The Effects and Mechanisms of MBCT on Depressive Symtoms and Depression Relapse

描述（由申请人提供）：本研究计划旨在阐明MBCT在复发性MDD缓解人群中的疗效和机制。这项研究的第一个目的是复制以前的研究结果，即MBCT对减少抑郁症状和抑郁复发率的影响。然而，这项建议的目的是通过使用一个随机的，控制的设计，并比较MBCT的效果，主动控制条件（ACC）的文献作出新的贡献。使用一个设计良好的ACC将使我们能够控制混杂变量，如社会支持和预期的结果，从而使我们能够确定是否特定的MBCT元素导致其有益的效果（目标1）。以前的正念认知疗法研究主要依赖于自我报告的测量方法，限制了关于正念认知疗法性质的有效结论。此外，很少有研究探讨MBCT对抑郁症状和复发的潜在作用机制。理论上的考虑和初步的经验证据表明，情感，生理和认知功能是有前途的MBCT机制。因此，我们建议使用自我报告，自主神经， 生理和反应时间任务。(Aim 2）。总的来说，这些目标预计将加强 MBCT的证据基础，同时培养其减少抑郁症状和抑郁复发率的作用和机制的科学模型。 公共卫生相关性：到2020年，抑郁症将成为全球第二大健康不良因素，这一严重的公共卫生问题导致了旨在降低抑郁症状严重程度和减少抑郁症复发的干预措施的激增。一些关于CAM治疗抑郁症的研究表明，冥想是一种有前途的干预措施。特别是，基于正念的认知疗法（MBCT），一种结构化的正念冥想干预，已被证明可以减少与复发性重度抑郁症（MDD）相关的抑郁症状和抑郁复发率。虽然MBCT研究是有希望的，但必须进行进一步严格的研究，以确定MBCT治疗抑郁症的疗效，特异性和机制。培养MBCT的实证支持和科学模型对于其蓬勃发展的治疗价值，有效性和对不同人群的抑郁症患者的可用性至关重要。

DESCRIPTION (provided by applicant): This research proposal is intended to elucidate the efficacy and mechanisms underlying MBCT in a population in remission from recurrent MDD. The first objective of the study is to replicate previous studies' findings of MBCT's effects on decreasing depressive symptoms and depression relapse rates. However, this proposal aims to make a novel contribution to the literature by using a randomized, controlled design, and comparing the effects of MBCT to an active control condition (ACC). The use of a well-designed ACC will enable us to control for confounding variables such as social support and expected outcomes, thus allowing us to determine whether elements specific to MBCT lead to its salutary effects (Aim 1). Previous MBCT studies have largely relied on self-report measurement methodologies, limiting valid conclusions about the nature of MBCT. Further, few studies have examined the mechanisms underlying effects of MBCT on depressive symptoms and relapse. Theoretical considerations and preliminary empirical evidence suggest emotional, physiological, and cognitive functioning to be promising mechanisms of MBCT. Therefore, we propose to assess each of these potential mechanisms of MBCT using self-report, autonomic physiological, and reaction time tasks. (Aim 2). Collectively, these aims are expected to strengthen the evidence base for MBCT while cultivating a scientific model for its effects and mechanisms on decreasing depressive symptoms and depression relapse rates. PUBLIC HEALTH RELEVANCE: The grave public health concern that by 2020 depression will be the second largest contributor to ill-health world-wide has resulted In a surge of interventions aimed at reducing the severity of depressive symptoms and decreasing depression relapse. Some research on CAM treatments for depression suggests meditation to be a promising intervention. In particular, Mindfulness-Based Cognitive Therapy (MBCT), a structured mindfulness meditation intervention, has been shown to reduce depressive symptoms and depression relapse rates associated with recurrent major depressive disorder (MDD). While MBCT studies are promising, further rigorous research must be conducted in order to determine the efficacy, specificity, and mechanisms underlying MBCT for depression. Cultivating empirical support and a scientific model of MBCT is vital to its flourishing therapeutic value, validity, and availability to a diverse population of depression sufferers.