Mindfulness and Rumination: Does Mindfulness Training Lead to Reductions in the Ruminative Thinking Associated With Depression?

ArticleinEXPLORE The Journal of Science and Healing 5(5):265-71 · September 2009with 407 Reads
Abstract
The purpose of this study was to investigate the impact of mindfulness-based stress reduction (MBSR; Kabat-Zinn, 1982, 1990) training on a self-selected adult community sample in the areas of mindfulness, rumination, depressive symptomatology and overall well-being. Targeting rumination was considered particularly important because a tendency toward rumination in nondepressed populations has been found to be predictive of subsequent onset of depression. As hypothesized, completers of the MBSR class showed increases in mindfulness and overall wellbeing, and decreases in rumination and symptoms of depression. Limitations of the study are discussed, as are the implications of these findings.
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  • Previous studies have shown that neuroticism is associated with higher levels of posttraumatic stress disorder (PTSD) and depression in individuals who have experienced traumatic events. This study investigated dispositional mindfulness as one pathway in which neuroticism is related to PTSD and depression symptoms among Chinese adolescents who have experienced trauma by considering the role of dispositional mindfulness. Participants were 443 Chinese adolescents who had experienced a severe tornado a year prior to this study. The results showed that our model fitted the data well (χ²/df = 2.113, comparative fit index (CFI) = 0.981, Tucker–Lewis index (TLI) = 0.969, root mean square error of approximation (RMSEA) (90% confidence interval (CI)) = 0.061 [0.047, 0.080]) and revealed that dispositional mindfulness partially mediated the relationship between neuroticism and PTSD and depression symptoms. The clinical implications and limitations of our research and recommendations for future research are discussed in this article.
  • Article
    Purpose – The present study aimed to clarify the inconsistent relationship between negative affect and innovative work behaviour by taking into account the role affect activation and mindfulness. Building on the conservation of resources theory, we hypothesized that low-activated negative affect can be associated with increased innovativeness, but only for employees with high levels of mindfulness. Conversely, high-activated negative affect is expected to have a positive, direct relationship with innovative work behaviour. Design/Methodology/Approach – Data were collected from two independent samples, namely 163 French Canadian and 101 Italian employees. Findings – Consistent with our predictions, multiple regression analysis results showed that low-activated negative affect was positively related to innovative behaviour only when mindfulness was high (vs. low), whereas high-activated negative affect was directly associated with higher innovativeness. Implications – Our findings challenge the assumption that low-activated negative affects are associated with undermined innovative behaviour, suggesting that these affective states can be related to increased innovativeness if employees are mindful. On the other hand, they support the view that high-activated negative affects provide the energizing potential for instigating innovative actions. Originality/Value – This study is unique in examining mindfulness as a moderator that is capable of shaping the link between deactivating negative affect and employee innovativeness. As such, it answers recent calls for research on how mindfulness can contribute to workplace functioning. Moreover, this is the first study to take into account the role of activation level in the negative affect-innovative work behaviour relationship.
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  • Chapter
    In this volume, our contributing experts have described the potential application of positive psychological constructs to the prevention of suicide, melding together the two seemingly disparate fields of positive psychology and suicidology. Using a framework of applied resiliency, this new field of Positive Suicidology stands in contrast to traditional deficit-oriented therapeutic and research approaches, with its emphasis on strengths, virtues, and adaptivity. Comprising classic topics such as reasons for living and social support, as well as the modern perspectives of gratitude, forgiveness, and mindfulness, we have posited Positive Suicidology as a new paradigm for suicide prevention and intervention, including as a proactive and preemptive public health strategy. Thematic patterns emerged from our exploration, suggesting that protection from suicide is multi-faceted, involving interpersonal and intrapersonal well-being, but also existential health and temporal balance. Our authors address theoretical and research support for an array of positive psychological factors found to reduce suicide risk, and discuss strategies for their clinical application, including therapies based on future orientation, mindfulness, and meaning-making. Future longitudinal research is needed on these and additional positive psychological factors, such as humor and grit, including in clinical samples, to insure the strengths-based approach we are advocating is efficacious. Overall, Positive Suicidology seems to be a necessary approach to suicide prevention, given that many of its primary constructs are overlooked in traditional therapeutic approaches, despite burgeoning empirical evidence, person-centered appeal, and the potential to improve well-being and prevent suicide.
  • Chapter
    This chapter presents mindfulness and mindfulness-based intervention studies involving individuals with intellectual and developmental disabilities (IDDs) in such a way as to allow practitioners in the field of IDDs to understand and make good use of mindfulness practices. We introduce mindfulness in its contemporary and traditional contexts. We then discuss why and how mindfulness-based interventions have been used for individuals with IDDs. We review mindfulness studies involving individuals with IDDs according to their intervention and research design and their methods. Finally, we present recommendations to strengthen the applications of mindfulness as an evidence-based practice.
  • Article
    The present study examined the structure of the Five Facet Mindfulness Questionnaire (FFMQ) in adolescents and whether predictive associations between mindfulness facets and depressive symptoms are mediated by reduced rumination. A sample of 520 Spanish adolescents (mean age = 16.11, SD = 0.98, range = 13–19, 57.9 % girls) completed the FFMQ and measures of depression and rumination initially and after 4 months. In study 1, a confirmatory factor analysis supported a five-factor correlated model for the five facets, which are observing, describing, acting with awareness, non-reactivity, and non-judging. All five facets and the total FFMQ scores showed acceptable internal consistency, test-retest reliability, and convergent and discriminant validity. All the mindfulness facets other than observing correlated negatively with depressive symptoms. In study 2, a subsample of 461 adolescents was followed up to examine longitudinal associations between mindfulness facets, rumination, and depression. The results demonstrated that acting with awareness and non-reactivity predicted a reduction in depression over time, whereas observing predicted an increase in depression through the mediation of increased rumination. Thus, this research provides support for the adaptive role of acting with awareness and non-reactivity and suggests that observing might play a maladaptive role in adolescents.
  • Poster
    Full-text available
    Research has long been concerned with the relationship between thinking and adolescent depression, however new findings have linked positive mental health outcomes in adults and youth to patterns of thought that were once classified as maladaptive. The present study explored differences in the thought patterns of three groups of adolescents - those with no depression, those with current depression, and those with future onset depression – in order to replicate previous findings and discover new associations.
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  • Article
    Clinical research has shown the mental health benefits of dance practice. This has become a significant subject of inquiry in psychotherapeutic settings for the elderly and adolescents. However, the relationship between dance practice and correlates of psychological well-being, such as mindfulness and life satisfaction (LS)—two relevant indicators of mental health, has been explored relatively little in young women. The present study contrasted mindfulness and LS in young women (n = 81) who practiced dance regularly in three modern dance schools in the Province of Barcelona with a control group of non-practitioners (n = 120) studying at a university in Barcelona. The data were collected during the first semester of 2015, and the total sample had an average age of 20.88 ± 3.36 years. Analyses of covariance showed higher levels of both mindfulness and LS in the dance practitioners, while a multiple regression analysis showed that, after controlling for age, dance was the factor most strongly associated with LS, explaining 28% of the variance in LS. These results are discussed in terms of the embodiment theory, and conclusions suggest that dance may be an effective gender-focused practice to enhance well-being and promote mental health in young women.
