Abstract
Objective: In patients with a history of suicidal depression, recurrence of depressive symptoms can easily reactivate suicidal thinking. In this study, we investigated whether training in mindfulness, which is aimed at helping patients “decenter” from negative thinking, could help weaken the link between depressive symptoms and suicidal cognitions. Method: Analyses were based on data from a recent randomized controlled trial, in which previously suicidal patients were allocated to mindfulness-based cognitive therapy (MBCT), an active control treatment, cognitive psychoeducation (CPE), which did not include any meditation practice, or treatment as usual (TAU). After the end of the treatment phase, we compared the associations between depressive symptoms, as assessed through self-reports on the Beck Depression Inventory–II (Beck, Steer, & Brown, 1996), and suicidal thinking, as assessed through the Suicidal Cognitions Scale (Rudd et al., 2001). Results: In patients with minimal to moderate symptoms at the time of assessment, comparisons of the correlations between depressive symptoms and suicidal cognitions showed significant differences between the groups. Although suicidal cognitions were significantly related to levels of symptoms in the 2 control groups, there was no such relation in the MBCT group. Conclusion: The findings suggest that, in patients with a history of suicidal depression, training in mindfulness can help to weaken the association between depressive symptoms and suicidal thinking, and thus reduce an important vulnerability for relapse to suicidal depression.
Highlights
What is the public health significance of this article? This study suggests that mindfulness-based cognitive therapy can help to uncouple the link between suicidal thinking and depressive symptoms in patients who have suffered from suicidal depression in the past
It has been suggested that, in patients with a history of suicidal depression, changes in mood can reactivate a suicidal mode of processing, reflected in cognitions revolving around core beliefs of unlovability, helplessness, and poor distress tolerance
To investigate whether training in mindfulness can uncouple this link, in the current study, we investigated the relations between levels of depressive symptoms and levels of suicidal cognitions in different treatment groups of a randomized, controlled trial
Summary
In patients with a history of suicidal depression, recurrence of depressive symptoms can reactivate suicidal thinking. The aim of the current analyses was to investigate whether mindfulness training can provide an effective tool for weakening the link between depressive symptoms and suicidal cognitions related to the core beliefs of the suicidal mode described by Rudd (2000) To test this hypothesis, we analyzed data from a randomized, controlled trial of MBCT for relapse prevention that included a large number of participants with a history of suicidal depression. Patients reported levels of suicidal cognitions related to the core beliefs of unlovability, helplessness, and poor distress tolerance as measured on the Suicidal Cognitions Scale by Rudd, Joiner and Rajab (2001), assessed before and after the treatment phase This provided the opportunity to investigate effects on the association between current depressive symptoms and suicidal cognitions. We hypothesized that following MBCT, suicidal reactivity, as indicated by correlations between symptoms of depression and suicidal cognitions, would be significantly lower than following treatment with CPE (which included verbal discussion of decentering but no mindfulness practice) and TAU, which was unlikely to include any systematic training of or reference to decentering strategies
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