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Mindfulness plays an increasing role in the field of health psychology, since mindfulness-based interventions in prevention and rehabilitation can lead to a higher bodily well-being and quality of life. How valid is the measurement of self-reported mindfulness as a multidimensional construct using the German translation of the Five-Facet Mindfulness Questionnaire (FFMQ)? The 39-item inventory was translated into German and presented to a sample of 550 undergraduate students. The dimensional structure, reliability, and validity of the different scales were evaluated. Results were largely comparable to those obtained for the original English version of the FFMQ. As anticipated, the five-factor structure was largely replicated and expected associations with symptom distress and indicators of psychological and physical well-being were found. The German version of the FFMQ seems to be an economic, reliable, and valid questionnaire for assessing self-reported mindfulness in a multidimensional way.
During the past decade, theoretical approaches have emerged that call into question the presumption that self-esteem is an absolute prerequisite for healthy functioning. The present study addressed the question of whether a non-judgmental accepting stance towards experience moderates the relationship between self-esteem and depression. In a sample of 216 undergraduate students, self-esteem was assessed with the Rosenberg Self-Esteem Scale (Rosenberg, 1965), acceptance with the ‘accept without judgment’ subscale of the Kentucky Inventory of Mindfulness Skills (Baer, Smith, & Allen, 2004), and depressive symptoms with the Beck Depression Inventory (Beck & Steer, 1987). Results showed that non-judgmental acceptance moderates the relationship between self-esteem and depression. In persons with low mindful acceptance, self-esteem was much more closely associated with depression than in persons with high mindful acceptance. These findings suggest that an accepting, allowing, and non-judgmental stance towards present-moment experience might buffer the detrimental effects of low self-esteem on depression.
During the past decade, theoretical approaches have emerged that call into question the presumption that self-esteem is an absolute prerequisite for healthy functioning. The present study addressed the question of whether a non-judgmental accepting stance towards experience moderates the relationship between self-esteem and depression. In a sample of 216 undergraduate students, self-esteem was assessed with the Rosenberg Self-Esteem Scale (Rosenberg, 1965), acceptance with the ‘accept without judgment’ subscale of the Kentucky Inventory of Mindfulness Skills (Baer, Smith, & Allen, 2004), and depressive symptoms with the Beck Depression Inventory (Beck & Steer, 1987). Results showed that non-judgmental acceptance moderates the relationship between self-esteem and depression. In persons with low mindful acceptance, self-esteem was much more closely associated with depression than in persons with high mindful acceptance. These findings suggest that an accepting, allowing, and non-judgmental stance towards present-moment experience might buffer the detrimental effects of low self-esteem on depression.
During the past decade, Mindfulness-Based Cognitive Therapy (MBCT) aiming at relapse prevention in depression has been developed and empirically tested. All exercises taught during MBCT are based on the development of a heightened awareness of one's body. The important role of the body is also stressed in a recently emerging interdisciplinary field of research termed ‘embodiment.’ This research program focuses on the interactions between bodily, cognitive, and emotional processes. Based on the obvious role of the body in MBCT and on the theoretical and empirical evidence highlighting the role of the body in emotional processes, we argue that considering embodied processes might be a useful perspective for research on the etiology of depression and for mechanisms of action in MBCT.
BackgroundSuicidal ideation (SI) is common in chronic depression, but only limited evidence exists for the assumption that psychological treatments for depression are effective for reducing SI.
Methods
In the present study, the effects of Mindfulness-based Cognitive Therapy (MBCT; group version) plus treatment-as-usual (TAU: individual treatment by either a psychiatrist or a licensed psychotherapist, including medication when indicated) and Cognitive Behavioral Analysis System of Psychotherapy (CBASP; group version) plus TAU on SI was compared to TAU alone in a prospective, bi-center, randomized controlled trial. The sample consisted of 106 outpatients with chronic depression.
