week 20 than MBCT (d = 0.40) and FA (d = 0.36), though these differences did not reach statistical significance after correcting for multiple comparisons (p's = .06). MBCT and OM showed deteriorations in stress, anxiety and depression at multiple timepoints during treatment, with lasting deteriorations in stress and depression. MBCT showed the most favorable pattern for long-term treatment of depression.
Conclusions: FA, OM and MBCT show different patterns of response for different dimensions of affective disturbance.
Trial Registration: This trial is registered at (v NCT01831362); www.clinicaltrials.gov.
Comparable studies
Other randomized controlled trials on meditation, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Alterations in Brain and Immune Function Produced by Mindfulness Meditation Healthy employees in a work environment | 2003 | Randomized controlled trial | n = 41 |
| Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy. Recovered recurrently depressed patients | 2000 | Randomized controlled trial | n = 145 |
| Open hearts build lives: Positive emotions, induced through loving-kindness meditation, build consequential personal resources. Working adults | 2008 | Randomized controlled trial | n = 139 |
| Short-term meditation training improves attention and self-regulation Undergraduate Chinese students | 2007 | Randomized controlled trial | n = 40 |
| Mindfulness-Based Cognitive Therapy for Depression: Replication and Exploration of Differential Relapse Prevention Effects. Recovered recurrently depressed patients | 2004 | Randomized controlled trial | n = 73 |
Citations in the library
Cited by 20
- From Self-Esteem to Selflessness: An Evidence (Gap) Map of Self-Related Processes as Mechanisms of Mindfulness-Based Interventions Frontiers in Psychology November 22, 2021
- A mindfulness meditation mobile app improves depression and anxiety in adults with sleep disturbance: Analysis from a randomized controlled trial General Hospital Psychiatry September 11, 2021
- Mindfulness-Based Cognitive Therapy in Clinical Practice: A Systematic Review of Neurocognitive Outcomes and Applications for Mental Health and Well-Being. Journal of Clinical Medicine March 3, 2025
- Comparing impacts of meditation training in focused attention, open monitoring, and mindfulness‐based cognitive therapy on emotion reactivity and regulation: Neural and subjective evidence from a dismantling study Psychophysiology February 19, 2022
- Impact of warm mindfulness on emotion regulation: A randomized controlled effectiveness trial. Health Psychology July 6, 2023
and 15 more in the library
Cites 19
- Meditation Programs for Psychological Stress and Well-being JAMA Internal Medicine January 6, 2014
- Mind the Hype: A Critical Evaluation and Prescriptive Agenda for Research on Mindfulness and Meditation Perspectives on Psychological Science October 10, 2017
- What defines mindfulness-based programs? The warp and the weft Psychological Medicine December 29, 2016
- Efficacy of Mindfulness-Based Cognitive Therapy in Prevention of Depressive Relapse JAMA Psychiatry April 28, 2016
- The mindfulness‐based cognitive therapy adherence scale: inter‐rater reliability, adherence to protocol and treatment distinctiveness Clinical Psychology & Psychotherapy March 1, 2002
and 14 more in the library