Category: Treatment - Mindfulness

Symposium

A Comparison of Various Potential Mediators of Mindfulness-Based Cognitive Therapy (MBCT)

Sunday, November 19
8:30 AM - 10:00 AM
Location: Indigo Ballroom A, Level 2, Indigo Level

Keywords: Mindfulness | Psychotherapy Process | Adult Depression
Presentation Type: Symposium

Recent meta-analyses (e.g., Piet & Hougaard, 2011) have suggested that mindfulness-based cognitive therapy (MBCT) is effective, both as an acute treatment for clinically-significant levels of depression, and in the prevention of relapse; however, how MBCT works remains unclear (Hawley et al., 2013). According to Fresco and colleagues (2007), “decentering” typically defined as the ability to observe one’s thoughts and feelings as temporary, objective events in the mind (Safran & Segal, 1990), is one candidate mechanism. The current study sought to examine the role of decentering, and other related variables, in the efficacy of MBCT as compared to two active comparison conditions. Formerly depressed individuals (N = 235), randomly assigned to MBCT (n = 76), relaxation group therapy (RGT; n = 79) or treatment-as-usual (TAU; n = 80), completed self-report measures of decentering and symptoms of depression at pre-, mid-, and post-treatment, and relapse was assessed at 3, 6, 9, and 12 months, post-treatment.


With regard to the acute treatment phase, results indicated that depression changed at differing rates between the three groups. Specifically, whereas levels of depression increased in both RGT and TAU, MBCT patients remained free from symptom gains. Moreover, changes in decentering (as measured by the Experiences Questionnaire) from mid- to post-treatment predicted residual change in depression from pre- to post-treatment for MBCT, β=-.32, t=-2.24, p=.03, Cohen’s f2=-.17, and TAU, β=-.33, t=-2.26, p=.03, f2=-.14, but not for RGT, β=-.38, t=-1.66, p=.12, f2=-.16 (although this effect was similar in magnitude to MBCT). This pattern of results was not found when other potential mediators were examined (i.e., subscales of the Five Facet Mindfulness Questionnaire, Toronto Mindfulness Scale, and Self-Compassion Scale).


With respect to treatment durability, mid- to post-treatment change in EQ-measured decentering was used as a covariate in a Cox regression model to predict differential patterns of relapse (during the 4 follow-up assessments) in MBCT versus RGT and TAU. The interaction of group and change in decentering significantly predicted relapse after both main effect terms and post-treatment symptoms of depression were included in previous steps in the model. Change in decentering significantly predicted relapse in MBCT, Wald Χ21=3.47, p=.06, RGT, Wald Χ21=2.77, p=.10, and TAU, Wald Χ21=4.70, p=.03 (albeit at trend level in both MBCT and TAU). Again, this result was not obtained with the other measures mentioned above.

Michael Moore

Adelphi University

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A Comparison of Various Potential Mediators of Mindfulness-Based Cognitive Therapy (MBCT)



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