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CONTEXT:Mindfulness-based cognitive therapy (MBCT) is a group-based psychosocial intervention designed to enhance self-management of prodromal symptoms associated with depressive relapse.
OBJECTIVE:
To compare rates of relapse in depressed patients in remission receiving MBCT against maintenance antidepressant pharmacotherapy, the current standard of care.
DESIGN:
Patients who met remission criteria after 8 months of algorithm-informed antidepressant treatment were randomized to receive maintenance antidepressant medication, MBCT, or placebo and were followed up for 18 months.
SETTING:
Outpatient clinics at the Centre for Addiction and Mental Health, Toronto, Ontario, Canada, and St Joseph's Healthcare, Hamilton, Ontario.
PARTICIPANTS:
One hundred sixty patients aged 18 to 65 years meeting DSM-IV criteria for major depressive disorder with a minimum of 2 past episodes. Of these, 84 achieved remission (52.5%) and were assigned to 1 of the 3 study conditions.
INTERVENTIONS:
Patients in remission discontinued their antidepressants and attended 8 weekly group sessions of MBCT, continued taking their therapeutic dose of antidepressant medication, or discontinued active medication and were switched to placebo.
MAIN OUTCOME MEASURE:
Relapse was defined as a return, for at least 2 weeks, of symptoms sufficient to meet the criteria for major depression on module A of the Structured Clinical Interview for DSM-IV.
RESULTS:
Intention-to-treat analyses showed a significant interaction between the quality of acute-phase remission and subsequent prevention of relapse in randomized patients (P = .03). Among unstable remitters (1 or more Hamilton Rating Scale for Depression score >7 during remission), patients in both MBCT and maintenance treatment showed a 73% decrease in hazard compared with placebo (P = .03), whereas for stable remitters (all Hamilton Rating Scale for Depression scores ≤7 during remission) there were no group differences in survival.
CONCLUSIONS:
For depressed patients achieving stable or unstable clinical remission, MBCT offers protection against relapse/recurrence on a par with that of maintenance antidepressant pharmacotherapy. Our data also highlight the importance of maintaining at least 1 long-term active treatment in unstable remitters.
This systematic review analyzes current data on effects of exercise interventions and physical activity behavior on objective and subjective cancer related cognitive impairments (CRCI). Out of the 19 studies which met all inclusion criteria, five RCTs investigated rodents, whereas the other 14 trials explored humans and these included six RCTs, one controlled trial, two prospective noncontrolled trials, one case series, one observational study, and three cross-sectional studies. The results from animal models revealed positive effects of exercise during and after chemotherapy or radiation on structural alterations of the central nervous system, physiological as well as neuropsychological outcomes. The overall study quality in patient studies was poor. The current data on intervention studies showed preliminary positive effects of Asian-influenced movement programs (e.g., Yoga) with benefits on self-perceived cognitive functions as well as a reduction of chronic inflammation for breast cancer patients in the aftercare. Exercise potentially contributes to the prevention and rehabilitation of CRCI. Additional RCTs with standardized neuropsychological assessments and controlling for potential confounders are needed to confirm and expand preliminary findings.
This systematic review analyzes current data on effects of exercise interventions and physical activity behavior on objective and subjective cancer related cognitive impairments (CRCI). Out of the 19 studies which met all inclusion criteria, five RCTs investigated rodents, whereas the other 14 trials explored humans and these included six RCTs, one controlled trial, two prospective noncontrolled trials, one case series, one observational study, and three cross-sectional studies. The results from animal models revealed positive effects of exercise during and after chemotherapy or radiation on structural alterations of the central nervous system, physiological as well as neuropsychological outcomes. The overall study quality in patient studies was poor. The current data on intervention studies showed preliminary positive effects of Asian-influenced movement programs (e.g., Yoga) with benefits on self-perceived cognitive functions as well as a reduction of chronic inflammation for breast cancer patients in the aftercare. Exercise potentially contributes to the prevention and rehabilitation of CRCI. Additional RCTs with standardized neuropsychological assessments and controlling for potential confounders are needed to confirm and expand preliminary findings.
