Mindfulness-based Cognitive Therapy Course Research Articles

The effectiveness of mindfulness-based cognitive therapy for social anxiety symptoms in people living with alopecia areata: a single-group case-series design.

Alopecia areata (AA) is an immunological disorder characterised by hair loss. Individuals with AA report high levels of social anxiety. One intervention that holds potential for reducing social anxiety in individuals with AA is mindfulness-based cognitive therapy (MBCT). Our key aim was to investigate whether MBCT reduces social anxiety in individuals with AA. The study also investigated whether MBCT reduces depression, general anxiety, and increases quality of life and increases trait mindfulness in individuals with AA. Five participants with AA took part in an 8-session in-person MBCT intervention. A multiple-baseline single-group case series design was adopted. Idiographic measures of social anxiety were measured each day from baseline, through intervention, to follow-up. Standardised questionnaires of trait mindfulness, social anxiety, depression, anxiety, and quality of life were completed at baseline, post-intervention, and at 4-week follow-up. All participants completed the MBCT course, but one participant was excluded from the idiographic analysis due to a high amount of missing data. The remaining four participants demonstrated reductions in idiographic measures of social anxiety from baseline to follow-up. These effects were larger between baseline and follow-up, than between baseline and post-intervention. Two participants demonstrated significant improvement in standardised measures of wellbeing from baseline to follow-up - they also practised mindfulness most regularly at home between sessions. MBCT may be effective in reducing social anxiety and improving wellbeing in individuals with AA, although this might be dependent on the extent to which participants regularly practise mindfulness exercises.

Preventing Depression Relapse: A Qualitative Study on the Need for Additional Structured Support Following Mindfulness-Based Cognitive Therapy.

Mindfulness-based cognitive therapy (MBCT) is an effective group intervention for reducing rates of depression relapse. However, about one-third of graduates experience relapse within 1year of completing the course. The current study aimed to explore the need and strategies for additional support following the MBCT course. We conducted 4 focus groups via videoconferencing, two with MBCT graduates (n = 9 in each group) and two with MBCT teachers (n = 9; n = 7). We explored participants' perceived need for and interest in MBCT programming beyond the core program and ways to optimize the long-term benefits of MBCT. We conducted thematic content analysis to identify patterns in transcribed focus group sessions. Through an iterative process, multiple researchers developed a codebook, independently coded the transcripts, and derived themes. Participants said the MBCT course is highly valued and was, for some, "life changing." Participants also described challenges with maintaining MBCT practices and sustaining benefits after the course despite using a range of approaches (ie, community and alumni-based meditation groups, mobile applications, taking the MBCT course a second time) to maintain mindfulness and meditative practice. One participant described finishing the MBCT course as feeling like "falling off a cliff." Both MBCT graduates and teachers were enthusiastic about the prospect of additional support following MBCT in the form of a maintenance program. Some MBCT graduates experienced difficulty maintaining practice of the skills they learned in the course. This is not surprising given that maintained behavior change is challenging and difficulty sustaining mindfulness practice after a mindfulness-based intervention is not specific to MBCT. Participants shared that additional support following the MBCT program is desired. Therefore, creating an MBCT maintenance program may help MBCT graduates maintain practice and sustain benefits longer-term, thereby decreasing risk for depression relapse.

Mindfulness-based intervention in patients with persistent pain in chest (MIPIC) of non-cardiac cause: a feasibility randomised control study

ObjectiveThe study evaluated the feasibility of mindfulness-based cognitive therapy (MBCT) in patients with non-cardiac chest pain by assessing their willingness to participate and adhere to the programme, and for these data to help further refine the content of MBCT for chest pain.Patients and methodsThis prospective 2:1 randomised controlled trial compared the intervention of adapted MBCT as an addition to usual care with just usual care in controls. Among 573 patients who attended the rapid access chest pain clinic over the previous 12 months and were not diagnosed with a cardiac cause but had persistent chest pain were invited. The intervention was a 2-hour, weekly, online guided 8-week MBCT course. Compliance with attendance and the home practice was recorded. Enrolled patients completed the Seattle angina questionnaire (SAQ), Hospital Anxiety and Depression Scale, Cardiac Anxiety Questionnaire, Five-Facet Mindfulness Questionnaire, and Euro Quality of Life–5 Dimensions–5 Level at baseline assessment and after 8-week period.ResultsPersistent chest pain was reported by 114 patients. Of these, 33 (29%) patients with a mean age of 54.2 (±12.2) years and 68% women, consented to the study. Baseline questionnaires revealed mild physical limitation (mean SAQ, 76.8±25), high levels of anxiety (76%) and depression (53%), modest cardiac anxiety (CAQ,1.78±0.61) and mindfulness score (FFMQ, 45.5±7.3). Six patients subsequently withdrew due to bereavement, caring responsibilities and ill health. Of the remaining 27 participants, 18 in the intervention arm attended an average of 5 sessions with 61% attending ≥6 sessions. Although not statistically powered, the study revealed a significant reduction in general anxiety, improved mindfulness and a trend towards improvement in SAQ scores in the intervention arm.ConclusionOne-third of patients with persistent non-cardiac chest pain were willing to participate in mindfulness-based therapy. An improvement in anxiety and mindfulness was detected in this feasibility study. A larger trial is required to demonstrate improvement in chest pain symptoms.

