Recovery from emotional challenge and increased tolerance of negative affect are both hallmarks of mental health. Mindfulness training (MT) has been shown to facilitate these outcomes, yet little is known about its mechanisms of action. The present study employed functional MRI (fMRI) to compare neural reactivity to sadness provocation in participants completing 8 weeks of MT and waitlisted controls. Sadness resulted in widespread recruitment of regions associated with self-referential processes along the cortical midline. Despite equivalent self-reported sadness, MT participants demonstrated a distinct neural response, with greater right-lateralized recruitment, including visceral and somatosensory areas associated with body sensation. The greater somatic recruitment observed in the MT group during evoked sadness was associated with decreased depression scores. Restoring balance between affective and sensory neural networks—supporting conceptual and body based representations of emotion—could be one path through which mindfulness reduces vulnerability to dysphoric reactivity.
Recovery from emotional challenge and increased tolerance of negative affect are both hallmarks of mental health. Mindfulness training (MT) has been shown to facilitate these outcomes, yet little is known about its mechanisms of action. The present study employed functional MRI (fMRI) to compare neural reactivity to sadness provocation in participants completing 8 weeks of MT and waitlisted controls. Sadness resulted in widespread recruitment of regions associated with self-referential processes along the cortical midline. Despite equivalent self-reported sadness, MT participants demonstrated a distinct neural response, with greater right-lateralized recruitment, including visceral and somatosensory areas associated with body sensation. The greater somatic recruitment observed in the MT group during evoked sadness was associated with decreased depression scores. Restoring balance between affective and sensory neural networks—supporting conceptual and body based representations of emotion—could be one path through which mindfulness reduces vulnerability to dysphoric reactivity.
Recent reports indicate that depression is the most common psychological disorder in the US, affecting as many as 17 million Americans. This book integrates the spiritual practice of mindfulness with psychological techniques for changing negative thoughts and behaviors into a powerful and proven-effective program for coping with this serious and distressing condition.Current statistics suggest that as many as 17 million Americans suffer from depression; further research states that less than 25 percent of these receive adequate treatment for the disorder. In clinical trials, treatment approaches that incorporate spirituality with psychology have proven to be dramatically effective at countering depression. This book is co-written by a leading specialist in the treatment of depression and a clinical nurse who, as a Zen practitioner trained with Charlotte Joko Beck and Jon Kabat-Zinn.
A concept grounded in the practice of certain forms of Buddhism, mindfulness is the conscious, uninvolved awareness of the present moment. Western psychologists have recently learned that this state of mind is particularly conducive to the accomplishment of cognitive behavioral therapy, or CBT: an active mode of psychological treatment that attempts to recognize and counter negative thoughts and behaviors before they lead to debilitating symptoms like depression. As statistics confirm again and again that depression is the single most common psychological problem affecting Americans, the refinement of psychotherapy through the integration of spirituality-based techniques has generated considerable interest among psychology professionals. This approachable and easy-to-use book makes these powerful techniques available to the general public.
The book is built around a compelling series of specific, step-by-step interventions that provide readers with an understanding of the thoughts that lead to depression. They learn how to find the motivation to confront depressive feelings. By sitting with painful emotions and allowing them to pass, you will find that you can reduce the frequency of depressive episodes. Using meditation practices for observation and awareness, develop the ability to recognize cognitive, physiological, and environmental triggers that can lead to aggravated periods of the disorder. When you change how you approach your day-to-day life, your daily activities, the choices you make, and the way you cope with life's ups and downs you strengthen the skills you need to move beyond depression and develop lasting peace of mind.
