Relationship of Posttreatment Decentering and Cognitive Reactivity to Relapse in Major Depression

Department of Psychology, Kent State University, Кент, Ohio, United States
Journal of Consulting and Clinical Psychology (Impact Factor: 4.85). 07/2007; 75(3):447-55. DOI: 10.1037/0022-006X.75.3.447
Source: PubMed


Z. V. Segal et al. (2006) demonstrated that depressed patients treated to remission through either antidepressant medication (ADM) or cognitive-behavioral therapy (CBT), but who evidenced mood-linked increases in dysfunctional thinking, showed elevated rates of relapse over 18 months. The current study sought to evaluate whether treatment response was associated with gains in decentering-the ability to observe one's thoughts and feelings as temporary, objective events in the mind-and whether these gains moderated the relationship between mood-linked cognitive reactivity and relapse of major depression. Findings revealed that CBT responders exhibited significantly greater gains in decentering compared with ADM responders. In addition, high post acute treatment levels of decentering and low cognitive reactivity were associated with the lowest rates of relapse in the 18-month follow-up period.

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Available from: David M Fresco,
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    • "In the context of mood disorders, the decentered view of depression-related thoughts may enable individuals to prevent the escalation of or even reduce negative thinking patterns, e.g., rumination, and may offer some protection against relapse of major depression (Fresco et al. 2007b; Teasdale 1999). Consistent with the model of Shapiro and colleagues (Shapiro et al. 2006) it has been shown previously that training mindfulness enables individuals (1) to notice depressogenic thoughts and (2) to respond to them by redirecting attention to other aspects of the present moment, such as breathing, and in turn to disengage from depressive ruminative processes (Teasdale et al. 1995). "
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    ABSTRACT: Background: Mindfulness and decentering are closely related processes both assumed to promote well-being. While some researchers claim that mindfulness and decentering can be clearly differentiated others suggest to use these concepts interchangeably. The precise relation between mindfulness and decentering remains unclear and therefore the present study aims to determine the relation between mindfulness and decentering. Methods: In a structural equation modeling framework, a mediation model was tested among a sample group of 495 university students (average age 20.8 years, 30.3% female). Results: The identified model shows an acceptable fit to the data and illustrates the role of decentering as a mediator of the relationship between mindfulness and depressive symptoms by complementary mediation and indirect-only mediation. Conclusion: The present results cannot sustain previous research, which converted mindfulness and decentering into one single variable. Rather the data suggests to treat mindfulness and decentering as two separable concepts and to regard decentering as an important working mechanism of mindfulness.
    07/2014; 2(1):18. DOI:10.1186/2050-7283-2-18
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    • "Only recently, evidence has been presented indicating that the change of metacognitive processes particularly, could be an important treatment target in CBT for depression.33–35 For example, Fresco et al34 showed that the ability to take a “decentered” perspective on one’s own thoughts conferred protection from depressive relapse. Decentering has been defined as the ability to observe one’s own thoughts and feelings as temporary, objective events in the mind, as opposed to reflections of the self that are necessarily true, and is thus a metacognitive process.36 "
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    ABSTRACT: Introduction Emotion regulation plays an important role in the development and treatment of depression. The present study investigated whether the emotion regulation strategies, expressive suppression (ES) and cognitive reappraisal (CR) change in the course of cognitive behavior therapy (CBT) of depressive inpatients. Furthermore, it also examined whether changes in CR and ES correlated with positive treatment outcomes. Methods Forty-four inpatients from a psychotherapeutic hospital who suffered from a depressive disorder (mean age =36.4 years, standard deviation =13.4 years; 63.6% female) filled in the Emotion Regulation Questionnaire and the Beck Depression Inventory at admission and discharge. To detect changes in emotion regulation, and depression across treatment, data were analyzed using multivariate analyses of variance (MANOVA) for repeated measures, effect sizes, and Spearman correlations. A P-value of ≤0.05 was considered statistically significant. Results Depression severity (F[1]=10.42, P=0.003; η2=0.22) and CR (F[1]=4.71, P=0.04; η2=0.11) changed significantly across CBT treatment. ES remained virtually stable. Post-treatment scores of CR were also positively correlated with reduction in depressive symptoms across treatment (ρ=0.30, P=0.05). Conclusion The results suggest that CBT affects emotion regulation in depressive inpatients only for CR and that higher post-treatment scores in CR were related to greater reduction in depressive symptoms across treatment.
    Psychology Research and Behavior Management 05/2014; 7:147-53. DOI:10.2147/PRBM.S59421
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    • "Because of its close relationship with IPS, meditation as a way of enhancement has been identified as a practical method (Ding et al., 2011; Ostafin and Kassman, 2012). Meditation cultivates skillful attentiveness by paying attention as non-reactively as possible and thereby prevents an individual from fixating on the mental impasse (Fresco et al., 2007) that hinders the search for new representation during problem solving (Ostafin and Kassman, 2012). Moreover, meditation is used as a form of introspection and allows the switch of attention to awareness of thought and perception at the present moment (Didonna, 2009). "

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