Decentering and Relapse/Recurrence in MBCT for Depression in Adults

University of British Columbia227 enrolled

Overview

Objective: "Decentering" is defined as the ability to observe one's thoughts and feelings as temporary, objective events in the mind, and is increasingly regarded as a candidate mechanism in mindfulness-based interventions. The current study sought to examine the role of decentering, and other related variables, in the efficacy of Mindfulness-based cognitive therapy (MBCT) as compared to two active comparison conditions. Method: Formerly depressed individuals (N = 227), randomly assigned to MBCT (n = 74), relaxation group therapy (RGT; n = 77) or treatment-as-usual (TAU; n = 76), 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.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

DOUBLE

Enrollment

227

Conditions

Depression Depressive Disorder, Major Depression in Remission

Eligibility

Sex: ALLHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: * a Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM IV-TR; American Psychiatric Association (APA), diagnosis of major depressive disorder (MDD) without psychotic features, in Full Remission; * three or more prior major depressive episodes; * age between 18 and 65 years; * cognitive reactivity (CR) or mood-activated dysfunctional beliefs score greater than or equal to eight (see assessment procedure below); * a score of less than 10 on the Hamilton Rating Scale for Depression (HRSD); * minimum of a 10 week period free of psychotropic medication other than stable dosage of antidepressant medication for a minimum of four weeks; * fluency in English; An increased cognitive reactivity score of eight points or more and, * ability to give informed consent and complete questionnaires unassisted. Exclusion Criteria: * a diagnosis of bipolar disorder (past or present), schizophreniform disorders, substance abuse or dependence (current or within the past six months), borderline or antisocial personality disorder, or neurocognitive disorders; * current psychotherapy or counselling more frequently than twice per month; * current practice of meditation more than once per week or yoga more than twice per week; * electroconvulsive therapy within the past six months; or * self-reported ingestion of alcohol or other psychoactive substances within the past 48 hrs.

Outcomes

Primary Outcomes

Major depressive disorder (MDD) relapse/recurrence - incidence of

Number of participants meeting criteria for relapse/recurrence of MDD during follow-up

Time frame: 12- month post-treatment follow-up

Change in major depressive disorder (MDD) relapse/recurrence - time to relapse/recurrence

Change in relapse/recurrence of MDD (i.e., survival) across follow-up

Time frame: 3-, 6-, 9-, and 12- month post-treatment follow-up

Secondary Outcomes

Change in Beck Depression Inventory - Second Edition total scores

Change in symptoms of depression across MBCT treatment

Time frame: Pre-, mid- (i.e., at week 4 of MBCT), and post-treatment (i.e., after 8 weeks of MBCT)