Recent reports indicate that depression is the most common psychological disorder in the US, affecting as many as 17 million Americans. This book integrates the spiritual practice of mindfulness with psychological techniques for changing negative thoughts and behaviors into a powerful and proven-effective program for coping with this serious and distressing condition.Current statistics suggest that as many as 17 million Americans suffer from depression; further research states that less than 25 percent of these receive adequate treatment for the disorder. In clinical trials, treatment approaches that incorporate spirituality with psychology have proven to be dramatically effective at countering depression. This book is co-written by a leading specialist in the treatment of depression and a clinical nurse who, as a Zen practitioner trained with Charlotte Joko Beck and Jon Kabat-Zinn.
A concept grounded in the practice of certain forms of Buddhism, mindfulness is the conscious, uninvolved awareness of the present moment. Western psychologists have recently learned that this state of mind is particularly conducive to the accomplishment of cognitive behavioral therapy, or CBT: an active mode of psychological treatment that attempts to recognize and counter negative thoughts and behaviors before they lead to debilitating symptoms like depression. As statistics confirm again and again that depression is the single most common psychological problem affecting Americans, the refinement of psychotherapy through the integration of spirituality-based techniques has generated considerable interest among psychology professionals. This approachable and easy-to-use book makes these powerful techniques available to the general public.
The book is built around a compelling series of specific, step-by-step interventions that provide readers with an understanding of the thoughts that lead to depression. They learn how to find the motivation to confront depressive feelings. By sitting with painful emotions and allowing them to pass, you will find that you can reduce the frequency of depressive episodes. Using meditation practices for observation and awareness, develop the ability to recognize cognitive, physiological, and environmental triggers that can lead to aggravated periods of the disorder. When you change how you approach your day-to-day life, your daily activities, the choices you make, and the way you cope with life's ups and downs you strengthen the skills you need to move beyond depression and develop lasting peace of mind.
<p>This study evaluated mindfulness-based cognitive therapy (MBCT), a group intervention designed to train recovered recurrently depressed patients to disengage from dysphoria-activated depressogenic thinking that may mediate relapse/recurrence. Recovered recurrently depressed patients ( n = 145) were randomized to continue with treatment as usual or, in addition, to receive MBCT. Relapse/recurrence to major depression was assessed over a 60-week study period. For patients with 3 or more previous episodes of depression (77% of the sample), MBCT significantly reduced risk of relapse/recurrence. For patients with only 2 previous episodes, MBCT did not reduce relapse/recurrence. MBCT offers a promising cost-efficient psychological approach to preventing relapse/recurrence in recovered recurrently depressed patients.</p>
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This study evaluated mindfulness-based cognitive therapy (MBCT), a group intervention designed to train recovered recurrently depressed patients to disengage from dysphoria-activated depressogenic thinking that may mediate relapse/recurrence. Recovered recurrently depressed patients (n = 145) were randomized to continue with treatment as usual or, in addition, to receive MBCT. Relapse/recurrence to major depression was assessed over a 60-week study period. For patients with 3 or more previous episodes of depression (77% of the sample), MBCT significantly reduced risk of relapse/recurrence. For patients with only 2 previous episodes, MBCT did not reduce relapse/recurrence. MBCT offers a promising cost-efficient psychological approach to preventing relapse/recurrence in recovered recurrently depressed patients.
Objective: Both Mindfulness Based Cognitive Therapy (MBCT) and Cognitive Therapy (CT) enhance self-management of prodromal symptoms associated with depressive relapse, albeit through divergent therapeutic procedures. We evaluated rates of relapse in remitted depressed patients receiving MBCT and CT. Decentering and dysfunctional attitudes were assessed as treatment-specific process markers. Method: Participants in remission from Major Depressive Disorder (MDD; N = 166) were randomized to 8 weeks of either MBCT (N = 82) or CT (N = 84) and were followed for 24 months, with process markers measured every 3 months. Attendance in both treatments was high (6.3/8 session) and treatment fidelity and competence were evaluated. Relapse was defined as a return of symptoms meeting the criteria for major depression on Module A of the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders (SCID). Results: Intention-to-treat analyses indicated no differences between MBCT and CT in either rates of relapse to MDD or time to relapse across 24 months of follow up. Both groups experienced significant increases in decentering and participants in CT reported greater reductions in dysfunctional attitudes. Within both treatments, participants who relapsed evidenced lower decentering scores than those who stayed well over the follow up. Conclusions: This is the first study to directly compare relapse prophylaxis following MBCT and CT directly. The lack of group differences in time to relapse supports the view that both interventions are equally effective and that increases in decentering achieved via either treatment are associated with greater protection. These findings lend credence to Teasdale et al.’s (2002) contention that, even though they may be taught through dissimilar methods, CT and MBCT help participants develop similar metacognitive skills for the regulation of distressing thoughts and emotions.