Audit of a Mindfulness-Based Cognitive Therapy Course Within a Prison.

This article examines the effectiveness of the 8-week mindfulness-based cognitive therapy course for depression within the prison population. Prisons see higher rates of mental ill health across the spectrum. This study examined how a manualized mindfulness approach to treating depression, a major cause of ill health, would affect this cohort. At the beginning of the course, participants were experiencing high levels of depression and anxiety, with low levels of mindfulness. At the end of 8 weeks, levels of depression and anxiety were reduced while mindfulness scores had increased, suggesting that mindfulness helped participants cope with difficult feelings and sensations. Retrospective study informed consent given by participants.

"You Can't Stop the Waves but You Can Learn to Surf": Mindfulness-Based Cognitive Therapy for People with Parkinson's Disease

<h3>Introduction</h3> Non-motor symptoms of Parkinson's disease (PD) are common and may lead to increased disability and functional impairment. Over half of people with PD experience anxiety and/or depression. Mindfulness-based interventions have been shown to alleviate physical and psychological symptoms of cancer, cardiovascular disease, chronic pain, anxiety, and depressive disorders. Mindfulness-based cognitive therapy (MBCT) is a manualized intervention conducted in 8-week group sessions, along with participant independent daily practice. MBCT combines mindfulness practice with cognitive therapy principles and has been shown to prevent the relapse of recurrent depression and improve anxiety. MBCT has been studied in patients with neurological diseases, including PD, albeit not extensively. In this pilot study, we aimed to investigate the effectiveness of MBCT in reducing anxiety and/or depression in people with PD. <h3>Methods</h3> A modified MBCT intervention was designed and offered to participants with PD and mild-moderate anxiety and/or depressive symptoms from the San Francisco Bay Area. IRB approval was obtained. Participants were recruited from local neurology clinics and through PD support groups. Two 8-week long MBCT groups were conducted, using a protocol adapted to the specific needs of people with PD. Participant demographic variables, prior experience with mindfulness, and pre- and post-intervention behavioral measures were collected (GAD-7, PHQ-9, and Five Facet Mindfulness Questionnaire-15 - FFMQ-15). A participant satisfaction survey was administered after the completion of the MBCT course. Descriptive analytics were used to analyze demographic and clinical variables and participant satisfaction survey responses. To make use of all available data, PHQ-9, GAD-7, and FFMQ scores pre- and post-intervention were compared using mixed-effects models implemented with PROC MIXED in SAS Version 9.4. This approach accounted for the correlated structure of the data due to repeated measures, allowed for missing data, and accommodated heterogeneous variances across assessment times. <h3>Results</h3> Of the 16 participants enrolled (8 per group), 15 completed the MBCT intervention (1 participant withdrew). Participants attended on average 7 of the 8 sessions. The statistical analysis revealed: • Significant reduction in PHQ-9 score post-intervention, compared to pre-intervention (<i>p</i> < 0.05) • Reduction in GAD-7 mean score post-intervention, compared to pre-intervention • Significant increase in FFMQ mean score post-intervention, compared to pre-intervention (<i>p</i> < 0.01). • 12 (80%) participants were very satisfied, 2 (13.3%) were satisfied, and 1 (6.7%) was dissatisfied with the overall MBCT course. • 14 (93.3%) participants planned to continue to practice mindfulness after completing the course, and 14 (93.3%) would recommend this intervention to family members or friends with PD. Tables 1-2 present the results. Table 1. Participant characteristics. Table 2. Behavioral measure scores, pre- and post-intervention. <h3>Conclusions</h3> At the completion of an 8-week modified MBCT course for people with PD, there was significant reduction in depressive symptoms. This pilot study shows that this is a feasible intervention for this population, met with high participant satisfaction. Discussion: COVID-19 pandemic started during the second MBCT group. Participants commented that this had increased their anxiety, which likely affected post-intervention GAD-7 scores in that group. The last 2 sessions were modified for online delivery, showing the versatility of this approach. Further research is needed to explore the effectiveness of MBCT in reducing anxiety and/or depressive symptoms in people with PD. <h3>Funding</h3> The Parkinson's Foundation