Results
Multivariate regression analyses revealed different results, depending on whether SI was assessed via self-report (Beck Depression Inventory suicide item) or via clinician rating (Hamilton Depression Rating Scale suicide item). Whereas significant reduction of SI emerged when assessed via clinician rating in the MBCT and CBASP group, but not in the TAU group while controlling for changes in depression, there was no significant effect of treatment on SI when assessed via self-report.
Limitations
SI was measured with only two single items.
Conclusions
Because all effects were of small to medium size and were independent of effects from other depression symptoms, the present results warrant the application of such psychotherapeutical treatment strategies like MBCT and CBASP for SI in patients with chronic depression.
The present study examines the relationships between mindfulness and rumination, repetitive negative thinking, and depressive symptoms, employing a newly developed paradigm for the assessment of mindfulness. Derived from a central exercise of mindfulness-based interventions, 42 undergraduates were asked to observe their breath for about 18 min. Within this time period, they were prompted 22 times at irregular intervals to indicate whether they had lost mindful contact with their breath as a result of mind wandering. The results show negative correlations between the degree of the ability to stay mindfully in contact with the breath and measures of rumination, repetitive negative thinking, and depression. Moreover, positive associations with self-report data of mindfulness and a negative relationship to fear of bodily sensations support the construct validity of our new approach for the assessment of mindfulness. In summary, findings suggest the healthy quality of mindful breathing regarding depression-related processes. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
The present study examines the relationships between mindfulness and rumination, repetitive negative thinking, and depressive symptoms, employing a newly developed paradigm for the assessment of mindfulness. Derived from a central exercise of mindfulness-based interventions, 42 undergraduates were asked to observe their breath for about 18 min. Within this time period, they were prompted 22 times at irregular intervals to indicate whether they had lost mindful contact with their breath as a result of mind wandering. The results show negative correlations between the degree of the ability to stay mindfully in contact with the breath and measures of rumination, repetitive negative thinking, and depression. Moreover, positive associations with self-report data of mindfulness and a negative relationship to fear of bodily sensations support the construct validity of our new approach for the assessment of mindfulness. In summary, findings suggest the healthy quality of mindful breathing regarding depression-related processes. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
The present study examines the relationships between mindfulness and rumination, repetitive negative thinking, and depressive symptoms, employing a newly developed paradigm for the assessment of mindfulness. Derived from a central exercise of mindfulness-based interventions, 42 undergraduates were asked to observe their breath for about 18 min. Within this time period, they were prompted 22 times at irregular intervals to indicate whether they had lost mindful contact with their breath as a result of mind wandering. The results show negative correlations between the degree of the ability to stay mindfully in contact with the breath and measures of rumination, repetitive negative thinking, and depression. Moreover, positive associations with self-report data of mindfulness and a negative relationship to fear of bodily sensations support the construct validity of our new approach for the assessment of mindfulness. In summary, findings suggest the healthy quality of mindful breathing regarding depression-related processes.
The present study examines the relationships between mindfulness and rumination, repetitive negative thinking, and depressive symptoms, employing a newly developed paradigm for the assessment of mindfulness. Derived from a central exercise of mindfulness-based interventions, 42 undergraduates were asked to observe their breath for about 18 min. Within this time period, they were prompted 22 times at irregular intervals to indicate whether they had lost mindful contact with their breath as a result of mind wandering. The results show negative correlations between the degree of the ability to stay mindfully in contact with the breath and measures of rumination, repetitive negative thinking, and depression. Moreover, positive associations with self-report data of mindfulness and a negative relationship to fear of bodily sensations support the construct validity of our new approach for the assessment of mindfulness. In summary, findings suggest the healthy quality of mindful breathing regarding depression-related processes. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
The use of questionnaires to measure two facets of mindfulness, ‘regulation of attention’ and ‘non-judgmental orientation,’ has been criticized. Furthermore, the assumption that depressed individuals show deficits in both facets has not yet been proven. In an attempt to minimize several biases associated with mindfulness questionnaires, we asked 43 currently depressed and 36 never-depressed participants to observe their breathing. The ‘regulation of attention’ facet of mindfulness was measured by the number of times participants’ focus drifted off of their breathing. The ‘non-judgmental orientation’ facet was assessed using skin conductance response (SCR) and corrugator activity measured by electromyography (EMG), as indicators associated with arousal and negative emotions following drifting, and also by a self-report questionnaire. Depressed patients showed deficits in both facets of mindfulness. Specifically, compared to never-depressed controls, depressed patients drifted focus from their breathing more often, had significantly higher self-reported self-criticism, and displayed an increase in corrugator activity after drifting from breathing.