  • Article
    Full-text available
    Celem artykułu była prezentacja i sprawdzenie wartości psychometrycznej Fryburskiego inwentarza uważności (FIU-14; Wallach, Buchheld, Buttenmüller, Kleinknecht, Schmidt, 2006), który służy do pomiaru nasilenia uważności (analiza rzetelności, konfirmacyjna analiza czynnikowa, analiza korelacji z innymi testami mierzącymi różne cechy psychologiczne: neurotyzm, stabilność emocjonalną, poziom ruminacji, otwartość na doświadczenie, refleksyjność oraz siłę ego). W badaniach brało udział 578 osób (128 uczniów Zespołu Państwowych Szkół Plastycznych w Krakowie w wieku od 15 do 19 lat oraz 450 studentów stacjonarnych i niestacjonarnych Uniwersytetu Papieskiego Jana Pawła II w Krakowie w wieku od 20 do 50 lat). Uzyskane rezultaty potwierdziły rzetelność (α = 0,75), bezwzględną stabilność (r = 0,91) oraz trafność stosowania stworzonej metody badawczej w stosunku do osób z populacji nieklinicznych w wieku 20–50 lat (model jednoczynnikowy: CMIN/df = 1,50; GFI = 0,95; AGFI = 0,93; CFI = 0,93; RMSEA = 0,04; PCLOSE = 0,81). War unkowo dopuszczalne jest stosowanie skróconej wersji kwestionariusza (FIU-8) wobec osób w wieku 15–19 lat (model dwuczynnikowy). Wskazana jest dalsza walidacja na próbkach klinicznych i z kontrolowanym poziomem doświadczenia w medytacji.
  • Article
    Although concurrent associations among dispositional mindfulness, rumination, and depression have been identified, lacking is a study that longitudinally examines the relationships among these three constructs in a non-clinical sample of adults. We specifically sought to determine whether rumination mediates the expected negative association between mindfulness and depressive symptoms across time. A community sample of 483 adults completed self-report measures of mindfulness, rumination, and depressive symptoms initially and after 3 months and after 6 months. The predicted cross-lag associations were found, i.e. mindfulness predicted diminished rumination, and rumination positively predicted depressive symptoms, and as a consequence, the predicted longitudinal mediation was supported in the data as well. At the facet level of mindfulness, three of the five facets (i.e. acting with awareness, non-judging, and non-reacting) exhibited the longitudinal mediation through rumination to depressive symptoms. The findings of this research suggest that certain aspects of mindfulness function to reduce rumination, which then predicts diminished depressive symptoms.
  • Article
    Full-text available
    Compared with white individuals and men, black individuals and women show a lower tolerance for experimental pain stimuli. Previous studies suggest that pain catastrophizing is important in this context, but little is known about which components of catastrophizing contribute to these race and sex differences. The purpose of the current study was to examine the individual components of catastrophizing (rumination, magnification, and helplessness) as candidate mediators of race and sex differences in experimental pain tolerance. Healthy undergraduates (N = 172, 74% female, 43.2% black) participated in a cold pressor task and completed a situation-specific version of the Pain Catastrophizing Scale. Black and female participants showed a lower pain tolerance than white (P < .01, d = .70) and male (P < .01, d = .55) participants, respectively. Multiple mediation analyses indicated that these race and sex differences were mediated by the rumination component of catastrophizing (indirect effect = -7.13, 95% confidence interval (CI), -16.20 to -1.96, and 5.75, 95% CI, .81-15.57, respectively) but not by the magnification (95% CI, -2.91 to 3.65 and -1.54 to 1.85, respectively) or helplessness (95% CI, -5.53 to 3.31 and -.72 to 5.38, respectively) components. This study provides new information about race and sex differences in pain and suggests that treatments targeting the rumination component of catastrophizing may help mitigate pain-related disparities. Perspective: This study suggests that differences in pain-related rumination, but not magnification or helplessness, are important contributors to race and sex differences in the pain experience. Interventions that target this maladaptive cognitive style may help reduce disparities in pain.
  • Article
    Full-text available
    Peer victimization is associated with several mental health and behavioral problems during childhood and adolescence. Identifying prospective associations between victimization and factors known to protect against these problems may ultimately contribute to more precise developmental models for victimization’s role in behavioral and mental health. This study tested prospective associations between peer victimization and dispositional mindfulness, defined by non-judgmental and accepting awareness of the constant stream of lived experience, during early adolescence. It was hypothesized that victimization would predict lower levels of mindfulness over a 4-month period. Study participants were 152 seventh and eighth grade students (female = 51%, Caucasian = 35%, Hispanic/Latino = 34%, African-American = 13%, and multi-ethnic or other = 18%) participating in a social-emotional learning intervention feasibility trial. A structural equation model tested associations between mindfulness, victimization, and covariates at baseline, and mindfulness and victimization at 4-month posttest. As hypothesized, baseline victimization predicted significantly lower levels of mindfulness at 4-month posttest. Baseline mindfulness did not predict victimization. Results may reflect victimized youths’ mindful awareness being recurrently diverted away from the present moment due to thoughts of prior and/or impending victimization. Study implications may include implementing mindful awareness practices as an intervention strategy for victimized youth to enhance and/or restore this promotive factor.
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  • Article
    Anxiety disorders among older adults are fairly common but often go undiagnosed and under treated. Unfortunately, untreated anxiety leads to hastened aging, including increased risk for cardiac morbidity and cognitive impairments. First-line treatments for anxiety disorders are typically pharmacological measures, primarily selective serotonin reuptake inhibitors (SSRIs), and benzodiazepines. However, many patients may not accept medications or may experience debilitating side effects. Additionally, anxiety symptoms may not be entirely addressed by medications alone. All of this points to the need for non-pharmacological treatments. When treating anxiety, cognitive behavioral therapy (CBT) has become the gold standard psychotherapeutic intervention. However, sometimes CBT alone is insufficient in treating anxiety. New innovative approaches, such as mindfulness therapy (MT) and acceptance and commitment therapy (ACT), have been developed to augment CBT and have proven to be beneficial in small studies. Additionally, the skills learned in these novel treatment modalities can continue to be used by older adults in managing anxiety long after the treatment sessions have ended.