Experiences of Mindfulness-Based Cognitive Therapy for Premanifest Huntington's Disease.

Psychological difficulties such as anxiety, depression, and irritability are common in Huntington's disease, even for premanifest individuals. However, very little evidence exists of psychological approaches to manage this distress. We have conducted a feasibility study with an embedded qualitative component to investigate the possibility of using mindfulness-based cognitive therapy (MBCT) and present here the findings from the qualitative data. To investigate the experience of premanifest individuals learning and practising mindfulness through completing a course of MBCT. Twelve premanifest individuals completed a course of MBCT and attended three follow up reunion meetings over the following year. Eleven participants agreed to be interviewed post-course and ten participants one year post-course about their experience of the course and any impact on their lives. Seven participants nominated a friend or relative (supporter) to be involved in the research, of whom six agreed to be interviewed post-course and two at one year about the impact of the course on the participants. Data were analysed using reflexive thematic analysis. Four themes were constructed from the data: 1) A meeting of minds: the group facilitating learning and support; 2) Mindfulness is hard, but enables more effective emotional management; 3) Mindfulness can change the relationship with self and others; and 4) Benefiting from mindfulness: the importance of persistence. The participants who completed the course found it beneficial. Some participants reported reductions in psychological distress, a greater sense of calm and better emotion regulation, with some of these positive changes also noticed by supporters. MBCT is worthy of further investigation for this population.

Comparison of Mindfulness With and Without Practice Among Women in Custody

This study aimed to explore the effects of standardized mindfulness-based cognitive therapy (MBCT) and MBCT training without practice on the negative mood of women in custody. Eighty participants were assigned to the standard MBCT group, theoretical learning group, or waitlist control group. We assessed participants’ mindfulness, stress, depression, and anxiety before and after the interventions. The results showed that, compared with controls, participants in the standard MBCT course showed significant improvement in depression and state anxiety; they also showed significant improvement in perceived stress. Although similar effects on depression were observed in the theoretical learning group, this group did not show decreased anxiety. These findings suggest that practice plays a crucial role in MBCT’s effects on female prisoners’ mental health. This study provides important insights into the application of mindfulness-based interventions (MBIs) as promising treatments for improving responsivity factors of the risk–need–responsivity model for female incarcerated populations.

Participant perspectives on the acceptability and effectiveness of mindfulness-based cognitive behaviour therapy approaches for obsessive compulsive disorder.

Cognitive behavioural therapy (CBT) which includes Exposure and Response (ERP) is a highly effective, gold standard treatment for Obsessive-Compulsive Disorder (OCD). Nonetheless, not all patients with OCD significantly benefit from CBT. This has generated interest in the potential benefits of Mindfulness-Based Interventions (MBIs), either integrated with CBT, to enhance engagement with ERP tasks, or delivered as a stand-alone, first-line or therapy to augment CBT. This paper reports on two qualitative studies that involved a thematic analysis of interview data with participants in a 10-week Mindfulness-Based ERP (MB-ERP) course (study 1) and a 9-week Mindfulness-Based Cognitive Therapy course adapted for OCD (MBCT-OCD) (study 2). Whilst MB-ERP integrated a mindfulness component into a standard ERP protocol, MBCT-OCD adapted the psychoeducational components of the standard MBCT for depression protocol to suit OCD, but without explicit ERP tasks. Three common main themes emerged across MB-ERP and MBCT-OCD: ‘satisfaction with course features’, ‘acceptability of key therapeutic tasks ‘and ‘using mindfulness to respond differently to OCD’. Sub-themes identified under the first two main themes were mostly unique to MB-ERP or MBCT-OCD, with the exception of ‘(struggles with) developing a mindfulness practice routine’ whilst most of the sub-themes under the last main theme were shared across MB-ERP and MBCT-OCD participants. Findings suggested that participants generally perceived both MBIs as acceptable and potentially beneficial treatments for OCD, in line with theorised mechanisms of change.