Identifying effective and sustainable treatments for chronic depression is a key issue in current psychiatric research. However, there are only very few psychotherapy studies that report follow-up effects. For the only specific psychological approach to the treatment of chronic depression, the Cognitive Behavioral Analysis System of Psychotherapy (CBASP), preliminary follow-up studies [2-4] showed promising results. For Mindfulness-Based Cognitive Therapy (MBCT) for treatment-resistant depression, there is only one follow-up study [5]. Up to now, no results comparing follow-up data between MBCT and CBASP have been available. The present study investigated the follow-up of a randomized controlled trial comparing CBASP and MBCT (both applied in a group format) with treatment-as-usual (TAU) in patients with chronic depression. In addition, the moderating role of childhood adversities on outcomes was explored.
Empirical evidence for the effectiveness of mindfulnessbased cognitive therapy (MBCT) is encouraging. However, dataconcerning the role of mindfulness in its relapse preventive effect
are lacking. In our study, 25 formerly depressed patients received
MBCT. Mindfulness was assessed before and immediately after
MBCT using the Mindful Attention and Awareness Scale. Mindfulness significantly increased during MBCT, and posttreatment levels
of mindfulness predicted the risk of relapse/recurrence to major
depressive disorder in the 12-month follow-up period. Mindfulness
predicted the risk of relapse/recurrence after controlling for numbers
of previous episodes and residual depressive symptoms. The results
provide preliminary evidence for the notion that mindfulness is an
important factor in relapse prevention in major depression.
Empirical research has demonstrated associations between heart rate variability (HRV) and the regulation of emotion and behavior. Similarly, self-regulation of attention to one’s experience of the present moment in an accepting and nonjudgmental manner is an essential characteristic of mindfulness that promotes emotional and behavioral regulation and psychological well-being. The present study investigated the relationship between mindfulness and HRV. A total of 23 undergraduate psychology students completed a recently developed measure of mindfulness, the mindful breathing exercise (MBE), which assesses the ability to mindfully stay in contact with one’s breath during breathing meditation. Moreover, indices of HRV were measured during a short version of the MBE. As predicted, positive correlations were found between indices of HRV and mindfulness. The findings demonstrate that the ability to mindfully regulate one’s attention is associated with higher HRV, a physiological correlate of physical and psychological health, and therefore support on a physiological level the potential benefit of the implemented mindfulness exercises in mindfulness-based clinical interventions.
Objective: Mindfulness-based cognitive therapy (MBCT) has recently been proposed as a treatment option for chronic depression. The cognitive behavioral analysis system of psychotherapy (CBASP) is the only approach specifically developed to date for the treatment of chronically depressed patients. The efficacy of MBCT plus treatment-as-usual (TAU), and CBASP (group version) plus TAU, was compared to TAU alone in a prospective, bicenter, randomized controlled trial. Method: One hundred and six patients with a current DSM–IV defined major depressive episode and persistent depressive symptoms for more than 2 years were randomized to TAU only (N = 35), or to TAU with additional 8-week group therapy of either 8 sessions of MBCT (n = 36) or CBASP (n = 35). The primary outcome measure was the Hamilton Depression Rating Scale (24-item HAM-D, Hamilton, 1967) at the end of treatment. Secondary outcome measures were the Beck Depression Inventory (BDI; Beck, Steer, & Brown, 1996) and measures of social functioning and quality of life. Results: In the overall sample as well as at 1 treatment site, MBCT was no more effective than TAU in reducing depressive symptoms, although it was significantly superior to TAU at the other treatment site. CBASP was significantly more effective than TAU in reducing depressive symptoms in the overall sample and at both treatment sites. Both treatments had only small to medium effects on social functioning and quality of life. Conclusions: Further studies should inquire whether the superiority of CBASP in this trial might be explained by the more active, problem-solving, and interpersonal focus of CBASP.