  • Article
    Previous research suggests that college-aged students, especially first-year college students, are particularly prone to experience relational conflict. Interpersonal forgiveness has been well-documented as a variable that can reduce relational conflict among young adults. However, limited empirical research to date has explored the motivation and ability of college-aged students to engage in forgiveness granting behaviors when they are the victim of an interpersonal conflict; this lack of empirical research is especially noteworthy when considering the perpetrator’s perspective and why (motivation) and how (ability) perpetrators engage in forgiveness seeking behaviors following conflict. The current research assessed forgiveness granting and seeking behaviors for victims and perpetrators of an interpersonal transgression, respectively. Using behavior change models as a theoretical guide, we exposed young adults to a message pertaining to reasons/motivations for why they should engage in forgiveness behaviors as well as two techniques (i.e., mindfulness or implementation planning) that may promote the ability to express granting/seeking forgiveness. Sampling from 144 young adults, results indicate that participants exposed to reasons/motives for forgiveness as well as a mindfulness or implementation planning technique were more likely to engage in forgiveness grating/seeking behaviors than participants who were not exposed to this information. Participants’ mood and attitudes toward forgiveness granting/seeking were enhanced by receiving both a message and a technique. These results were especially pronounced for victims of an interpersonal transgression who practiced mindfulness. Overall, mindfulness appeared to be the most promising technique in promoting forgiveness.
  • Article
    This study explores the mediating role of rumination and valued living in the relationship between mindfulness and depressive symptoms in a sample of women with chronic pain. Women with musculoskeletal chronic pain (N = 124) were recruited online through the advertisement of the study in several national associations for individuals with chronic pain. Participants responded a set of questionnaires that aimed to assess mindfulness, rumination, obstructions to and progress in valued living, and depressive symptoms. All variables were significantly associated in the expected directions. Results showed the relationship between mindfulness and depressive symptoms was fully mediated by rumination and experiencing obstructions in valued living, but not by difficulties in moving forward towards valued living. Clinical implications are discussed. Results seem to suggest the potential benefits of explicitly targeting general rumination and internal obstructions to living congruently to personal values, when conducting mindfulness-based interventions for reducing depression in chronic pain.
  • Article
    Full-text available
    Abstrakt. Teorie poznawczo-behawioralne są jednymi z najmłodszych koncepcji w psycholo-gii klinicznej. Ulegają one ciągłym przemianom, co rodzi wiele nieporozumień i błędnych interpre-tacji. Niektórzy autorzy uważają, że jest to koncepcja „mało spójna”, a kwestie osobowości schodzą na dalszy plan, „gdyż jest to bardziej psychologia zachowań, procesów i struktur poznawczych niż psychologia człowieka” (Sęk, 2005, s. 106). Historia rozwoju koncepcji poznawczych pozwala zro-zumieć jej założenia, aktualne miejsce w psychopatologii oraz obecny stan wiedzy. Podział na tzw. trzy generacje koncepcji poznawczo-behawioralnych pozwala oddzielić stereotypy dotyczące tej koncepcji od jej właściwego obrazu. W artykule opisano aktualny stan teorii poznawczych z uwzględnieniem najnowszej generacji koncepcji poznawczo-behawioralnych, obejmujących: te-rapię poznawczą opartą na uważności (MBCT), terapię akceptacji i zaangażowania (ACT), jak również terapię schematów (SFT).
  • Article
    Objective The current study focused on the role of trait mindfulness in asthma-related quality of life (QoL) and asthma control in adolescent asthma patients. Furthermore, potential underlying mechanisms (general and asthma-specific stress) of this relationship were investigated. Methods In this cross-sectional study, questionnaire data of 94 adolescents with asthma that were prescribed daily asthma medication were included. Two Structural Equation Models (SEMs), a direct model and an indirect model, were tested. Results We found that trait mindfulness was directly related to asthma-related QoL, but not to asthma control. The relationship between trait mindfulness and asthma-related QoL was explained by asthma-specific, but not by general stress. Furthermore, an indirect relation from mindfulness to asthma control via asthma-specific stress was found. Conclusions Cross-sectional evidence for a relation between mindfulness and asthma-related QoL is found. These findings may point to the possibility that an intervention aimed at increasing mindfulness could be a promising tool to improve asthma-related QoL in adolescents via a decrease in asthma-specific stress.
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  • Article
    The quality of teachers' relationships with children is a key predictor of children's later social emotional competence and academic achievement. Interventions to increase mindfulness among teachers have focused primarily on the impacts on teachers' subjective well-being, but not on the quality of their relationships with children. Furthermore, none of these interventions have involved preschool teachers. To consider the potential of mindfulness-based interventions to improve the quality of teachers' relationships with preschool-aged children, we examined data from an online survey of 1001 classroom teachers in 37 Pennsylvania Head Start Programs. Using path analysis we investigated the association between teachers' dispositional mindfulness and the quality of their relationships with children (conflict and closeness). We further examined whether this association was mediated by teacher depressive symptoms and moderated by perceived workplace stress. Higher levels of dispositional mindfulness among teachers were associated with higher quality relationships with children (less conflict and greater closeness). The association between greater dispositional mindfulness and less conflict was partially mediated by lower depressive symptoms, and the conditional direct effect of mindfulness on conflict was stronger when perceived workplace stress was lower. These findings suggest that preschool teachers who have higher levels of dispositional mindfulness may experience higher quality relationships with children in their classrooms. Interventions to increase levels of dispositional mindfulness among early childhood educators may improve their well-being along with the quality of their relationships with children, potentially impacting children's educational outcomes. The potential impacts of such interventions may be even stronger if structural and systemic changes are also made to reduce workplace stress.
  • Chapter
    Integrative medicine emphasizes the care of the whole person and employs both conventional and complementary therapeutic approaches. Techniques such as mind-body therapies, therapeutic art, music and writing, biofield therapies, and emotional freedom technique can be used to support family members of patients in the ICU. Complementary and integrative modalities have been shown to improve perceived stress, anxiety, depression, and PTSD and enhance quality of life, resilience, and sleep.
  • Article
    Objective Rumination, thinking about a negative mood repetitively, is a common cognitive process that may affect health behavior engagement or avoidance. Little research has examined relations between rumination and health behaviors. Purpose We aimed to test links between rumination and health behaviors as well as possible moderators and mediators of those links. Methods We used an 11-day online daily diary design. Health behavior outcomes included fruit intake, vegetable intake, exercise, alcohol intake, sexual risk taking behavior, and cigarette smoking. Results Rumination was related to alcohol intake at the within-person level. Using multivariate modeling, we found that significant within-person mediators for rumination to health behaviors included impulsivity, amotivation, self control, and using health behaviors as coping, with each of these mediating relationships for one to four out of the five health behavior outcomes. A significant between-person moderator includes perceived behavioral control for alcohol intake only, and intention was not a significant moderator of the rumination to health behavior relationships. Conclusions Rumination affects various maladaptive health behaviors differentially, through a number of mechanisms and under a moderating condition whereby those who feel more control are better able to buffer rumination’s deleterious effects. Future interventions can apply the results to individual and multiple behavior change interventions for chronic disease prevention, especially for those who are particularly suffering from ruminative thoughts.