Mindfulness and Affect During Mindfulness-Based Cognitive Therapy for Recurrent Depression: an Autoregressive Latent Trajectory Analysis

ObjectivesGaining knowledge of dynamic processes of mechanisms underlying mindfulness-based cognitive therapy (MBCT) for recurrent depression could help to improve treatment efficacy. The current study examined the overall course and week-to-week associations of mindfulness and positive/negative affect during MBCT for recurrent depression.MethodsUsing data from the MOMENT study, 235 patients with recurrent depression in (partial) remission allocated to MBCT were included. Prior to each MBCT session, self-reports were obtained on mindfulness, positive affect, and negative affect.ResultsAutoregressive latent trajectory (ALT) modeling revealed that, across the MBCT course, larger increases in mindfulness were associated with larger increases in positive affect (r = .80, p < .050). Higher general levels of negative affect were associated with smaller increases in mindfulness over time (r = −.26, p < .001). Week-to-week effects showed no reciprocal cross-lagged effects between mindfulness and positive affect or negative affect, except for positive affect at session 2 which was positively associated with mindfulness at session 3 (r = .11, p < .050).ConclusionsThe current study supports a positive association in strength of increase between mindfulness and positive affect, while higher general levels of negative affect might be associated with smaller increases of mindfulness during MBCT for recurrent depression. For future research, experience sampling methods (ESMs) are recommended to capture dynamics on a smaller time scale. ALT modeling techniques are advised to be better able to interpret the processes of stability and change during MBCT for recurrent depression.

\u201cI Need to Start Listening to What my Body Is Telling Me.\u201d: Does Mindfulness-Based Cognitive Therapy Help People with Chronic Fatigue Syndrome?

Mindfulness-Based Cognitive Therapy (MBCT) was lightly adapted for participants diagnosed with chronic fatigue syndrome (CFS). The aim of the study was to explore participants’ experiences of the MBCT course, with a particular focus on how they applied MBCT to living with and coping with the symptoms of CFS. Nine participants with CFS who completed the MBCT course were interviewed using semi-structured interview methods. Inductive thematic analysis, a methodology designed to generate themes from the “bottom up,” was used. Four superordinate themes were generated from the data: (1) awareness of unhelpful behavioral patterns associated with CFS, (2) benefits of group solidarity, (3) use of mindfulness tools to facilitate shifts in behavioral patterns, and (4) a sense of change and agency. Participants became aware of three specific transformative changes that contributed to a more skillful way of living with CFS: development of acceptance, improved self-care and self-compassion, and reduction in heightened stress response. MBCT appears to enable people with CFS to actively work with their symptoms, and make transformative changes in their behavioral patterns, resulting in benefits to well-being.

A feasibility investigation of mindfulness-based cognitive therapy for people with Huntington\u2019s disease

BackgroundHuntington’s disease (HD) is an inherited neurodegenerative condition which affects movement, coordination and cognitive functioning. Psychological difficulties are commonly experienced; however, psychological interventions have been little researched with this population. We investigated the feasibility of conducting a randomised controlled trial (RCT) of mindfulness-based cognitive therapy (MBCT) with people with the HD genetic mutation, either pre-manifest (before onset of movement symptoms) or at an early disease stage. Specifically, we evaluated the willingness of participants to be recruited into and complete the intervention; the acceptability of the study measures in relation to completion; the feasibility of offering the standard MBCT course to people with HD; the acceptability of the intervention and the estimated effect sizes.MethodsParticipants were recruited from two UK HD centres and took part in an 8-week course of MBCT, with three reunions throughout the following year. Stress, depression, anxiety, and mindfulness were measured pre-, mid-, and post-course, at 3 months and at 1 year. Sleep, quality of life, positive affect and coping were measured pre- and post-course, at 3 months and at 1 year. Descriptive data and approximate effect sizes were calculated. Interviews were conducted post-course and at 1 year and data pertaining to the acceptability of the course were extracted.ResultsTwelve participants took part in two groups; all were pre-manifest. Levels of depression and anxiety were low pre-course leaving little room for improvement. Changes in stress and in some aspects of mindfulness were medium to large. The qualitative data suggested participants rated the course highly and found it helpful and no changes to the standard course were needed. Recruitment levels were below those anticipated. Most measures were found to be acceptable.ConclusionsAlthough the course was acceptable to those who took part, given the difficulties in recruiting and the rarity of HD, conducting an RCT of MBCT teaching groups in person does not seem feasible. However, alternative modes of course delivery (e.g. online) would allow the recruitment of people from a greater geographical area and may make an RCT feasible; this revised focus would be suitable for future feasibility studies.Trial registrationClinicalTrials.gov identifier NCT02464293, registered 8 June 2015.