Objective: Both Mindfulness Based Cognitive Therapy (MBCT) and Cognitive Therapy (CT) enhance self-management of prodromal symptoms associated with depressive relapse, albeit through divergent therapeutic procedures. We evaluated rates of relapse in remitted depressed patients receiving MBCT and CT. Decentering and dysfunctional attitudes were assessed as treatment-specific process markers. Method: Participants in remission from Major Depressive Disorder (MDD; N = 166) were randomized to 8 weeks of either MBCT (N = 82) or CT (N = 84) and were followed for 24 months, with process markers measured every 3 months. Attendance in both treatments was high (6.3/8 session) and treatment fidelity and competence were evaluated. Relapse was defined as a return of symptoms meeting the criteria for major depression on Module A of the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders (SCID). Results: Intention-to-treat analyses indicated no differences between MBCT and CT in either rates of relapse to MDD or time to relapse across 24 months of follow up. Both groups experienced significant increases in decentering and participants in CT reported greater reductions in dysfunctional attitudes. Within both treatments, participants who relapsed evidenced lower decentering scores than those who stayed well over the follow up. Conclusions: This is the first study to directly compare relapse prophylaxis following MBCT and CT directly. The lack of group differences in time to relapse supports the view that both interventions are equally effective and that increases in decentering achieved via either treatment are associated with greater protection. These findings lend credence to Teasdale et al.’s (2002) contention that, even though they may be taught through dissimilar methods, CT and MBCT help participants develop similar metacognitive skills for the regulation of distressing thoughts and emotions.
Mindfulness-based interventions (MBIs) are at a pivotal point in their future development. Spurred on by an ever-increasing number of studies and breadth of clinical application, the value of such approaches may appear self-evident. We contend, however, that the public health impact of MBIs can be enhanced significantly by situating this work in a broader framework of clinical psychological science. Utilizing the National Institutes of Health stage model (Onken, Carroll, Shoham, Cuthbert, & Riddle, 2014), we map the evidence base for mindfulness-based cognitive therapy and mindfulness-based stress reduction as exemplars of MBIs. From this perspective, we suggest that important gaps in the current evidence base become apparent and, furthermore, that generating more of the same types of studies without addressing such gaps will limit the relevance and reach of these interventions. We offer a set of 7 recommendations that promote an integrated approach to core research questions, enhanced methodological quality of individual studies, and increased logical links among stages of clinical translation in order to increase the potential of MBIs to impact positively the mental health needs of individuals and communities.
Background/AimsThe persistence of residual depressive symptoms (RDS) among patients in clinical remission predicts a negative prognosis and is considered an important target for adjunctive treatment. Mindfulness-Based Cognitive Therapy (MBCT) is effective in reducing RDS. Delivered in 8 in-person group sessions, MBCT teaches disengagement from depression-related ruminative thought patterns to reduce RDS and vulnerability to relapse. However, MBCT faces barriers to dissemination including service costs and access. We developed an 8 session web-based version of MBCT (Mindful Mood Balance, or MMB), incorporating experiential practice, video-based vicarious learning, and didactic information that replicate core components of in-person MBCT.
