Cognitive reactivity as outcome and working mechanism of mindfulness-based cognitive therapy for recurrently depressed patients in remission

ABSTRACT

Major depressive disorder is a prevalent condition with high relapse rates. There is evidence that cognitive reactivity is an important vulnerability factor for the recurrence of depression. Mindfulness-based interventions are designed to reduce relapse rates, with cognitive reactivity as one of the proposed working mechanisms. In a randomised controlled trial we compared the effect of mindfulness-based cognitive therapy (MBCT) with treatment-as-usual (TAU) on cognitive reactivity in recurrently depressed patients (N = 115). Depressive symptoms, cognitive reactivity, and mindfulness skills were assessed pre and post treatment. Patients in the MBCT group reported a significantly greater reduction in cognitive reactivity than those in the TAU group (d = .51). The reduction of cognitive reactivity appeared to mediate the association between MBCT/TAU and decrease of depressive symptoms, using pre and post scores. The current study provides evidence that MBCT reduces cognitive reactivity and preliminary evidence that cognitive reactivity is a working mechanism of MBCT.

KEYWORDS:

• Depression
• mindfulness
• cognitive reactivity
• MBCT
• relapse

Acknowledgements

We would like to thank the trainers for providing the MBCT training. We are grateful to the patients for their willingness to participate in the study. The original trial is registered at Clinical Trials.gov (ID: NCT01038765).

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

The original trial was funded by Fonds Psychische Gezondheid, Netherlands Foundation for Mental Health [grant no 2005 6028]; and part of the Spinoza prize 2002 awarded to Professor H.P. Barendregt.