How does mindfulness-based cognitive therapy work?
How does mindfulness-based cognitive therapy work?
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DOI：
10.1016/j.brat.2010.08.003
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发表时间：
2010-11-01
影响因子：
4.1
通讯作者：
Dalgleish, Tim
中科院分区：
文献类型：
--
作者：
Kuyken, Willem;Watkins, Ed;Dalgleish, Tim
基于正念的认知疗法（MBCT）是对复发性抑郁症的有效的心理社会干预（Kuyken等人，2008; Ma & Teasdale，2004; Teasdale et al.. 2000）。到目前为止，没有令人信服的研究解决MBCT的变化机制。本研究确定MBCT的治疗效果是否是通过增强正念和自我同情来介导的，和/或通过改变治疗后的认知反应。该研究被嵌入在随机对照试验中，该试验比较了MBCT与维持性抗抑郁药（mADM），随访15个月（Kuyken等人，2008年）。在MBCT治疗前后（或在mADM组的同等时间点）评估正念和自我同情。在MBCT组疗程后一个月或mADM组的同等时间点评估治疗后反应性。123例既往有≥ 3次抑郁发作并成功接受抗抑郁药治疗的患者随机分为mADM组和MBCT组。MBCT组参与MBCT，一个基于小组的心理社会干预，教正念技能，并停止ADM。mADM组参与维持治疗ADM剂量的随访期间。在15个月的随访中，访谈者管理的结局指标评估了抑郁症状和复发/复发。正念和自我同情使用自我报告问卷进行测量。认知反应可操作为实验室情绪诱导期间抑郁思维的变化。MBCT的效果是通过在治疗过程中增强正念和自我同情来介导的。MBCT也改变了治疗后认知反应和结果之间关系的性质。更大的反应性预测更糟糕的结果为mADM参与者，但这种关系是不明显的MBCT group.MBCT的治疗效果介导的增强自我同情和正念，沿着的脱钩抑郁思维的反应性和不良结果之间的关系。这种分离与治疗过程中自我同情的培养有关。(C)2010爱思唯尔有限公司版权所有。
Mindfulness-based cognitive therapy (MBCT) is an efficacious psychosocial intervention for recurrent depression (Kuyken et al., 2008; Ma & Teasdale, 2004; Teasdale et al.. 2000). To date, no compelling research addresses MBCT's mechanisms of change. This study determines whether MBCT's treatment effects are mediated by enhancement of mindfulness and self-compassion across treatment, and/or by alterations in post-treatment cognitive reactivity. The study was embedded in a randomized controlled trial comparing MBCT with maintenance antidepressants (mADM) with 15-month follow-up (Kuyken et al., 2008). Mindfulness and self-compassion were assessed before and after MBCT treatment (or at equivalent time points in the mADM group). Post-treatment reactivity was assessed one month after the MBCT group sessions or at the equivalent time point in the mADM group. One hundred and twenty-three patients with >= 3 prior depressive episodes, and successfully treated with antidepressants, were randomized either to mADM or MBCT. The MBCT arm involved participation in MBCT, a group-based psychosocial intervention that teaches mindfulness skills, and discontinuation of ADM. The mADM arm involved maintenance on a therapeutic ADM dose for the duration of follow-up. Interviewer-administered outcome measures assessed depressive symptoms and relapse/recurrence across 15-month follow-up. Mindfulness and self-compassion were measured using self-report questionnaire. Cognitive reactivity was operationalized as change in depressive thinking during a laboratory mood induction.MBCT's effects were mediated by enhancement of mindfulness and self-compassion across treatment. MBCT also changed the nature of the relationship between post-treatment cognitive reactivity and outcome. Greater reactivity predicted worse outcome for mADM participants but this relationship was not evident in the MBCT group.MBCT's treatment effects are mediated by augmented self-compassion and mindfulness, along with a decoupling of the relationship between reactivity of depressive thinking and poor outcome. This decoupling is associated with the cultivation of self-compassion across treatment. (C) 2010 Elsevier Ltd. All rights reserved.