Background/Aims Mindfulness-based cognitive therapy (MBCT) is an empirically supported intervention designed to teach emotion regulation skills for reducing residual depressive symptoms and avoiding relapse triggers that contribute to chronic illness course. MBCT faces common challenges to dissemination, including: service costs, waiting lists, and access. Online treatments address these challenges by increasing treatment accessibility and flexibility, but present other challenges of high dropout rates and decreased engagement. The present study is the first qualitative investigation of patients’ experiences with Mindful Mood Balance (MMB), an 8 week online treatment that features the core elements of in-person MBCT.Methods Conducted qualitative content analysis on 38 exit interviews with adult patients who participated in MMB. Interviews gathered constructive feedback on website activities and content, program administration, as well as on skills learned and personal insights achieved through participation. Participation required current PHQ-9 score less than or equal to 12 and lifetime history of one or more major depressive episodes.
Results Participants were majority female (71%), white (89.5%), employed (79%), married (73.7%), with a mean age of 46.89. Majority of participants had 3 or more past major depressive episodes (68.4%) and were currently using anti-depressant medications (71%). Codes were organized into four main themes: evidence of concept comprehension, translation of MBCT content, translation of MBCT group process, and home practice. Within these four areas, participants highlighted the advantages and challenges of delivering MBCT in an online environment and endorsed learning and retaining central skills taught.
Conclusions This work will be used to inform programmatic changes to MMB including addition of an online community and alternatives to home practice expectations. Participants endorsed retaining central skills observed previously during in-person delivery of MBCT, and identified several advantages to online delivery including flexibility, reduced cost and time commitment. Overall feedback indicated a high level of participant satisfaction, which is encouraging as MMB could drastically widen the availability of an empirically based depression relapse prevention treatment.
BACKGROUND:Due to the clinical challenges of treatment-resistant depression (TRD), we evaluated the efficacy of mindfulness-based cognitive therapy (MBCT) relative to a structurally equivalent active comparison condition as adjuncts to treatment-as-usual (TAU) pharmacotherapy in TRD.
METHODS:
This single-site, randomized controlled trial compared 8-week courses of MBCT and the Health Enhancement Program (HEP), comprising physical fitness, music therapy and nutritional education, as adjuncts to TAU pharmacotherapy for outpatient adults with TRD. The primary outcome was change in depression severity, measured by percent reduction in the total score on the 17-item Hamilton Depression Rating Scale (HAM-D17), with secondary depression indicators of treatment response and remission.
RESULTS:
We enrolled 173 adults; mean length of a current depressive episode was 6.8 years (SD = 8.9). At the end of 8 weeks of treatment, a multivariate analysis showed that relative to the HEP condition, the MBCT condition was associated with a significantly greater mean percent reduction in the HAM-D17 (36.6 vs. 25.3%; p = 0.01) and a significantly higher rate of treatment responders (30.3 vs. 15.3%; p = 0.03). Although numerically superior for MBCT than for HEP, the rates of remission did not significantly differ between treatments (22.4 vs. 13.9%; p = 0.15). In these models, state anxiety, perceived stress and the presence of personality disorder had adverse effects on outcomes.
CONCLUSIONS:
MBCT significantly decreased depression severity and improved treatment response rates at 8 weeks but not remission rates. MBCT appears to be a viable adjunct in the management of TRD.
BACKGROUND:Due to the clinical challenges of treatment-resistant depression (TRD), we evaluated the efficacy of mindfulness-based cognitive therapy (MBCT) relative to a structurally equivalent active comparison condition as adjuncts to treatment-as-usual (TAU) pharmacotherapy in TRD.
METHODS:
This single-site, randomized controlled trial compared 8-week courses of MBCT and the Health Enhancement Program (HEP), comprising physical fitness, music therapy and nutritional education, as adjuncts to TAU pharmacotherapy for outpatient adults with TRD. The primary outcome was change in depression severity, measured by percent reduction in the total score on the 17-item Hamilton Depression Rating Scale (HAM-D17), with secondary depression indicators of treatment response and remission.