Mechanisms of Change in Mindfulness-Based Cognitive Therapy in Adults With ADHD

Objective: Mindfulness-based cognitive therapy (MBCT) has been demonstrated to be effective in adults with ADHD. The aim of the current study was to examine its possible working mechanisms. Method: In the context of an randomized controlled trial (RCT), MBCT + TAU (treatment as usual) (n = 43) versus TAU (n = 51), we used mediation analyses to examine whether reduction of clinician-rated ADHD symptoms and improvement of positive mental health at 6-month follow-up had been mediated by change in mindfulness skills, self-compassion, and executive functioning over the course of MBCT. Results: Increase of self-compassion mediated improvement of positive mental health at 6-month follow-up. Improvement of mindfulness skills or self-compassion did not mediate the reduction in ADHD symptoms. Additional analyses suggest that self-reported inhibition did. Conclusion: The effect of MBCT on ADHD symptoms and positive mental health thus occurred via different mechanisms of change, that is, by improvements in inhibition and self-compassion, respectively.

Mindfulness Improves Emotion Regulation and Executive Control on Bereaved Individuals: An fMRI Study.

The grief of bereavement is recognized as a severe psychosocial stressor that can trigger a variety of mental and physical disorders, and the long-lasting unresolved grief has a detrimental effect on brain functionality. Literature has documented mindfulness-based cognitive therapy (MBCT) as an efficient treatment for improving well-being, specifically related to the mood and cognition, in a variety of populations. However, little attention has been devoted to neural mechanisms with regard to bereaved individuals’ cognition after MBCT intervention. In this study, we recruited 23 bereaved participants who lost a significant relative within 6 months to 4 years to attend 8-week MBCT course. We used self-reporting questionnaires to measure emotion regulation and functional magnetic resonance imaging (fMRI) with the numerical Stroop task to evaluate the MBCT effect on executive control among the bereaved participants. The self-reported questionnaires showed improvements on mindfulness and reductions in grief, difficulties in emotion regulation, anxiety, and depression after the MBCT intervention. The fMRI analysis demonstrated two scenarios: (1) the activity of the fronto-parietal network slightly declined accompanied with significant improvements in the reaction time of incongruent trials; (2) the activities in the posterior cingulate cortex and thalamus were positively associated with the Texas Revised Inventory of Grief, implying emotional interferences on cognitive functions. Results indicated that MBCT facilitated the executive control function by alleviating the emotional interferences over the cognitive functions and suggested that the 8-week MBCT intervention significantly improved both executive control and emotion regulation in bereaved individuals.

The effects of Mindfulness-Based Cognitive Therapy (MBCT) on cognitive skills in young soccer players

&amp;lt;p&amp;gt;TThe aim of this study was to examine the effect of Mindfulness-Based Cognitive Therapy training on mental skills of young soccer players. For this purpose, 30 soccer players were assigned to an experimental group of 15 players (intervention based on Mindfulness) and control group of 15 players that participations&amp;amp;rsquo; age ranged from 17 to 20 years old in provincial competitions in the year 2017-18. Athletes in the experimental group participated in MBCT course over eight weekly sessions of 2 h each. The control group did not receive any intervention. Before and after interventions Ottawa mental skills assessment tool questionnaire (Omsat-3) were used to collect data. The results of MANOVA showed that significant improvement in all sub-scales scores; Focusing (P=0.001), Refocusing (P=0.001), Imagery (P=0.001), Mental practice (P=0.001), and Competition planning (P=0.001) in the experimental group than control group. According to these findings, we concluded that Mindfulness-Based Cognitive Therapy training is appropriate to improve the level of cognitive skills of soccer players.&amp;lt;/p&amp;gt;

Mindfulness-based cognitive therapy: An efficacy study for mental health care staff.

