Mechanisms of Change in Mindfulness-Based Cognitive Therapy for Depression: Preliminary Evidence from a Randomized Controlled Trial
Mechanisms of Change in Mindfulness-Based Cognitive Therapy for Depression: Preliminary Evidence from a Randomized Controlled Trial
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DOI：
10.1521/ijct.2010.3.4.402
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发表时间：
2010-12-01
影响因子：
2.6
通讯作者：
Bootzin, Richard R.
中科院分区：
文献类型：
--
作者：
Shahar, Ben;Britton, Willoughby B.;Bootzin, Richard R.
基于正念的认知疗法（MBCT）是一种有效的治疗方法，可以减少复发性抑郁症成年人的抑郁复发和残留抑郁症状，但这种治疗的具体机制还有待研究。本研究采用随机对照试验的方法，探讨正念认知疗法对抑郁症状的即时（治疗前到治疗后）效果及其潜在的理论驱动的改变机制。复发性抑郁症患者，其中大多数在部分缓解，被随机分为8周MBCT组（N = 26）或等待名单对照组（N = 19）。参与者在干预前后完成了抑郁症状的测量以及反刍和特质正念的测量。与MBCT改变理论相一致，基于引导的中介分析表明，沉思（沉思的一个方面）的减少和正念的增加独立和独特（考虑其他中介）介导了干预对抑郁症状的影响。考虑到前后设计和缺乏时间优先性，这些研究结果提供了初步证据，支持正念和沉思可能是MBCT影响抑郁结果的重要变化过程。
Mindfulness-based cognitive therapy (MBCT) is an effective treatment for reducing depressive relapse as well as residual depressive symptoms among adults with recurrent depression but the specific mechanisms through which this treatment works have yet to be examined. This study investigated MBCT's immediate (pre to post) effects on depressive symptoms and its potential theory-driven change mechanisms in a wait-list randomized control trial. Recurrently depressed patients, the majority of them in partial remission, were randomized to either an 8-week MBCT group (N = 26) or a wait-list control group (N = 19). Participants completed measures of depressive symptoms as well as measures of rumination and trait mindfulness before and after the intervention. Consistent with the MBCT change theory, bootstrapping-based mediation analyses demonstrated that reductions in brooding (an aspect of rumination) and increases in mindfulness independently and uniquely (accounting for other mediators) mediated the effects of the intervention on depressive symptoms. Given the pre-post design and the lack of temporal precedence, these findings provide initial evidence supporting the notion that mindfulness and brooding may be important change processes through which MBCT affects depressive outcomes.