  • Article
    Purpose: This study focuses on the spiritual well-being (SWB) of the family caregivers of cancer patients, examining the relationship with personality traits and quality of life (QoL) in palliative and curative care settings. Methods: All participants (n = 199) underwent the following self-report questionnaires: the Structural Analysis of Social Behavior (SASB)-Form A, the SWB Index, and the Medical Outcomes Study Short Form (SF-36). SWB scores were dichotomized at a cutoff corresponding to the 75th percentile. Statistical analysis: Student's t test or by χ squared tests to compare high and low SWB and multivariate linear regression to estimate relations between SWB, SASB clusters (Cl), and QoL dimensions. Results: Caregivers with high SWB reported significantly better scores than low SWB caregivers in the following SF-36 subscales: bodily pain (p = 0.035), vitality (p < 0.001), social activities (p < 0.001), mental health subscales (p < 0.001), and standardized mental component (p < 0.001) in the SASB Cl2 (p < 0.005), SASB Cl7 (p = 0.007), and SASB Cl8 (p < 0.001). Multivariate linear regression was performed with vitality, standardized mental component, SASB Cl2, SASB Cl7, and SASB Cl8. Greater SWB is associated with greater vitality (p < 0.001), mental standardized component (p < 0.001), and SASB Cl2 (p < 0.001), but lower SASB Cl7 (p < 0.05) and SASB Cl8 (p < 0.05); palliative care is associated with greater SASB Cl8 (p < 0.05) and lower standardized mental component compared with the caregivers in active care. Conclusions: This study points out that caregivers who experience low SWB have a poorer QoL and more problematic intrapsychic aspects of personality, such as low self-acceptance of their own emotions, are self-refusing and unable to be in contact with their own feelings. This suggests that spirituality could be a source of strength and a potential avenue for therapeutic intervention.
  • Article
    Mindfulness has been a focus of psychological research and practice in recent decades. Yet, there is limited research on the relationship between mindfulness and vocational decision‐making. This study’s purpose was to examine the role of mindfulness in a career context by investigating the relationships among mindfulness, decision‐making style, negative career thoughts, and vocational identity. The sample included 258 undergraduate students (204 women, 54 men) at a large southeastern U.S. university. Mindfulness was significantly (p < .01) associated with fewer negative career thoughts, external and thinking‐based decision‐making styles, and higher vocational identity. Multiple regression procedures found that mindfulness, coupled with decision‐making style, accounted for 31% of the variance in negative career thoughts and 22% of the variance in vocational identity. These findings suggest that more holistic career counseling interventions could incorporate mindfulness techniques to help reduce anxiety and negative thoughts while increasing self‐clarity and problem‐solving skills. Future research could include more diverse samples, additional constructs (e.g., choice volition, self‐efficacy), and a pretest–posttest design to examine the efficacy of mindfulness‐based career interventions.
  • Article
    I propose that the ways people respond to their own symptoms of depression influence the duration of these symptoms. People who engage in ruminative responses to depression, focusing on their symptoms and the possible causes and consequences of their symptoms, will show longer depressions than people who take action to distract themselves from their symptoms. Ruminative responses prolong depression because they allow the depressed mood to negatively bias thinking and interfere with instrumental behavior and problem-solving. Laboratory and field studies directly testing this theory have supported its predictions. I discuss how response styles can explain the greater likelihood of depression in women than men. Then I intergrate this response styles theory with studies of coping with discrete events. The response styles theory is compared to other theories of the duration of depression. Finally, I suggest what may help a depressed person to stop engaging in ruminative responses and how response styles for depression may develop.
  • Article
    It was hypothesized that women are more vulnerable to depressive symptoms than men because they are more likely to experience chronic negative circumstances (or strain), to have a low sense of mastery, and to engage in ruminative coping. The hypotheses were tested in a 2-wave study of approximately 1,100 community-based adults who were 25 to 75 years old. Chronic strain, low mastery, and rumination were each more common in women than in men and mediated the gender difference in depressive symptoms. Rumination amplified the effects of mastery and, to some extent, chronic strain on depressive symptoms. In addition, chronic strain and rumination had reciprocal effects on each other over time, and low mastery also contributed to more rumination. Finally, depressive symptoms contributed to more rumination and less mastery over time.
  • Chapter
    Mindfulness-based cognitive therapy (MBCT) is an 8-week group protocol, which is developed to prevent the relapse of depression episodes in future. MBCT is based on a theoretical model that describes factors contributing to vulnerability to relapse and recurrence of major depression and the efficiency of cognitive therapy in reducing this vulnerability. MBCT combines mindfulness strategies with traditional cognitive behavioral strategies for treatment. It is designed to help patients with histories of depression and prevent the relapse and recurrence of depression in the future. MBCT provides a cost-effective approach for relapse prevention in patients whose previous episode was treated with antidepressant medication. This chapter reviews the rationale and background of the model, as well as relevant research. A case illustration is presented to provide additional detail about the use of common treatment strategies and client responses, describing the experience of one client who benefited tremendously from the treatment.
  • Article
    A distinction between ruminative and reflective types of private self-attentiveness is introduced and evaluated with respect to L. R. Goldberg's (1982) list of 1,710 English trait adjectives (Study 1), the five-factor model of personality (FFM) and A. Fenigstein, M. F. Scheier, and A. Buss's(1975) Self-Consciousness Scales (Study 2), and previously reported correlates and effects of private self-consciousness (PrSC; Studies 3 and 4). Results suggest that the PrSC scale confounds two unrelated motivationally distinct disposition-rumination and reflection-and that this confounding may account for the "self-absorption paradox" implicit in PrSC research findings: Higher PrSC sources are associated with more accurate and extensive self-knowledge yet higher levels of psychological distress. The potential of the FFM to provide a comprehensive Framework for conceptualizing self-attentive dispositions, and to order and integrate research findings within this domain, is discussed.
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  • Book
    This edited volume provides chapters on the leading evidence-based mindfulness interventions as of 2006: mindfulness-based stress reduction, mindfulness-based cognitive therapy, dialectical behavior therapy, and acceptance and commitment therapy. Applications for clinical, medical, and nonclinical but stressed populations, as well as children, adolescents, and older adults, are described. Each chapter includes a detailed case study illustrating how the intervention is implemented, conceptual background, empirical support, and a discussion of practical issues that clinicians wishing to use these treatments must consider. A second edition (2014) focusing on MBSR, MBCT, and related treatment programs is also available.
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  • Article
    The reliability estimates for the Beck Depression Inventory (BDI) scores across studies were accumulated and summarized in a meta-analysis. Only 7.5% of the articles reviewed reported meaningful reliability estimates, indicating that the logic of “test score reliability” generally has not prevailed in clinical psychology regarding application of BDI. Analyses revealed that for BDI, the measurement error due to time sampling as captured by test-retest reliability estimate is considerably larger than the measurement error due to item heterogeneity and content sampling as captured by internal consistency reliability estimate. Also, reliability estimates involving substance addicts were consistently lower than reliability estimates involving normal subjects, possibly due to restriction of range problems. Correlation analyses revealed that standard errors of measurement (SEMs) were not correlated with reliability estimates but were substantially related to standard deviations of BDI scores, suggesting that SEMs should be considered in addition to reliability estimates when interpreting individual BDI scores.