Burnout is a major concern within the NHS impacting negatively on mental healthcare professionals. Evidence suggests that burnout can lead to reduced productivity and reduced quality of care for patients. Mindfulness-based interventions (MBIs) have demonstrated effectiveness in mitigating burnout for healthcare professionals. This paper reinforces the positive outcomes within the current literature that MBIs can help reduce burnout amongst mental healthcare professionals. The strength of the paper is that it reports significant correlations between decreased burnout following an increase in mindfulness. No previous research has examined this area and this is the first study to do so. The participants within this study demonstrated increased personal accomplishment and decreased emotional exhaustion following an 8-week MBCT course which was maintained at 6-month follow-up. Occupational departments should consider MBI's as part of a package of care for mental healthcare staff as a preventative intervention or as a means of reducing burnout amongst healthcare staff that are currently experiencing emotional and physical exhaustion. Introduction Burnout is a major concern within the NHS impacting negatively on mental healthcare professionals. Evidence suggests that burnout can lead to reduced productivity and reduced quality of care for patients. Mindfulness-based interventions (MBIs) have demonstrated effectiveness in mitigating burnout for healthcare professionals; however, no previous research has directly reported correlations between burnout and mindfulness. Aim Does mindfulness-based cognitive therapy (MBCT) reduce burnout amongst mental healthcare professionals and are there any direct correlations between mindfulness and burnout itself? Method This effectiveness study evaluated a series of 8-week (MBCT) groups adapted for healthcare professionals. Participants completed the Maslach Burnout Inventory (MBI) and Friedberg Mindfulness Inventory (FMI) at pre, post and 6-month follow-up. Results Analysis revealed overall significance and large effect sizes on all three subscales of the MBI and the FMI. There were significant correlations in mindfulness when burnout was reduced. Discussion These results suggest that MBCT groups for healthcare professionals offer a promising intervention for reducing burnout. Implications for Practice Occupational departments could consider MBI's as part of a package of care for mental healthcare staff as a preventative intervention or as a means of reducing burnout amongst healthcare staff.

‘I had a sort of epiphany!’ An exploratory study of group mindfulness-based cognitive therapy for older people with depression

ABSTRACTObjectives: Mindfulness-based cognitive therapy (MBCT) has been successful in reducing depressive symptoms in people with chronic-recurrent depression. However, the research evaluating the efficacy of this approach, and other innovative treatments for mood disorders, has mainly been with people under 65 years. This paper aims to help redress this imbalance by exploring older people's own reflections of their experience of MBCT.Methods: A qualitative approach was used to explore 13 participants' experiences of MBCT; participants were interviewed pre and post-intervention and again after six months. To see whether the standard course requires any adaptations for older participants, the two MBCT course facilitators were interviewed post-intervention.Results: Thematic analysis identified five overarching themes and showed that older people reported positive changes in their mental health and well-being and reported being ‘released from the past’. The facilitators reported that they needed to be aware of later life issues, such as loneliness and potential physical limitations, but otherwise only minor adaptations were needed to the standard MBCT course for older people.Conclusion: MBCT is an acceptable approach for people aged 65 years and over and further research should explore potential mechanisms of change including changes in meta-cognitive awareness and self-compassion.

Evaluating metabolites in patients with major depressive disorder who received mindfulness-based cognitive therapy and healthy controls using shortecho MRSI at 7 Tesla.

ObjectivesOur aim was to evaluate differences in metabolite levels between unmedicated patients with major depressive disorder (MDD) and healthy controls, to assess changes in metabolites in patients after they completed an 8-week course of mindfulness-based cognitive therapy (MBCT), and to exam the correlation between metabolites and depression severity.Materials and methodsSixteen patients with MDD and ten age- and gender-matched healthy controls were studied using 3D short echo-time (20 ms) magnetic resonance spectroscopic imaging (MRSI) at 7 Tesla. Relative metabolite ratios were estimated in five regions of interest corresponding to insula, anterior cingulate cortex (ACC), caudate, putamen, and thalamus.ResultsIn all cases, MBCT reduced severity of depression. The ratio of total choline-containing compounds/total creatine (tCr) in the right caudate was significantly increased compared to that in healthy controls, while ratios of N-acetyl aspartate (NAA)/tCr in the left ACC, myo-inositol/tCr in the right insula, and glutathione/tCr in the left putamen were significantly decreased. At baseline, the severity of depression was negatively correlated with my-inositol/tCr in the left insula and putamen. The improvement in depression severity was significantly associated with changes in NAA/tCr in the left ACC.ConclusionsThis study has successfully evaluated regional differences in metabolites for patients with MDD who received MBCT treatment and in controls using 7 Tesla MRSI.

