How does mindfulness-based cognitive therapy work?
Study Goal
The researchers aimed to determine whether MBCT's treatment effects for recurrent depression are mediated by enhanced mindfulness and self-compassion, and/or by changes in post-treatment cognitive reactivity.
Results Summary
MBCT's effects were mediated by increased mindfulness and self-compassion during treatment, and it altered the relationship between cognitive reactivity and depressive outcomes, decoupling reactivity from poor outcomes. Greater reactivity predicted worse outcomes in the antidepressant group but not in the MBCT group.
Population
Patients with ≥3 prior depressive episodes who were successfully treated with antidepressants.
Effective Dosage
Not specified
Duration
15-month follow-up (intervention duration not explicitly stated)
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
Mindfulness-based cognitive therapy (MBCT) | increase | mindfulness | patients with ≥3 prior depressive episodes, and successfully treated with antidepressants | - | mediated by enhancement of | #1 |
Mindfulness-based cognitive therapy (MBCT) | increase | self-compassion | patients with ≥3 prior depressive episodes, and successfully treated with antidepressants | - | mediated by enhancement of | #2 |
Mindfulness-based cognitive therapy (MBCT) | no change | post-treatment cognitive reactivity and outcome | patients with ≥3 prior depressive episodes, and successfully treated with antidepressants | - | changed the nature of the relationship between | #3 |
maintenance antidepressants (mADM) | decrease | outcome | mADM participants | - | greater reactivity predicted worse outcome for | #4 |
Mindfulness-based cognitive therapy (MBCT) | increase | self-compassion | patients with ≥3 prior depressive episodes, and successfully treated with antidepressants | - | mediated by augmented | #5 |
Mindfulness-based cognitive therapy (MBCT) | increase | mindfulness | patients with ≥3 prior depressive episodes, and successfully treated with antidepressants | - | mediated by augmented | #6 |
Mindfulness-based cognitive therapy (MBCT) | decrease | relationship between reactivity of depressive thinking and poor outcome | patients with ≥3 prior depressive episodes, and successfully treated with antidepressants | - | decoupling of the relationship between reactivity of depressive thinking and poor outcome | #7 |
Mindfulness-based cognitive therapy (MBCT) | increase | self-compassion across treatment | patients with ≥3 prior depressive episodes, and successfully treated with antidepressants | - | decoupling is associated with the cultivation of | #8 |
Mindfulness-based cognitive therapy (MBCT) is an efficacious psychosocial intervention for recurrent depression (Kuyken et al., 2008; Ma & Teasdale, 2004; Teasdale et al., 2000). To date, no compelling research addresses MBCT's mechanisms of change. This study determines whether MBCT's treatment effects are mediated by enhancement of mindfulness and self-compassion across treatment, and/or by alterations in post-treatment cognitive reactivity. The study was embedded in a randomized controlled trial comparing MBCT with maintenance antidepressants (mADM) with 15-month follow-up (Kuyken et al., 2008). Mindfulness and self-compassion were assessed before and after MBCT treatment (or at equivalent time points in the mADM group). Post-treatment reactivity was assessed one month after the MBCT group sessions or at the equivalent time point in the mADM group. One hundred and twenty-three patients with ≥3 prior depressive episodes, and successfully treated with antidepressants, were randomized either to mADM or MBCT. The MBCT arm involved participation in MBCT, a group-based psychosocial intervention that teaches mindfulness skills, and discontinuation of ADM. The mADM arm involved maintenance on a therapeutic ADM dose for the duration of follow-up. Interviewer-administered outcome measures assessed depressive symptoms and relapse/recurrence across 15-month follow-up. Mindfulness and self-compassion were measured using self-report questionnaire. Cognitive reactivity was operationalized as change in depressive thinking during a laboratory mood induction. MBCT's effects were mediated by enhancement of mindfulness and self-compassion across treatment. MBCT also changed the nature of the relationship between post-treatment cognitive reactivity and outcome. Greater reactivity predicted worse outcome for mADM participants but this relationship was not evident in the MBCT group. MBCT's treatment effects are mediated by augmented self-compassion and mindfulness, along with a decoupling of the relationship between reactivity of depressive thinking and poor outcome. This decoupling is associated with the cultivation of self-compassion across treatment.