  • Article
    Mindfulness-based stress reduction (MBSR) has grown in popularity over the last two decades, showing efficacy for a variety of health issues. In the current study, we examined the effects of an MBSR intervention on pain, positive states of mind, stress, and mindfulness self-efficacy. These measures were collected before and following an 8-week intervention. Post-intervention levels of stress were significantly lower than pre-intervention levels, while mindfulness self-efficacy and positive states of mind were at significantly higher levels. The findings underscore the potential for stress management, awareness and attention training, and positive states of mind using MBSR. Copyright © 2004 John Wiley & Sons, Ltd.
  • Article
    Interventions based on training in mindfulness skills are becoming increasingly popular. Mindfulness involves intentionally bringing one's attention to the internal and external experiences occurring in the present moment, and is often taught through a variety of meditation exercises. This review summarizes conceptual approaches to mind-fulness and empirical research on the utility of mindfulness-based interventions. Meta-analytic techniques were incorporated to facilitate quantification of findings and comparison across studies. Although the current empirical literature includes many methodological flaws, findings suggest that mindfulness-based interventions may be helpful in the treatment of several disorders. Methodologically sound investigations are recommended in order to clarify the utility of these interventions.
  • Article
    Scheel's review (this issue) of the empirical evidence for dialectical behavior therapy raises issues about how to interpret data on DBT's efficacy as well as how practitioners might best use research on DBT to guide their clinical practice. Recent data that were not included in Scheel's review are presented here, and their implications discussed.
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  • Article
    Rumination is engaging in a passive focus on one's symptoms of distress and on the possible causes and consequences of these symptoms. Women are more likely than men to engage in rumination. This study examined whether gender differences in the following beliefs would mediate the gender difference in rumination: the controllability of emotions, the appropriateness of rumination as a coping strategy, responsibility for the emotional tone of relationships, and mastery over negative events. The sample was 740 community-dwelling adults between 25 and 75 years of age, who completed a survey by mail. The combination of beliefs about control of emotions, responsibility for the emotional tone of relationships, and mastery over negative events fully mediated the gender difference in rumination. Alternative hypotheses that the gender difference in rumination was due to gender differences in distress, emotional expressivity, and the tendency to give socially desirable answers were not supported.
  • Article
    Full-text available
    This study describes the effects of an 8-week course in Mindfulness-Based Stress Reduction (MBSR; J. Kabat-Zinn, 1982, 1990) on affective symptoms (depression and anxiety), dysfunctional attitudes, and rumination. Given the focus of mindfulness meditation (MM) in modifying cognitive processes, it was hypothesized that the primary change in MM practice involves reductions in ruminative tendencies. We studied a sample of individuals with lifetime mood disorders who were assessed prior to and upon completion of an MBSR course. We also compared a waitlist sample matched with a subset of the MBSR completers. Overall, the results suggest that MM practice primarily leads to decreases in ruminative thinking, even after controlling for reductions in affective symptoms and dysfunctional beliefs.
  • Article
    Past research has shown that rumination exacerbates dysphoric mood whereas distraction attenuates it. This research examined whether the practice of mindfulness meditation could reduce dysphoric mood even more effectively than distraction. A dysphoric mood was induced in 139 female and 38 male participants who were then randomly assigned to a rumination, distraction, or meditation condition. As predicted, participants instructed to meditate reported significantly lower levels of negative mood than those in either of the two other conditions. Distraction was associated with a lessening of dysphoric mood when compared to rumination but was not as effective as mindfulness meditation. The implications of these findings are discussed.
  • Article
    Dialectical Behavior Therapy, Acceptance and Commitment Therapy, and Functional Analytic Psychotherapy have recently come under fire for “getting ahead of their data” (Corrigan, 2001). The current article presents a descriptive review of some of the actual evidence available. Dialectical Behavior Therapy and Acceptance and Commitment Therapy have a small but growing body of outcome research supporting these procedures and the theoretical mechanisms thought to be responsible for them. Functional Analytic Psychotherapy has a limited research base, but its central claim is well substantiated. The claims made in the published literature about these technologies, at least by their originators, seem proportionate to the strength of the current evidence. There is no indication that those interested in the new wave of behavior therapy innovations are less committed to empirical evaluation than has always been the case in behavior therapy.
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  • Article
    Twenty women veterans who met criteria for borderline personality disorder (BPD) were randomly assigned to Dialectical Behavior Therapy (DBT) or to treatment as usual (TAU) for 6 months. Compared with patients in TAU, those in DBT reported significantly greater decreases in suicidal ideation, hopelessness, depression, and anger expression. In addition, only patients in DBT demonstrated significant decreases in number of parasuicidal acts, anger experienced but not expressed, and dissociation, and a strong trend on number of hospitalizations, although treatment group differences were not statistically significant on these variables. Patients in both conditions reported significant decreases in depressive symptoms and in number of BPD criterion behavior patterns, but no decrease in anxiety. Results of this pilot study suggest that DBT can be provided effectively independent of the treatment's developer, and that larger efficacy and effectiveness studies are warranted.
  • Article
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    Dysphoric people who ruminate about their negative mood experience longer and more intense depressive episodes, yet often persist in ruminating. This study investigated whether a ruminative coping style would be related to a cognitive style marked by perseveration and inflexibility. We examined the performance of ruminators and nonruminators on the Wisconsin Card Sorting Test (WCST), a measure of cognitive flexibility, and tasks measuring related cognitive processes. Ruminators committed significantly more perseverative errors and failed to maintain set significantly more often than nonruminators on the WCST. On an advanced section of the WCST designed for this study, male ruminators exhibited significantly greater inflexibility than male nonruminators. These effects could not be attributed to differences in general intelligence or the presence of depressed mood. Results suggest that rumination may be characterized by, and perhaps prolonged by, an inflexible cognitive style. Peer Reviewed http://deepblue.lib.umich.edu/bitstream/2027.42/44338/1/10608_2004_Article_227193.pdf
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    Clinical, field, and experimental studies of response to potentially stressful life events give concordant findings: there is a general human tendency to undergo episodes of intrusive thinking and periods of avoidance. A scale of current subjective distress, related to a specific event, was based on a list of items composed of commonly reported experiences of intrusion and avoidance. Responses of 66 persons admitted to an outpatient clinic for the treatment of stress response syndromes indicated that the scale had a useful degree of significance and homogeneity. Empirical clusters supported the concept of subscores for intrusions and avoidance responses.
