Studies have similarly sought to compare the effect of MBCT treatments and psychopharmacological treatments. Namely, Kuyken et al. (2008) conducted a study with two randomized controlled trials in which one was comprised of individuals currently on antidepressants as a maintenance method for depression while the other was comprised of individuals who were exposed to MBCT and were on a discontinuance plan for antidepressants. The subject sizes of these groups were relatively equal, with both groups containing 60 individuals. The results of this study indicated that at the 15 month follow-up mark, the relapse rate in relation to depression was 47% in those who had experienced MBCT as compared to 60% relapse rate in the individuals who were in the maintenance antidepressant group. Hence, overall the results of this study exhibited that MBCT was more effective than maintenance antidepressants in these subjects at reducing symptoms of depression and it also augmented emotional well-being. Also, within the MBCT group, rates of antidepressant medication usage were reduced in that three quarters of this group stopped using antidepressant medication. Thus, Kuyken et al. concluded that MBCT may be a viable alternative at prevention of depressive relapse in individuals. Overall, the researcher of this review deduced that MBCT can play a crucial role in preventing depression long term by creating a different way for individuals to relate to their thoughts as opposed to merely correcting the chemical imbalance with medication.
Kuyken et al. (2010) studied whether MBCT treatment effects become mediated through enhanced mindfulness, increased self-compassion, and changes in cognitive reactivity in treatment. Levels of mindfulness and self-compassion were analyzed prior to and after MBCT treatment and the maintenance antidepressant medication group. This study included 123 participants who had experienced three or more previous episodes of depression and who had been treated successfully with antidepressant medication. The participants were assigned to either a group of MBCT treatment or a group of maintenance antidepressant medication. Mindfulness and cognitive reactivity were measured with usage of a self-report questionnaire. Cognitive reactivity came to be defined in relation to changes in depressive thinking. Overall, the results of this study indicated that the treatment effects were mediated by increases in self-compassion and mindfulness. Treatment effects of MBCT were also shown to be mediated by unlinking the relationship between depressed thinking and unfavorable outcome in therapy. Delinking this relationship also created more self-compassion in the participants (Kuyken et al., 2010). A potential criticism of this study is that it relied on self-report questionnaires, which are subject to biases in completion and self-presentation.
Kingston, Dooley, Bates, Lawlor, and Malone (2007) studied how to reduce depressive symptoms in outpatient individuals with residual depression. As well, this study sought to determine the effects affiliated with mindfulness on reducing ruminative thought processes. In this study, the first design contained 19 individuals who were assigned to receiving MBCT or their treatment as usual for depression. In the second design of this study, the treatment as usual group participated in a MBCT group and the researchers observed that the BDI and rumination tests of the groups were reduced. Symptoms of depression and rumination were also analyzed prior to, during, and posttreatment at the one-month follow-up point. The results of this study indicated that depressive symptoms were significantly reduced at the end of MBCT and an even further reduction in relation to symptoms was observed in the one-month follow-up time period. Reduction in relation to ruminative scores was also exhibited. Hence, overall Kingston et al. concluded that group MBCT has a potent effect on reducing depressive symptoms that are residual. Depressive symptoms in the participants were also mediated through MBCT approaches to negative, ruminative thought processes in individuals experiencing residual depressive symptoms after a depressive episode (Kingston et al., 2007). A limitation of this study is that only 19 individuals were used. This may inhibit the ability of the study to be generalized. As well, in the second component of the study the same subjects were used to receive MBCT who had initially received treatment as usual. This method of dividing subjects may mean that the individuals could have potentially benefit from the treatment as usual condition prior to receiving MBCT. Therefore, this could mean that MBCT may not have been the primary determinant of decrease in depressive symptoms.
In addition to assisting in reduction of these symptoms of depression, MBCT also plays a useful role in helping one to experience and appreciate daily pleasantries in life. Particularly, Geschwind, Peeters, Drukker, Van Os, and Wichers (2011) found this result when they undertook a study to determine if MBCT increases positive emotions or increases one’s ability to use rewards and resources in one’s daily life. The individuals in this study experienced a life-time history of depressive symptoms and at the time of the study were in remission. The participants were then randomized to either a MBCT group or a wait-list control group. An experience sampling method was utilized in order to measure positive emotions and ability to appraise pleasant activities in daily life prior to and after the intervention occurred. Residual symptoms of depression were measured by the Hamilton Depression Rating Scale. The results of this study concluded that MBCT was affiliated with increased appraisal of positive emotions, increased praising of positive activities, and an increased ability to engage in pleasant activities to increase positive emotions. As well, in the MBCT condition, increased positive emotion was affiliated with reduction in residual depressive symptoms. Geschwind et al. stated that the results that were yielded in this study had an unlikely occurrence of being merely from alleviation of depressive symptoms. Geschwind et al. further stated that MBCT offers a protective effect against depression since this method generates positive emotions which make individuals more resilient.
