Decentering and Relapse/Recurrence in MBCT for Depression in Adults

The Association Between Decentering and Reductions in Relapse/Recurrence in Mindfulness-Based Cognitive Therapy for Depression in Adults: A Randomized Controlled Trial

Objective: "Decentering" is defined as the ability to observe one's thoughts and feelings as temporary, objective events in the mind, and is increasingly regarded as a candidate mechanism in mindfulness-based interventions. The current study sought to examine the role of decentering, and other related variables, in the efficacy of Mindfulness-based cognitive therapy (MBCT) as compared to two active comparison conditions.

Method: Formerly depressed individuals (N = 227), randomly assigned to MBCT (n = 74), relaxation group therapy (RGT; n = 77) or treatment-as-usual (TAU; n = 76), completed self-report measures of decentering and symptoms of depression at pre-, mid-, and post-treatment, and relapse was assessed at 3, 6, 9, and 12 months, post-treatment.

Inclusion Criteria:

• a Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM IV-TR; American Psychiatric Association (APA), diagnosis of major depressive disorder (MDD) without psychotic features, in Full Remission;
• three or more prior major depressive episodes;
• age between 18 and 65 years;
• cognitive reactivity (CR) or mood-activated dysfunctional beliefs score greater than or equal to eight (see assessment procedure below);
• a score of less than 10 on the Hamilton Rating Scale for Depression (HRSD);
• minimum of a 10 week period free of psychotropic medication other than stable dosage of antidepressant medication for a minimum of four weeks;
• fluency in English; An increased cognitive reactivity score of eight points or more and,
• ability to give informed consent and complete questionnaires unassisted.

Exclusion Criteria:

• a diagnosis of bipolar disorder (past or present), schizophreniform disorders, substance abuse or dependence (current or within the past six months), borderline or antisocial personality disorder, or neurocognitive disorders;
• current psychotherapy or counselling more frequently than twice per month;
• current practice of meditation more than once per week or yoga more than twice per week;
• electroconvulsive therapy within the past six months; or
• self-reported ingestion of alcohol or other psychoactive substances within the past 48 hrs.