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Clin Psychol Rev. 2015 Apr;37:26-39. doi: 10.1016/j.cpr.2015.02.001. Epub 2015 Feb 11.

A systematic review of mechanisms of change in mindfulness-based cognitive therapy in the treatment of recurrent major depressive disorder.

Author information

1
Danish Center for Mindfulness at the Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Aarhus, Denmark; Department of Psychology, Copenhagen University, Copenhagen, Denmark.
2
Mood Disorders Centre, University of Exeter, Exeter, UK; Department of Psychiatry, University of Oxford, Oxford, UK.
3
Wattar Gruppen, Kognitiv Center, Copenhagen, Denmark.
4
Department of Psychiatry, University of Oxford, Oxford, UK.
5
Danish Center for Mindfulness at the Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Aarhus, Denmark.
6
Department of Psychology and Behavioral Sciences, Aarhus University, Aarhus, Denmark.

Abstract

BACKGROUND:

The investigation of treatment mechanisms in randomized controlled trials has considerable clinical and theoretical relevance. Despite the empirical support for the effect of mindfulness-based cognitive therapy (MBCT) in the treatment of recurrent major depressive disorder (MDD), the specific mechanisms by which MBCT leads to therapeutic change remain unclear.

OBJECTIVE:

By means of a systematic review we evaluate how the field is progressing in its empirical investigation of mechanisms of change in MBCT for recurrent MDD.

METHOD:

To identify relevant studies, a systematic search was conducted. Studies were coded and ranked for quality.

RESULTS:

The search produced 476 articles, of which 23 were included. In line with the theoretical premise, 12 studies found that alterations in mindfulness, rumination, worry, compassion, or meta-awareness were associated with, predicted or mediated MBCT's effect on treatment outcome. In addition, preliminary studies indicated that alterations in attention, memory specificity, self-discrepancy, emotional reactivity and momentary positive and negative affect might play a role in how MBCT exerts its clinical effects.

CONCLUSION:

The results suggest that MBCT could work through some of the MBCT model's theoretically predicted mechanisms. However, there is a need for more rigorous designs that can assess greater levels of causal specificity.

KEYWORDS:

Depression; MBCT; Mediation; Mindfulness; Review; Treatment mechanisms

PMID:
25748559
DOI:
10.1016/j.cpr.2015.02.001
[Indexed for MEDLINE]
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