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Previous research on depressed and suicidal patients and those with posttraumatic stress disorder has shown that patients' memory for the past is overgeneral (i.e., patients retrieve generic summaries of past events rather than specific events). This study investigated whether autobiographical memory could be affected by psychological treatment. Recovered depressed patients were randomly allocated to receive either treatment as usual or treatment designed to reduce risk of relapse. Whereas control patients showed no change in specificity of memories recalled in response to cue words, the treatment group showed a significantly reduced number of generic memories. Although such a memory deficit may arise from long-standing tendencies to encode and retrieve events generically, such a style is open to modification.

Previous research on depressed and suicidal patients and those with posttraumatic stress disorder has shown that patients' memory for the past is overgeneral (i.e., patients retrieve generic summaries of past events rather than specific events). This study investigated whether autobiographical memory could be affected by psychological treatment. Recovered depressed patients were randomly allocated to receive either treatment as usual or treatment designed to reduce risk of relapse. Whereas control patients showed no change in specificity of memories recalled in response to cue words, the treatment group showed a significantly reduced number of generic memories. Although such a memory deficit may arise from long-standing tendencies to encode and retrieve events generically, such a style is open to modification.

This study was designed to test the hypothesis that mindfulness involves sustained attention, attention switching, inhibition of elaborative processing and non-directed attention. Healthy adults were tested before and after random assignment to an 8-weekMindfulness-Based Stress Reduction (MBSR) course (n = 39) or a wait-list control (n = 33). Testing included measures of sustained attention, attention switching, Stroop interference (as a measure of inhibition of laborative processing), detection of objects in consistent or inconsistent scenes (as a measure of non-directed attention), as well as self-report measures of emotional well-being and mindfulness. Participation in the MBSR course was associated with significantly greater improvements in emotional well-being and mindfulness, but no improvements in attentional control relative to the control group. However, improvements in mindfulness after MBSR were correlated with improvements in object detection. We discuss the implications of these results as they relate to the role of attention in mindfulness.

Evidence suggests mindfulness‐based clinical interventions are effective. Accepting this, we caution against assuming that mindfulness can be applied as a generic technique across a range of disorders without formulating how the approach addresses the factors maintaining the disorder in question. Six specific issues are raised: mindfulness has been found to be unhelpful in some contexts; where mindfulness has been found to be effective, instructors have derived and shared with clients a clear problem formulation; there may be many dimensions of effectiveness underlying the apparent simplicity of mindfulness; mindfulness was developed within a particular “view” of emotional suffering that implies wider changes that go beyond meditation practice alone; professionals need to match the different components of mindfulness with the psychopathology being targeted; nonetheless, mindfulness may affect processes common to different pathologies.

Evidence suggests mindfulness-based clinical interventions are effective. Accepting this, we caution against assuming that mindfulness can be applied as a generic technique across a range of disorders (as suggested by R. Baer, see record 2003-03824-001) without formulating how the approach addresses the factors maintaining the disorder in question. Six specific issues are raised: mindfulness has been found to be unhelpful in some contexts; where mindfulness has been found to be effective, instructors have derived and shared with clients a clear problem formulation; there may be many dimensions of effectiveness underlying the apparent simplicity of mindfulness; mindfulness was developed within a particular "view" of emotional suffering that implies wider changes that go beyond meditation practice alone; professionals need to match the different components of mindfulness with the psychopathology being targeted; nonetheless, mindfulness may affect processes common to different pathologies. (PsycINFO Database Record (c) 2016 APA, all rights reserved)

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.

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.

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.

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.

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.

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