RESULTS:
We enrolled 173 adults; mean length of a current depressive episode was 6.8 years (SD = 8.9). At the end of 8 weeks of treatment, a multivariate analysis showed that relative to the HEP condition, the MBCT condition was associated with a significantly greater mean percent reduction in the HAM-D17 (36.6 vs. 25.3%; p = 0.01) and a significantly higher rate of treatment responders (30.3 vs. 15.3%; p = 0.03). Although numerically superior for MBCT than for HEP, the rates of remission did not significantly differ between treatments (22.4 vs. 13.9%; p = 0.15). In these models, state anxiety, perceived stress and the presence of personality disorder had adverse effects on outcomes.
CONCLUSIONS:
MBCT significantly decreased depression severity and improved treatment response rates at 8 weeks but not remission rates. MBCT appears to be a viable adjunct in the management of TRD.
Z. V. Segal et al. (2006) demonstrated that depressed patients treated to remission through either antidepressant medication (ADM) or cognitive-behavioral therapy (CBT), but who evidenced mood-linked increases in dysfunctional thinking, showed elevated rates of relapse over 18 months. The current study sought to evaluate whether treatment response was associated with gains in decentering-the ability to observe one's thoughts and feelings as temporary, objective events in the mind-and whether these gains moderated the relationship between mood-linked cognitive reactivity and relapse of major depression. Findings revealed that CBT responders exhibited significantly greater gains in decentering compared with ADM responders. In addition, high post acute treatment levels of decentering and low cognitive reactivity were associated with the lowest rates of relapse in the 18-month follow-up period.
Examined how aspects of social-emotional learning (SEL)-specifically, emotion knowledge, emotional and social behaviors, social problem-solving, and self-regulation-clustered to typify groups of children who differ in terms of their motivation to learn, participation in the classroom, and other indices of early school adjustment and academic success. 275 four-year-old children from private day schools and Head Start were directly assessed and observed in these areas, and preschool and kindergarten teachers provided information on social and academic aspects of their school success. Three groups of children were identified: SEL Risk, SEL Competent-Social/Expressive, and SEL Competent-Restrained. Group members differed on demographic dimensions of gender and center type, and groups differed in meaningful ways on school success indices, pointing to needed prevention/intervention programming. In particular, the SEL Risk group could benefit from emotion-focused programming, and the long-term developmental trajectory of the SEL Competent-Restrained group requires study.
Comment éviter les rechutes dépressives grâce à un programme basé sur la pleine conscience. Un programme qui a fait ses preuves et ne cesse de prouver son efficacité sur le terrain!
Comment éviter les rechutes dépressives grâce à un programme basé sur la pleine conscience. Un programme qui a fait ses preuves et ne cesse de prouver son efficacité sur le terrain!
Comment éviter les rechutes dépressives grâce à un programme basé sur la pleine conscience. Un programme qui a fait ses preuves et ne cesse de prouver son efficacité sur le terrain!
In this study, the authors both developed and validated a self-report mindfulness measure, the Toronto Mindfulness Scale (TMS). In Study 1, participants were individuals with and without meditation experience. Results showed good internal consistency and two factors, Curiosity and Decentering. Most of the expected relationships with other constructs were as expected. The TMS scores increased with increasing mindfulness meditation experience. In Study 2. criterion and incremental validity of the TMS were investigated on a group of individuals participating in 8-week mindfulness-based stress reduction programs. Results showed that TMS scores increased following treatment, and Decentering scores predicted improvements in clinical outcome. Thus, the TMS is a promising measure of the mindfulness state with good psychometric properties and predictive of treatment outcome. Keywords: Toronto Mindfulness Scale; self-report assessment: mindfulness; meditation; psychometric characteristics
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In this study, the authors both developed and validated a self-report mind- fulness measure, the Toronto Mindfulness Scale (TMS). In Study 1, partici- pants were individuals with and without meditation experience. Results showed good internal consistency and two factors, Curiosity and Decen- tering. Most of the expected relationships with other constructs were as expected. The TMS scores increased with increasing mindfulness medita- tion experience. In Study 2, criterion and incremental validity of the TMS were investigated on a group of individuals participating in 8-week mindfulness-based stress reduction programs. Results showed that TMS scores increased following treatment, and Decentering scores predicted improvements in clinical outcome. Thus, the TMS is a promising measure of the mindfulness state with good psychometric properties and predic- tive of treatment outcome.