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    This study was designed to determine the effectiveness of a group stress reduction program based on mindfulness meditation for patients with anxiety disorders. The 22 study participants were screened with a structured clinical interview and found to meet the DSM-III-R criteria for generalized anxiety disorder or panic disorder with or without agoraphobia. Assessments, including self-ratings and therapists' ratings, were obtained weekly before and during the meditation-based stress reduction and relaxation program and monthly during the 3-month follow-up period. Repeated measures analyses of variance documented significant reductions in anxiety and depression scores after treatment for 20 of the subjects--changes that were maintained at follow-up. The number of subjects experiencing panic symptoms was also substantially reduced. A comparison of the study subjects with a group of nonstudy participants in the program who met the initial screening criteria for entry into the study showed that both groups achieved similar reductions in anxiety scores on the SCL-90-R and on the Medical Symptom Checklist, suggesting generalizability of the study findings. A group mindfulness meditation training program can effectively reduce symptoms of anxiety and panic and can help maintain these reductions in patients with generalized anxiety disorder, panic disorder, or panic disorder with agoraphobia.
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    Ninety chronic pain patients were trained in mindfulness meditation in a 10-week Stress Reduction and Relaxation Program. Statistically significant reductions were observed in measures of present-moment pain, negative body image, inhibition of activity by pain, symptoms, mood disturbance, and psychological symptomatology, including anxiety and depression. Pain-related drug utilization decreased and activity levels and feelings of self-esteem increased. Improvement appeared to be independent of gender, source of referral, and type of pain. A comparison group of pain patients did not show significant improvement on these measures after traditional treatment protocols. At follow-up, the improvements observed during the meditation training were maintained up to 15 months post-meditation training for all measures except present-moment pain. The majority of subjects reported continued high compliance with the meditation practice as part of their daily lives. The relationship of mindfulness meditation to other psychological methods for chronic pain control is discussed.
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    The practice of mindfulness meditation was used in a 10-week Stress Reduction and Relaxation Program to train chronic pain patients in self-regulation. The meditation facilitates an attentional stance towards proprioception known as detached observation. This appears to cause an "uncoupling " of the sensory dimension of the pain experience from the affective/evaluative alarm reaction and reduce the experience of suffering via cognitive reappraisal. Data are presented on 51 chronic pain patients who had not improved with traditional medical care. The dominant pain categories were low back, neck and shoulder, and headache. Facial pain, angina pectoris, noncoronary chest pain, and GI pain were also represented. At 10 weeks, 65% of the patients showed a reduction of greater than or equal to 33% in the mean total Pain Rating Index (Melzack) and 50% showed a reduction of greater than or equal to 50%. Similar decreases were recorded on other pain indices and in the number of medical symptoms reported. Large and significant reductions in mood disturbance and psychiatric symptomatology accompanied these changes and were relatively stable on follow-up. These improvements were independent of the pain category. We conclude that this form of meditation can be used as the basis for an effective behavioral program in self-regulation for chronic pain patients. Key features of the program structure, and the limitations of the present uncontrolled study are discussed.
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  • Article
    A previous study of 22 medical patients with DSM-III-R-defined anxiety disorders showed clinically and statistically significant improvements in subjective and objective symptoms of anxiety and panic following an 8-week outpatient physician-referred group stress reduction intervention based on mindfulness meditation. Twenty subjects demonstrated significant reductions in Hamilton and Beck Anxiety and Depression scores postintervention and at 3-month follow-up. In this study, 3-year follow-up data were obtained and analyzed on 18 of the original 22 subjects to probe long-term effects. Repeated measures analysis showed maintenance of the gains obtained in the original study on the Hamilton [F(2,32) = 13.22; p < 0.001] and Beck [F(2,32) = 9.83; p < 0.001] anxiety scales as well as on their respective depression scales, on the Hamilton panic score, the number and severity of panic attacks, and on the Mobility Index-Accompanied and the Fear Survey. A 3-year follow-up comparison of this cohort with a larger group of subjects from the intervention who had met criteria for screening for the original study suggests generalizability of the results obtained with the smaller, more intensively studied cohort. Ongoing compliance with the meditation practice was also demonstrated in the majority of subjects at 3 years. We conclude that an intensive but time-limited group stress reduction intervention based on mindfulness meditation can have long-term beneficial effects in the treatment of people diagnosed with anxiety disorders.
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    There is encouraging evidence that structured psychological treatments for depression, in particular cognitive therapy, can reduce subsequent relapse after the period of initial treatment has been completed. However, there is a continuing need for prophylactic psychological approaches that can be administered to recovered patients in euthymic mood. An information-processing analysis of depressive maintenance and relapse is used to define the requirements for effective prevention, and to propose mechanisms through which cognitive therapy achieves its prophylactic effects. This analysis suggests that similar effects can be achieved using techniques of stress-reduction based on the skills of attentional control taught in mindfulness meditation. An information-processing analysis is presented of mindfulness and mindlessness, and of their relevance to preventing depressive relapse. This analysis provides the basis for the development of Attentional Control Training, a new approach to preventing relapse that integrates features of cognitive therapy and mindfulness training and is applicable to recovered depressed patients.
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    A cognitive science analysis of the interaction between psychological stress and the neurobiology of affective illness highlights a number of mechanisms relevant to the study of recurrence in major depressive disorder. It builds on observations previously offered by Post (1992) regarding the importance of kindling and sensitization effects in determining activation of neural structures, and proposes a model of knowledge structure activation that follows similar parameters. Vulnerability to depressive relapse/recurrence is determined by the increased risk of particular negative patterns of information processing being activated in depressed states. As is found in studies of kindling and behavioural sensitization, the likelihood of cognitive patterns being activated is dependent on the frequency of past usage, and increased reliance on these patterns of processing makes it easier for their future activation to be achieved on the basis of increasingly minimal cues. This model suggests that the processes related to relapse/recurrence and episode onset may not be isomorphic and, as such, treatments that emphasize relapse prevention strategies should take this distinction into account.
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    The authors tested and extended S. Nolen-Hoeksema's (1991) response styles (RSs) theory of depression by assessing the role of RSs in the onset of depressive episodes (DEs), controlling for the effects of concurrent depression, examining the dispositional aspects of RS, clarifying the role of distraction in the course of a DE, and studying the predictive validity of the Response Styles Questionnaire, Nondepressed (ND) participants who reported that they ruminate in response to their depressive symptoms were more likely to experience a DE over 18 months than were participants who reported that they distract themselves from their symptoms. Both a ruminative RS as measured in an ND state and the use of rumination during the first DE predicted the severity of that episode. In contrast, neither trait nor state rumination predicted the duration of the first DE. Participants showed moderate stability of RSs over 1 year and responded in a consistent manner when depressed.
