Positive Shifts in Emotion Evaluation Following Mindfulness-Based Cognitive Therapy (MBCT) in Remitted Depressed Participants

Objectives: A combination of negatively biased information processing and a reduced ability to experience positive emotions can persist into remission from major depression (rMDD). Studies have shown that mindfulness-based cognitive therapy (MBCT) can increase self-reported positive emotions in rMDD participants; similar changes using neuropsychological tasks have not been shown. In this study, we investigated neuropsychological change in emotional processing following MBCT in rMDD participants. Methods: Seventy-three rMDD participants, 40 of whom received MBCT and 33 of whom continued with treatment as usual (TAU), and 42 never depressed participants took part; neither the TAU nor never depressed participants received MBCT. All were assessed at baseline and immediately following MBCT or after an 8-week gap for those without active intervention. Participants completed emotion evaluation and face emotion recognition tasks with self-report measures (mood, mindfulness) at each session. Results: Results showed an MBCT-specific shift in ratings from less negative to more positive emotion evaluations, which correlated with mindfulness practice and self-report mindfulness change. Both the MBCT and TAU groups showed a small increase in overall face emotion recognition accuracy compared with no change in never depressed participants. Conclusions: These findings support a specific role for MBCT in encouraging more positive evaluations of life situations in those with previous depression rather than influencing lower-level processing of emotions. Results should be interpreted cautiously given that this was a non-randomised, preference choice trial. Trial Registration: NCT0222604

How Does MBCT for Depression Work? Studying Cognitive and Affective Mediation Pathways

Mindfulness based cognitive therapy (MBCT) is a non-pharmacological intervention to reduce current symptoms and to prevent recurrence of major depressive disorder. At present, it is not well understood which underlying mechanisms during MBCT are associated with its efficacy. The current study (n = 130) was designed to examine the roles of mindfulness skills, rumination, worry and affect, and the interplay between those factors, in the mechanisms of change in MBCT for residual depressive symptoms. An exploratory but systematic approach was chosen using Sobel-Goodman mediation analyses to identify mediators on the pathway from MBCT to reduction in depressive symptoms. We replicated earlier findings that therapeutic effects of MBCT are mediated by changes in mindfulness skills and worry. Second, results showed that changes in momentary positive and negative affect significantly mediated the efficacy of MBCT, and also mediated the effect of worry on depressive symptoms. Third, within the group of patients with a prior history of = 3 episodes of MDD, only changes in affect were significant mediators for the effect of MBCT. Trail Registration: Nederlands Trial Register NTR108