Mindfulnessbased cognitive therapy for depressed

Authors: Jonathan Greenberg Benjamin G Shapero David Mischoulon Sara W Lazar

Publish Date: 2016/11/09

Volume: 267, Issue: 3, Pages: 277-282

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Abstract

An impaired ability to suppress currently irrelevant mentalsets is a key cognitive deficit in depression Mindfulnessbased cognitive therapy MBCT was specifically designed to help depressed individuals avoid getting caught in such irrelevant mentalsets In the current study a group assigned to MBCT plus treatmentasusual n = 22 exhibited significantly lower depression scores and greater improvements in irrelevant mentalset suppression compared to a waitlist plus treatmentasusual n = 18 group Improvements in mentalsetsuppression were associated with improvements in depression scores Results provide the first evidence that MBCT can improve suppression of irrelevant mentalsets and that such improvements are associated with depressive alleviationDepression is a leading cause of disability and one of the most common mental disorders 1 It is characterized by impaired ability to suppress competing or currently irrelevant mentalsets 2 3 4 5 6 7 8 such as distracting ruminative thoughts Impairments in mentalset suppression have been found to predict onset and recurrence of depression correlate with depressive rumination 9 10 and mediate symptom severity 4 11 However little is known about whether or how suppression impairments can be improved and if this would affect depressive symptomatology This study aims to determine whether mindfulness training can improve mentalset suppression and whether such improvement is associated with depressive alleviationMindfulnessbased cognitive therapy MBCT specifically targets avoiding getting caught in ruminative mentalsets 12 13 14 and can prevent depressive relapse 13 15 While mindfulness training can improve cognitive functioning 16 including mentalset suppression 17 18 19 primarily among healthy adults cognition improvements among depressed individuals remain largely unexploredThe current study focuses on Competitor Rule Suppression CRS 20 as a measure of mentalset suppression CRS refers to suppression of mentalsets which implicate a response that competes with the correct or currently relevant response for example suppressing selfcritical thoughts of giving up rather than staying focused on a difficult task CRS specifically counters “troublemaking” irrelevant mentalsets by tagging them in episodic memory as “tobesuppressed” 21 thus facilitating adherence to current task demands CRS is measured within a taskswitching paradigm 22 23 in which the context and task requirements are in constant flux This design permits examination of dynamic finetuning of suppression processes 20 24 25 rather than more crude and consistent suppression of a single process or stimulus seen in other suppression measures such as the Stroop 20 26 We hypothesized that MBCT will improve CRS and that such improvements will be linked to depressive symptom reduction

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