MBCT for Patients with Respiratory Conditions Who Experience Anxiety and Depression: A Qualitative Study

Patients with asthma and chronic obstructive pulmonary disease (COPD) often experience anxiety and depression in relation to their respiratory condition. Anxiety and depression in this population are associated with decreased activity. The aim of this phenomenological study was to carry out in-depth qualitative interviews with a purposive sample of patients with asthma and COPD taking part in an 8-week mindfulness-based cognitive therapy (MBCT) course to explore their experiences of MBCT. In particular, we were interested in how the mindfulness approach helped them, or not, and their awareness of any meaningful changes in relation to their breathlessness, activity levels, anxiety or low mood. Twenty-two patients were recruited from primary and secondary care to receive an 8-week course in MBCT. Two groups of MBCT were taught by qualified MBCT teachers in a community setting. Of the 22 patients who attended the MBCT course, 12 patients were purposively sampled to take part in an in-depth qualitative interview 2 months after completing the MBCT course. Interviews were digitally recorded and transcribed verbatim. Analysis was thematic. The themes that emerged included greater acceptance and reduced sense of disease-related stigma; noticing subtle bodily sensations to detect early warning signs of breathlessness; linking pulmonary rehabilitation advice with mindfulness; developing a new relationship to breathing, activity and associated thoughts; having a greater sense of control; being creative around limitations and removing psychological barriers to being more active. Findings offer, for the first time, qualitative evidence on how MBCT benefits patients with asthma and COPD who experience anxiety and depression. These data provide a useful adjunct to existing quantitative evidence in this area.

Mindfulness-based cognitive therapy (MBCT) for patients with medically unexplained symptoms: Process of change

BackgroundA recent randomized controlled trial provided preliminary evidence for the effectiveness of mindfulness based cognitive therapy (MBCT) for the top 10% frequent attenders in primary care with persistent medically unexplained symptoms (MUS). This qualitative study aims to explore working mechanisms and possible barriers of MBCT in this population. MethodsTwelve participants of the trial were interviewed about their experiences. This was done before and after the MBCT course, and 12months later. Written evaluations of participants and notes of participant observers were used for data-triangulation. ResultsIn total, 35 qualitative interviews were conducted. MBCT initiated a process of change, starting with awareness of the present moment, the associated sensory experiences, thoughts and emotions and accepting rather than resisting these. Participants started to recognize their own behavioral patterns and change them, thus improving self-care. Self-compassion seemed to result from and facilitate this process. Main barriers were concurrent social problems and the inability or unwillingness to accept symptoms. ConclusionsMBCT can start a process of change in patients with persistent MUS. Awareness and acceptance of painful symptoms and emotions are key factors in this process. Change of unhelpful behavioral patterns and increased self-care and self-compassion can result from this process.

The Process of Engaging in Mindfulness-Based Cognitive Therapy as a Partnership: A Grounded Theory Study

Mindfulness-based cognitive therapy (MBCT) has been evidenced as a relapse prevention strategy for depression. Depression often influences and is influenced by intimate partnerships; thus, it makes sense to include both individuals in interventions. This study aimed to develop a theory of the process of engaging in MBCT as a partnership. As there was no theory or research that could be directly applied to understand the process of engaging in MBCT for depression, as a partnership, an exploratory grounded theory study seemed appropriate to generate rich data and a theory. Twelve participants who had attended an MBCT course as a partnership were interviewed. Analysis and interviews ran simultaneously, so that initial findings influenced subsequent data collection. Constant comparison of data and higher-level concepts facilitated the generation of a theory grounded in the data. The proposed theory captured the ‘process of learning new mindfulness skills together’. The partnership’s rationale for pursuing MBCT together seemed to influence engagement with the course. Participants’ accounts suggested that learning mindfulness skills together led to shifts in the relationship and how they managed depression. While partnerships learned similar mindfulness skills as in individual MBCT courses, learning as a partnership seemed to facilitate home practice, attendance and a sense of mutual support, which led to unique outcomes for the partnership and their sense of responsibility for each others’ well-being. It may be helpful for course facilitators to consider inviting intimate partners to attend where both partners are suffering or there is a willing partnership.