Objectives. In mindfulness‐based cognitive therapy (MBCT), it is proposed that training in mindfulness should reduce the tendency of formerly depressed patients to enter into ruminative thinking, thus reducing their risk of depressive relapse. However, data showing that rumination is associated with depressive relapse are lacking.Method. In an uncontrolled study with 24 formerly depressed patients, rumination was assessed with the Ruminative Response Scale. To assess the occurrence of relapse or recurrence, the Structured Clinical Interview for DSM‐IV was administered 12 months after the end of the MBCT.
Results. Rumination significantly decreased during the MBCT course. Post‐treatment levels of rumination predicted the risk of relapse of major depressive disorder in the 12‐month follow‐up period even after controlling for numbers of previous episodes and residual depressive symptoms.
Conclusions. The results provide preliminary evidence that rumination is important in the process of depressive relapse.
ObjectiveTo capture any sleep quality changes associated with group psychotherapy.
Patients/methods
Physician-referred, chronically depressed patients (n = 25) were randomized to either eight group sessions of Mindfulness-based Cognitive Therapy (MBCT, n = 9) plus Treatment As Usual (TAU), or the Cognitive Behavioral Analysis System of Psychotherapy (CBASP, n = 8) plus TAU, or to TAU only (control group, n = 8). Participants recorded their sleep at home. The primary outcome variables were: stable and unstable sleep, which were assessed using cardiopulmonary coupling (CPC) analysis, and estimated total sleep and wake time (minutes). Cardiopulmonary coupling measures heart rate variability and the electrocardiogram's R-wave amplitude fluctuations associated with respiration.
Results
By post-treatment night 6, the CBASP group had more stable sleep (p = 0.044) and less wake (p = 0.004) compared with TAU, and less wake vs MBCT (p = 0.039).
Conclusion
The CBASP group psychotherapy treatment improved sleep quality compared with Treatment As Usual.
BackgroundChronic depression is a severe and disabling condition. Compared to an episodic course, chronic depression has been shown to be less responsive to psychopharmacological and psychological treatments. The cognitive behavioral analysis system of psychotherapy (CBASP) has been developed as a specific psychotherapy for chronic depression. However, conflicting results concerning its efficacy have been reported in randomized‐controlled trials (RCT). Therefore, we aimed at examining the efficacy of CBASP using meta‐analytical methods.
Methods
Randomized‐controlled trials assessing the efficacy of CBASP in chronic depression were identified by searching electronic databases (PsycINFO, PubMed, Scopus, Cochrane Central Register of Controlled Trials) and by manual searches (citation search, contacting experts). Searching period was restricted from the first available entry to October 2015. Identified studies were systematically reviewed. The standardized mean difference Hedges' g was calculated from posttreatment and mean change scores. The random‐effects model was used to compute combined overall effect sizes. A risk of publication bias was addressed using fail‐safe N calculations and trim‐and‐fill analysis.
Results
Six studies comprising 1.510 patients met our inclusion criteria. The combined overall effect sizes of CBASP versus other treatments or treatment as usual (TAU) pointed to a significant effect of small magnitude (g = 0.34–0.44, P < 0.01). In particular, CBASP revealed moderate‐to‐high effect sizes when compared to TAU and interpersonal psychotherapy (g = 0.64–0.75, P < 0.05), and showed similar effects when compared to antidepressant medication (ADM) (g = −0.29 to 0.02, ns). The combination of CBASP and ADM yielded benefits over antidepressant monotherapy (g = 0.49–0.59, P < 0.05).
Limitations
The small number of included studies, a certain degree of heterogeneity among the study designs and comparison conditions, and insufficient data evaluating long‐term effects of CBASP restrict generalizability yet.
Conclusions
We conclude that there is supporting evidence that CBASP is effective in the treatment of chronic depression.