Mindfulness skills and experiential avoidance as therapeutic mechanisms for treatment-resistant depression through mindfulness-based cognitive therapy and lifestyle modification.
Mauro Garcia-Toro, Alejandra Aguilar-Latorre, Aurora Garcia, Capilla Navarro-Guzmán, Elena Gervilla, Andrea Seguí, Francisco Gazquez, Jose Antonio Marino, Rocío Gómez-juanes, María J Serrano-Ripoll, Bárbara Oliván-Blázquez, Javier García-campayo, Shannon Maloney, Jesus Montero-Marin
Frontiers in Psychology 2023 DOI: 10.3389/fpsyg.2023.1008891 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Secondary analysis of a clinical trial Peer reviewed |
|---|---|
| Sample size | 66 |
| Population | Patients with treatment-resistant depression |
| Interventions | Minimal Lifestyle Intervention (MLI) Mindfulness-Based Cognitive Therapy (MBCT) Lifestyle Modification Program (LMP) |
| Measures | Five Facet Mindfulness Questionnaire (FFMQ), Self-Compassion Scale (SCS), Acceptance and Action Questionnaire-II (AAQ-II), Beck Depression Inventory-II (BDI-II) |
| Topics | Depression Meditation |
| Keywords | Intervention Lifestyle modification Mediation |
| Key findings | Mindfulness skills mediated the effect of Mindfulness-Based Cognitive Therapy on depressive symptoms (ab = -4.69, 95% CI -12.93 to -0.32), and reduced experiential avoidance mediated the effect of the Lifestyle Modification Program (ab = -3.22, 95% CI -7.03 to -0.14). The authors suggest that strengthening mindfulness skills and decreasing experiential avoidance may promote recovery in treatment-resistant depression. |
Abstract
The COVID-19 pandemic and consequent physical distancing has made it difficult to provide care for those with Treatment-Resistant Depression (TRD). As a secondary analysis of a clinical trial, the aim of this study was to explore potential mechanisms through which three online-delivered approaches, added to treatment as usual, improve depressive symptoms in TRD patients. The three approaches included (a) Minimal Lifestyle Intervention (MLI), (b) Mindfulness-Based Cognitive Therapy (MBCT), and (c) Lifestyle Modification Program (LMP). Sixty-six participants with TRD completed assessments pre-post intervention (mindfulness skills [FFMQ]; self-compassion [SCS]; and experiential avoidance [AAQ-II]) and pre-intervention to follow-up (depressive symptoms [BDI-II]). Data were analyzed using within-subjects regression models to test mediation. Mindfulness skills mediated the effect of MBCT on depressive symptoms (ab = -4.69, 95% CI = -12.93 to-0.32), whereas the lack of experiential avoidance mediated the effect of LMP on depressive symptoms (ab = -3.22, 95% CI = -7.03 to-0.14). Strengthening mindfulness skills and decreasing experiential avoidance may promote recovery in patients with TRD, MBCT, and LMP have demonstrated that they may help increase mindfulness skills and decrease experiential avoidance, respectively. Future work will need to unpick the components of these interventions to help isolate active ingredients and increase optimization.
Comparable studies
Other non-randomized and open-label trials on depression, most cited first.
Citations in the library
Cited by 5
- Target mechanisms of mindfulness-based programmes and practices: a scoping review. BMJ mental health August 24, 2024
- Examining what works for whom and how in mindfulness-based cognitive therapy (MBCT) for recurrent depression: moderated-mediation analysis in the PREVENT trial. The British Journal of Psychiatry April 1, 2025
- Meditation and Compassion Therapy in Psychiatric Disorders: A Pilot Study. Cureus July 1, 2024
- Latent profile analysis of mindfulness and experiential avoidance associated with social media use disorder. BMC Psychology June 8, 2026
- Case Report: Case report : Mindfulness training led to catharsis and mindfulness-to-meaning in a patient with social anxiety disorder comorbid with persistent depressive disorder (Dysthymia) F1000Research December 6, 2024
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