Objective: To examine whether metacognitive psychological skills, acquired in mindfulness-based cognitive therapy (MBCT), are also present in patients receiving medication treatments for prevention of depressive relapse and whether these skills mediate MBCT's effectiveness. Method: This study, embedded within a randomized efficacy trial of MBCT, was the first to examine changes in mindfulness and decentering during 6–8 months of antidepressant treatment and then during an 18-month maintenance phase in which patients discontinued medication and received MBCT, continued on antidepressants, or were switched to a placebo. In total, 84 patients (mean age = 44 years, 58% female) were randomized to 1 of these 3 prevention conditions. In addition to symptom variables, changes in mindfulness, rumination, and decentering were assessed during the phases of the study. Results: Pharmacological treatment of acute depression was associated with reductions in scores for rumination and increased wider experiences. During the maintenance phase, only patients receiving MBCT showed significant increases in the ability to monitor and observe thoughts and feelings as measured by the Wider Experiences (p < .01) and Decentering (p < .01) subscales of the Experiences Questionnaire and by the Toronto Mindfulness Scale. In addition, changes in Wider Experiences (p < .05) and Curiosity (p < .01) predicted lower Hamilton Rating Scale for Depression scores at 6-month follow-up. Conclusions: An increased capacity for decentering and curiosity may be fostered during MBCT and may underlie its effectiveness. With practice, patients can learn to counter habitual avoidance tendencies and to regulate dysphoric affect in ways that support recovery.
BACKGROUND:Mindful Mood Balance (MMB) is a Web-based intervention designed to treat residual depressive symptoms and prevent relapse. MMB was designed to deliver the core concepts of mindfulness-based cognitive therapy (MBCT), a group treatment, which, despite its strong evidence base, faces a number of dissemination challenges.
OBJECTIVE:
The present study is a qualitative investigation of participants' experiences with MMB.
METHODS:
Qualitative content analysis was conducted via 38 exit interviews with MMB participants. Study inclusion required a current PHQ-9 (Patient Health Questionnaire) score ≤12 and lifetime history ≥1 major depressive episode. Feedback was obtained on specific website components, program content, and administration as well as skills learned.
RESULTS:
Codes were assigned to interview responses and organized into four main themes: MBCT Web content, MBCT Web-based group process, home practice, and evidence of concept comprehension. Within these four areas, participants highlighted the advantages and obstacles of translating and delivering MBCT in a Web-based format. Adding increased support was suggested for troubleshooting session content as well as managing time challenges for completing home mindfulness practice. Participants endorsed developing affect regulation skills and identified several advantages to Web-based delivery including flexibility, reduced cost, and time commitment.
CONCLUSIONS:
These findings support the viability of providing MBCT online and are consistent with prior qualitative accounts derived from in-person MBCT groups. While there is certainly room for innovation in the domains of program support and engagement, the high levels of participant satisfaction indicated that MMB can significantly increase access to evidence-based psychological treatments for sub-threshold symptoms of unipolar affective disorder.
BACKGROUND:Mindful Mood Balance (MMB) is a Web-based intervention designed to treat residual depressive symptoms and prevent relapse. MMB was designed to deliver the core concepts of mindfulness-based cognitive therapy (MBCT), a group treatment, which, despite its strong evidence base, faces a number of dissemination challenges.
OBJECTIVE:
The present study is a qualitative investigation of participants' experiences with MMB.