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    A distinction between ruminative and reflective types of private self-attentiveness is introduced and evaluated with respect to L. R. Goldberg's (1982) list of 1,710 English trait adjectives (Study 1), the five-factor model of personality (FFM) and A. Fenigstein, M. F. Scheier, and A. Buss's (1975) Self-Consciousness Scales (Study 2), and previously reported correlates and effects of private self-consciousness (PrSC; Studies 3 and 4). Results suggest that the PrSC scale confounds two unrelated, motivationally distinct dispositions--rumination and reflection--and that this confounding may account for the "self-absorption paradox" implicit in PrSC research findings: Higher PrSC scores are associated with more accurate and extensive self-knowledge yet higher levels of psychological distress. The potential of the FFM to provide a comprehensive framework for conceptualizing self-attentive dispositions, and to order and integrate research findings within this domain, is discussed.
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  • Article
    It was hypothesized that women are more vulnerable to depressive symptoms than men because they are more likely to experience chronic negative circumstances (or strain), to have a low sense of mastery, and to engage in ruminative coping. The hypotheses were tested in a 2-wave study of approximately 1,100 community-based adults who were 25 to 75 years old. Chronic strain, low mastery, and rumination were each more common in women than in men and mediated the gender difference in depressive symptoms. Rumination amplified the effects of mastery and, to some extent, chronic strain on depressive symptoms. In addition, chronic strain and rumination had reciprocal effects on each other over time, and low mastery also contributed to more rumination. Finally, depressive symptoms contributed to more rumination and less mastery over time.
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    Using a combination of classical test theory and Rasch item analysis, we developed a short scale designed to measure the effectiveness of mental health treatment across a wide range of mental health services and populations. Item development for the scale was guided by literature review and interviews with senior clinicians and with patients. Using 3 different samples consisting of inpatients, outpatients, and nonpatients, we reduced our initial item pool from 81 to 10 items. The 10-item scale had an alpha of .96 and showed strong correlations with commonly used measures of psychological well-being and distress. Our results suggest that the scale appears to measure a broad domain of psychological health. The scale appeared to lack ceiling and floor effects, and it discriminated between inpatients, outpatients, and nonpatients, suggesting the scale has excellent potential to be broadly responsive to a variety of treatment effects. In addition, the new scale proved to be sensitive to treatment changes in a sample of 20 psychiatric inpatients. Overall, the initial data suggest that we have developed a brief, sensitive outcome measure designed to have wide application across psychiatric and psychological treatments and populations.
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    This study evaluated mindfulness-based cognitive therapy (MBCT), a group intervention designed to train recovered recurrently depressed patients to disengage from dysphoria-activated depressogenic thinking that may mediate relapse/recurrence. Recovered recurrently depressed patients (n = 145) were randomized to continue with treatment as usual or, in addition, to receive MBCT. Relapse/recurrence to major depression was assessed over a 60-week study period. For patients with 3 or more previous episodes of depression (77% of the sample), MBCT significantly reduced risk of relapse/recurrence. For patients with only 2 previous episodes, MBCT did not reduce relapse/recurrence. MBCT offers a promising cost-efficient psychological approach to preventing relapse/recurrence in recovered recurrently depressed patients.
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    Several studies have shown that people who engage in ruminative responses to depressive symptoms have higher levels of depressive symptoms over time, after accounting for baseline levels of depressive symptoms. The analyses reported here showed that rumination also predicted depressive disorders, including new onsets of depressive episodes. Rumination predicted chronicity of depressive disorders before accounting for the effects of baseline depressive symptoms but not after accounting for the effects of baseline depressive symptoms. Rumination also predicted anxiety symptoms and may be particularly characteristic of people with mixed anxiety/depressive symptoms.
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    The objective of this study was to assess the effects of participation in a mindfulness meditation-based stress reduction program on mood disturbance and symptoms of stress in cancer outpatients. A randomized, wait-list controlled design was used. A convenience sample of eligible cancer patients enrolled after giving informed consent and were randomly assigned to either an immediate treatment condition or a wait-list control condition. Patients completed the Profile of Mood States and the Symptoms of Stress Inventory both before and after the intervention. The intervention consisted of a weekly meditation group lasting 1.5 hours for 7 weeks plus home meditation practice. Ninety patients (mean age, 51 years) completed the study. The group was heterogeneous in type and stage of cancer. Patients' mean preintervention scores on dependent measures were equivalent between groups. After the intervention, patients in the treatment group had significantly lower scores on Total Mood Disturbance and subscales of Depression, Anxiety, Anger, and Confusion and more Vigor than control subjects. The treatment group also had fewer overall Symptoms of Stress; fewer Cardiopulmonary and Gastrointestinal symptoms; less Emotional Irritability, Depression, and Cognitive Disorganization; and fewer Habitual Patterns of stress. Overall reduction in Total Mood Disturbance was 65%, with a 31% reduction in Symptoms of Stress. This program was effective in decreasing mood disturbance and stress symptoms in both male and female patients with a wide variety of cancer diagnoses, stages of illness, and ages. cancer, stress, mood, intervention, mindfulness.
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    Mindfulness-Based Stress Reduction (MBSR) is a clinical program, developed to facilitate adaptation to medical illness, which provides systematic training in mindfulness meditation as a self-regulatory approach to stress reduction and emotion management. There has been widespread and growing use of this approach within medical settings in the last 20 years, and many claims have been made regarding its efficacy. This article will provide a critical evaluation of the available state of knowledge regarding MBSR and suggestions for future research. A review of the current literature available within the medical and social sciences was undertaken to provide an evaluation regarding what we know about the construct of mindfulness, the effectiveness of MBSR, and mechanisms of action. There has been a paucity of research and what has been published has been rife with methodological problems. At present, we know very little about the effectiveness of this approach. However, there is some evidence that suggests that it may hold some promise. The available evidence does not support a strong endorsement of this approach at present. However, serious investigation is warranted and strongly recommended.
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    Rumination was examined as a potential common mechanism linking risk factors with depression. Initially nondepressed individuals (N = 137) were assessed for presence of a ruminative response style and 4 other hypothesized risk factors for depression. They were followed for 2.5 years. Negative cognitive styles, self-criticism, dependency, neediness, and history of past depression were all significantly associated with rumination. Rumination mediated the predictive relationships of all risk factors except dependency with the number of prospective Diagnostic and Statistical Manual of Mental Disorders (3rd ed., rev.; American Psychiatric Association, 1987) major depressive episodes (MDEs; definite and subthreshold) during the follow-up period. In contrast, private self-consciousness did not mediate any relationships between risk factors and subsequent MDEs. Thus, rumination, as a special kind of self-focus, may act as a general proximal mechanism through which other vulnerability factors affect depression.
