Effects of Mindfulness-Based Cognitive Therapy on a Behavioural Measure of Rumination in Patients with Chronic, Treatment-Resistant Depression

Mira B Cladder-Micus,Janna N Vrijsen,Eni S Becker,Jan Spijker,Anne E M Speckens

doi:10.1007/s10608-019-09997-8

Abstract

It has been found that Mindfulness-based cognitive therapy (MBCT) reduces rumination in remitted and currently depressed patients. However, less is known about the effects of MBCT on rumination in chronically and treatment-resistant depressed patients. Typically, questionnaires are used to assess rumination, but this introduces the risk of response and recall biases. A recent systematic review (van der Velden et al. Clinical Psychology Review 37:26–39, 2015) proposes to also include behavioural measures. A behavioural measure that has previously been used to assess rumination in dysphoric students is the breathing focus task (BFT). The first aim of this research was to investigate whether the BFT can be used in chronically, treatment-resistant depressed patients to measure rumination. We therefore administered the BFT in patients with chronic, treatment-resistant depression (n = 73) and compared them with never-depressed controls (n = 106). Patients reported significantly more negative thought intrusions and subsequent sad mood. Secondly we tested in a randomized-controlled trial whether MBCT in combination with treatment-as-usual (MBCT + TAU, n = 26) compared with TAU (n = 36) reduces rumination assessed with the BFT in chronically, treatment-resistant depressed patients. Negative thought intrusions significantly decreased in the MBCT + TAU condition, compared with TAU. The results show that MBCT reduces rumination assessed with the BFT in chronically, treatment-resistant depressed patients.

Highlights

Mindfulness-based cognitive therapy (MBCT) is an 8-week group training for depression that combines mindfulness meditation techniques with elements of cognitive behavioural therapy (Segal et al 2012)
There is a need for state rumination measures that are independent of depressive symptoms because this would allow testing specific hypotheses about the effects of interventions on rumination and depressive symptoms (LeMoult et al 2013)
The results show that participants of MBCT + TAU compared with TAU show a decrease of negative thought intrusions on the breathing focus task (BFT)

Summary

Introduction

Mindfulness-based cognitive therapy (MBCT) is an 8-week group training for depression that combines mindfulness meditation techniques with elements of cognitive behavioural therapy (Segal et al 2012). In. It is assumed that MBCT decreases depressive symptoms by reducing dysfunctional cognitive processes, depressive rumination (Segal et al 2012). Nolen-Hoeksema et al (2008) define depressive rumination as the repetitive dwelling on negative emotions and their causes and implications. Researchers (Ehring and Watkins 2008; Harvey et al 2004) have argued that rumination together with other negative dysfunctional cognitive processes, such as worry, can be described as ‘repetitive negative thinking’ (RNT). Ehring et al (2011) formulated three key characteristics of repetitive negative thinking: “(1a) Researchers (Ehring and Watkins 2008; Harvey et al 2004) have argued that rumination together with other negative dysfunctional cognitive processes, such as worry, can be described as ‘repetitive negative thinking’ (RNT). Ehring et al (2011) formulated three key characteristics of repetitive negative thinking: “(1a)

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