METHODS:
Qualitative content analysis was conducted via 38 exit interviews with MMB participants. Study inclusion required a current PHQ-9 (Patient Health Questionnaire) score ≤12 and lifetime history ≥1 major depressive episode. Feedback was obtained on specific website components, program content, and administration as well as skills learned.
RESULTS:
Codes were assigned to interview responses and organized into four main themes: MBCT Web content, MBCT Web-based group process, home practice, and evidence of concept comprehension. Within these four areas, participants highlighted the advantages and obstacles of translating and delivering MBCT in a Web-based format. Adding increased support was suggested for troubleshooting session content as well as managing time challenges for completing home mindfulness practice. Participants endorsed developing affect regulation skills and identified several advantages to Web-based delivery including flexibility, reduced cost, and time commitment.
CONCLUSIONS:
These findings support the viability of providing MBCT online and are consistent with prior qualitative accounts derived from in-person MBCT groups. While there is certainly room for innovation in the domains of program support and engagement, the high levels of participant satisfaction indicated that MMB can significantly increase access to evidence-based psychological treatments for sub-threshold symptoms of unipolar affective disorder.
Mindfulness-based Cognitive Therapy (MBCT) has been shown to effectively prevent relapse and reduce residual depressive symptoms (RDS), yet it faces barriers to dissemination. The present study examined Mindful Mood Balance (MMB), the first web-based approach to deliver the core content of MBCT. Of the 107 recurrently depressed individuals screened, 100 elected to enroll in the study and received MMB in an 8-session open trial with 6-month follow-up. Outcomes included depressive symptom severity, rumination and mindful awareness, and program engagement. A quasi-experimental comparison between MMB participants and propensity matched case-controls receiving usual depression care (UDC) (N = 100) also was conducted. The full sample and the subgroup with residual depressive symptoms (N = 42) showed significantly reduced depressive severity, which was sustained over six months, and improvement on rumination and mindfulness. Examination of acceptability of MMB indicated that 42% of participants within the full sample and 36% of the RDS subgroup completed all 8 sessions and 53% within the full sample and 50% within the RDS subgroup completed at least 4 sessions, and that participants engaged with daily mindfulness practice. MMB also was associated with significant reduction in RDS severity as compared to quasi-experimental propensity matched controls. Although the use of a non-randomized design, with potential unmeasured differences between groups, and short interval of clinical follow-up were limitations, findings from this study support the web-based delivery of MBCT and suggest clinical benefits for participants with histories of depression and with RDS, relative to those receiving usual care alone.
Mindfulness-based Cognitive Therapy (MBCT) has been shown to effectively prevent relapse and reduce residual depressive symptoms (RDS), yet it faces barriers to dissemination. The present study examined Mindful Mood Balance (MMB), the first web-based approach to deliver the core content of MBCT. Of the 107 recurrently depressed individuals screened, 100 elected to enroll in the study and received MMB in an 8-session open trial with 6-month follow-up. Outcomes included depressive symptom severity, rumination and mindful awareness, and program engagement. A quasi-experimental comparison between MMB participants and propensity matched case-controls receiving usual depression care (UDC) (N = 100) also was conducted. The full sample and the subgroup with residual depressive symptoms (N = 42) showed significantly reduced depressive severity, which was sustained over six months, and improvement on rumination and mindfulness. Examination of acceptability of MMB indicated that 42% of participants within the full sample and 36% of the RDS subgroup completed all 8 sessions and 53% within the full sample and 50% within the RDS subgroup completed at least 4 sessions, and that participants engaged with daily mindfulness practice. MMB also was associated with significant reduction in RDS severity as compared to quasi-experimental propensity matched controls. Although the use of a non-randomized design, with potential unmeasured differences between groups, and short interval of clinical follow-up were limitations, findings from this study support the web-based delivery of MBCT and suggest clinical benefits for participants with histories of depression and with RDS, relative to those receiving usual care alone.
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