The intent of the current research was to explore the impact of a specific Tibetan Buddhist meditation course containing a lab for applied practice of modern techniques upon psychological well-being in college students. We evaluated the impact of a semester-long undergraduate Tibetan Buddhist meditation course on the psychological well-being of 205 students and assessed whether changes in well-being were mediated by mindfulness. The course was composed of two weekly lectures regarding the tradition and modern applications of meditation, respectively, and a weekly lab in which the students were taught a survey of related modern contemplative techniques to practice. Students were assessed at the beginning, middle, and end of the course, and their time spent practicing the exercises were prospectively recorded. Participants reported statistically significant increases in self-reported mindfulness, self-compassion, and positive coping and significant decreases in self-reported anxiety. Mindfulness was a significant predictor of changes in self-compassion and anxiety. These results suggest that a large lecture course with weekly meditation practice can have a positive impact on the psychological well-being of students and that some of these changes are mediated by mindfulness.
The intent of the current research was to explore the impact of a specific Tibetan Buddhist meditation course containing a lab for applied practice of modern techniques upon psychological well-being in college students. We evaluated the impact of a semester-long undergraduate Tibetan Buddhist meditation course on the psychological well-being of 205 students and assessed whether changes in well-being were mediated by mindfulness. The course was composed of two weekly lectures regarding the tradition and modern applications of meditation, respectively, and a weekly lab in which the students were taught a survey of related modern contemplative techniques to practice. Students were assessed at the beginning, middle, and end of the course, and their time spent practicing the exercises were prospectively recorded. Participants reported statistically significant increases in self-reported mindfulness, self-compassion, and positive coping and significant decreases in self-reported anxiety. Mindfulness was a significant predictor of changes in self-compassion and anxiety. These results suggest that a large lecture course with weekly meditation practice can have a positive impact on the psychological well-being of students and that some of these changes are mediated by mindfulness. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
Self-compassion has consistently been found to be related to well-being (Barnard & Curry 2011). Most research has focused on the intrapersonal benefits of self-compassion, such as its positive relationships with happiness, optimism, positive affect (Neff & Vonk, 2009), and life satisfaction (Neff, Kirkpatrick, & Rude, 2007). In contrast, little research has addressed how engaging in self-compassion may be beneficial to one’s relationships. There is strong evidence that social connectedness (e.g. Lee, Draper, & Lee, 2001; Lee & Robbins, 1998; Mauss et al., 2011; Neff, 2003b) and interpersonal competence (e.g Fiori, Antonucci, & Cortina, 2006; Berkman & Syme, 1979; Delongis, Folkman, & Lazarus, 1988) are positively related to well- being in a variety of ways. The purpose of this study was to investigate whether self-compassion is related to social connectedness and interpersonal competence. Responding to oneself with self-compassion may allow a person to be more present and attentive to others in interpersonal contexts, rather than being self-critical and focused on one’s own manner of engaging. Two hundred thirty-one participants were recruited from a university in the pacific northwest and completed the Self-Compassion Scale (SCS; Neff, 2003b), Social Connectedness Scale-Revised (SCS-R; Lee, Draper, & Lee, 2001), and Interpersonal Competence Questionnaire (ICQ; Buhrmester, Furman, Wittenberg, & Reis, 1988). Self-compassion was examined as a global construct. In addition, six components of self-compassion were also explored: “(a) self- kindness—extending kindness and understanding to oneself, (b) common humanity—seeing one’s experiences as part of the larger human experience, and (c) mindfulness—holding one’s painful thoughts and feelings in balanced awareness,” as well as the opposites of these, (self- judgment versus self-kindness, isolation versus common humanity, and over-identification versus mindfulness; Neff, 2003b). Results indicated that: 1) self-compassion and all of its subscales are significantly related to social connectedness, 2) the self-kindness and isolation subscales of self-compassion are predictive of social connectedness, 3) people reporting a greater tendency toward self-compassion were more likely to report initiating interpersonal interactions with others, engaging in more self-disclosure, and offering more emotional support to others, and 4) the components of self-compassion are all significantly related to the initiation and self- disclosure domains of interpersonal competence, but they have a more complex relationship with emotional support. These results lend further support to the importance of self-compassion to interpersonal functioning and underscore its importance to well-being overall.
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.