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    Meditation is becoming widely popular as an adjunct to conventional medical therapies. This article reviews the literature regarding the experience of chronic illness, theories about meditation, and clinical effects of this self-care practice. Eastern theories of meditation include Buddhist psychology. The word Buddha means the awakened one, and Buddhist meditators have been called the first scientists, alluding to more than 2500 years of precise, detailed observation of inner experience. The knowledge that comprises Buddhist psychology was derived inductively from the historical figure's (Prince Siddhartha Gautama) diligent self-inquiry. Western theories of meditation include Jungian, Benson's relaxation response, and transpersonal psychology. Clinical effects of meditation impact a broad spectrum of physical and psychological symptoms and syndromes, including reduced anxiety, pain, and depression, enhanced mood and self-esteem, and decreased stress. Meditation has been studied in populations with fibromyalgia, cancer, hypertension, and psoriasis. While earlier studies were small and lacked experimental controls, the quality and quantity of valid research is growing. Meditation practice can positively influence the experience of chronic illness and can serve as a primary, secondary, and/or tertiary prevention strategy. Health professionals demonstrate commitment to holistic practice by asking patients about use of meditation, and can encourage this self-care activity. Simple techniques for mindfulness can be taught in the clinical setting. Living mindfully with chronic illness is a fruitful area for research, and it can be predicted that evidence will grow to support the role of consciousness in the human experience of disease.
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    Recovered recurrently depressed patients were randomized to treatment as usual (TAU) or TAU plus mindfulness-based cognitive therapy (MBCT). Replicating previous findings, MBCT reduced relapse from 78% to 36% in 55 patients with 3 or more previous episodes; but in 18 patients with only 2 (recent) episodes corresponding figures were 20% and 50%. MBCT was most effective in preventing relapses not preceded by life events. Relapses were more often associated with significant life events in the 2-episode group. This group also reported less childhood adversity and later first depression onset than the 3-or-more-episode group, suggesting that these groups represented distinct populations. MBCT is an effective and efficient way to prevent relapse/recurrence in recovered depressed patients with 3 or more previous episodes.
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    Mindfulness-based stress reduction (MBSR) is a structured group program that employs mindfulness meditation to alleviate suffering associated with physical, psychosomatic and psychiatric disorders. The program, nonreligious and nonesoteric, is based upon a systematic procedure to develop enhanced awareness of moment-to-moment experience of perceptible mental processes. The approach assumes that greater awareness will provide more veridical perception, reduce negative affect and improve vitality and coping. In the last two decades, a number of research reports appeared that seem to support many of these claims. We performed a comprehensive review and meta-analysis of published and unpublished studies of health-related studies related to MBSR. Sixty-four empirical studies were found, but only 20 reports met criteria of acceptable quality or relevance to be included in the meta-analysis. Reports were excluded due to (1) insufficient information about interventions, (2) poor quantitative health evaluation, (3) inadequate statistical analysis, (4) mindfulness not being the central component of intervention, or (5) the setting of intervention or sample composition deviating too widely from the health-related MBSR program. Acceptable studies covered a wide spectrum of clinical populations (e.g., pain, cancer, heart disease, depression, and anxiety), as well as stressed nonclinical groups. Both controlled and observational investigations were included. Standardized measures of physical and mental well-being constituted the dependent variables of the analysis. Overall, both controlled and uncontrolled studies showed similar effect sizes of approximately 0.5 (P<.0001) with homogeneity of distribution. Although derived from a relatively small number of studies, these results suggest that MBSR may help a broad range of individuals to cope with their clinical and nonclinical problems.
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    A self-report inventory for the assessment of mindfulness skills was developed, and its psychometric characteristics and relationships with other constructs were examined. Participants included three samples of undergraduate students and a sample of outpatients with borderline personality disorder Based on discussions of mindfulness in the current literature, four mindfulness skills were specified: observing, describing, acting with awareness, and accepting without judgment. Scales designed to measure each skill were developed and evaluated. Results showed good internal consistency and test-retest reliability and a clear factor structure. Most expected relationships with other constructs were significant. Findings suggest that mindfulness skills are differentially related to aspects of personality and mental health, including neuroticism, psychological symptoms, emotional intelligence, alexithymia, experiential avoidance, dissociation, and absorption.
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    Sleep disturbance is a very common problem for cancer patients that has largely not been addressed in the clinical intervention literature. Mindfulness meditation has demonstrated clinical benefits for a variety of patient populations in other areas of functioning. This study examined the effects of an 8-week Mindfulness-Based Stress Reduction (MBSR) program on the sleep quality of a heterogeneous sample of 63 cancer patients. Overall sleep disturbance was significantly reduced (p < .001) and participants reported that their sleep quality had improved (p .001). There was also a significant reduction in stress (p < .001), mood disturbance (p = .001), and fatigue (p < .001). The associations among these changes and implications for improving quality of life of cancer patients are discussed.
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    The authors examine the facet structure of mindfulness using five recently developed mindfulness questionnaires. Two large samples of undergraduate students completed mindfulness questionnaires and measures of other constructs. Psychometric properties of the mindfulness questionnaires were examined, including internal consistency and convergent and discriminant relationships with other variables. Factor analyses of the combined pool of items from the mindfulness questionnaires suggested that collectively they contain five clear, interpretable facets of mindfulness. Hierarchical confirmatory factor analyses suggested that at least four of the identified factors are components of an overall mindfulness construct and that the factor structure of mindfulness may vary with meditation experience. Mindfulness facets were shown to be differentially correlated in expected ways with several other constructs and to have incremental validity in the prediction of psychological symptoms. Findings suggest that conceptualizing mindfulness as a multifaceted construct is helpful in understanding its components and its relationships with other variables.
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    Background: Although mindfulness meditation interventions have recently shown benefits for reducing stress in various populations, little is known about their relative efficacy compared with relaxation interventions. Purpose: This randomized controlled trial examines the effects of a 1-month mindfulness meditation versus somatic relaxation training as compared to a control group in 83 students (M age = 25; 16 men and 67 women) reporting distress. Method: Psychological distress, positive states of mind, distractive and ruminative thoughts and behaviors, and spiritual experience were measured, while controlling for social desirability. Results: Hierarchical linear modeling reveals that both meditation and relaxation groups experienced significant decreases in distress as well as increases in positive mood states over time, compared with the control group (p < .05 in all cases). There were no significant differences between meditation and relaxation on distress and positive mood states over time. Effect sizes for distress were large for both meditation and relaxation (Cohen's d = 1.36 and .91, respectively), whereas the meditation group showed a larger effect size for positive states of mind than relaxation (Cohen's d =.71 and .25, respectively). The meditation group also demonstrated significant pre-post decreases in both distractive and ruminative thoughts/behaviors compared with the control group (p < .04 in all cases; Cohen's d = .57 for rumination and .25 for distraction for the meditation group), with mediation models suggesting that mindfulness meditation's effects on reducing distress were partially mediated by reducing rumination. No significant effects were found for spiritual experience. Conclusions: The data suggest that compared with a no-treatment control, brief training in mindfulness meditation or somatic relaxation reduces distress and improves positive mood states. However, mindfulness meditation may be specific in its ability to reduce distractive and ruminative thoughts and behaviors, and this ability may provide a unique mechanism by which mindfulness meditation reduces distress.
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