Leary, Tate, Adams, Batts Allen, and Hancock’s (2007) study also demonstrated that mindfulness can assist one to transform negative events experienced in life into something positive. The study was a meta-analytic overview of five studies which examined the emotional and cognitive processes used by self-compassionate individuals to life events that are unpleasant. The result of these five studies was that self-compassion reduced negative reactions people had to adverse life events. Self-compassion was also found to be a mitigating factor against negative self-perceptions when experiencing or imagining distressing social events (Leary et al., 2007).
Watkins and Teasdale (2004) conducted a study on 28 individuals suffering from depression who used either analytical thinking styles or thoughts that focused on the present moment. This study was conducted in order to determine if overgeneral memory would be reduced by engaging in experiential self-focus as opposed to analytical thinking. Overgeneral memory is defined as a form of memory in which individuals retrieve more generic perceptions of the past as opposed to retrieving specific events (Williams, Teasdale, Segal, & Soulsby, 2000). Watkins and Teasdale stated that Overgeneral autobiographical memory creates poor clinical prognosis in individuals. The participants in this study completed the autobiographical memory test before and after self-focus exercises (Watkins & Teasdale, 2004). The results of this study indicated that experiential self-focus facilitated reduced overgeneral memory as compared to when analytical self-focus was utilized by the participants (Watkins & Teasdale, 2004). However, overall, these two forms of self-focus did not differ in relation to the effects they had on mood symptoms (Watkins & Teasdale, 2004). Hence, overall the results of this study indicated that dissociation can occur between overgeneral memory and depressed mood (Watkins & Teasdale, 2004). A limitation of this study is that only 28 participants were included, which creates issues with generalizability.
Williams, Duggan, Crane, and Fennell (2006) described that another useful function of MBCT is its ability to prevent reactivation of suicidal ideation in individuals Namely, Williams et al. stated in their review that when suicidal thoughts have occurred as a result of depression, then there is a likelihood that they will recur when sad mood develops. Williams et al. also noted that pilot work conducted in this area demonstrated that MBCT is a useful intervention for preventing recurrence of suicidal ideation in depressed individuals who have previously had suicidal thoughts. Williams et al. stated that mindfulness-based interventions are useful to prevent depression since they allow for one to see suicidal and depressive thoughts as merely thoughts as opposed to viewing them as facts.
Hofmann, Sawyer, Witt, and Oh (2010) conducted a study to determine the effect of mindfulness-based interventions on mitigating anxiety and mood-related symptoms within a clinical populace. In this study, a meta-analysis was undertaken using 39 studies which included 1,140 participants who received therapy from a mindfulness-based modality for a variety of psychopathologies. The results of this study indicated that mindfulness-based therapy is a useful treatment method for anxiety and mood-related issues in a clinical population.
Bondolfi et al.’s (2010) study demonstrated mixed results in relation to the benefits of MBCT. Bondolfi et al. conducted a study to replicate previous studies pertaining to the effect of MBCT on preventing relapse of depression. The effect of MBCT was tested on individuals who were exposed to treatment as usual and then on individuals who underwent treatment as usual in addition to MBCT (Bondolfi et al., 2010). In this study, 60 patients were used who were currently in remission from depression and were unmedicated (Bondolfi et al., 2010). Relapse rate in addition to time taken to relapse was measured over the course of a 60-week observational period (Bondolfi et al., 2010). In a follow-up 14 months later, the time to relapse was longer for individuals who had undergone MBCT in addition to their treatment as usual as opposed to those who merely experienced treatment as usual (Bondolfi et al., 2010). However, Bondolfi et al. also found that the frequency of informal or brief mindfulness practice remained stagnant over 14 months. Also, Bondolfi et al. found that that there was also a decrease in longer, formal mindfulness practice as time progressed. A limitation of this study is that future studies are needed in order to determine which characteristics other than quantity of previous depressive episodes are able to predict benefits from mindfulness practice. An overall limitation in relation to mindfulness-based practice is that longer practices are practiced less over time. This is problematic since longer meditative practices have been shown to be more effective at alleviating depression symptoms (Carmody & Baer, 2008). Thus, although longer practices may be more effective, on a practical level it may be more useful to teach individuals shorter practices that they will maintain beyond treatment.
Williams et al. (2000) also investigated autobiographical memory’s effect on treatment of individuals experiencing depression as mitigated by mindfulness-based interventions. Individuals in this study were placed in either a treatment as usual grouping or a group in which they experienced treatment to reduce depression. The results of this study demonstrated that the group of individuals who received the treatment with the goal of reducing depressive relapse exhibited a reduction in generic memories. Williams et al. concluded therefore that memories can be modified. Hence, mindfulness-based techniques may be able to help individuals with a more healthy encoding process for their memories. However, a limitation of this study is that it demonstrated that memory deficits can create a pattern to retrieve events generically (Williams et al., 2000). Therefore, individuals may have an overall style of relating to memory content that creates their experience with depression as opposed to having experienced an effective treatment for depression.
