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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    • "Indeed, a series of experimental studies have shown that adopting a self-distanced ( " fly-on-the-wall " ) perspective when recalling distressing autobiographical memories reduced depressogenic, ruminative thinking and physiological reactivity, and facilitated adaptive self-reflection, when compared to adopting a self-immersed, first-person perspective ( Kross & Ayduk, 2009; Kross, Ayduk, & Mischel, 2005; Wisco & Nolen-Hoeksema, 2011). Decentering is a naturally occurring characteristic of individuals that can be trained using traditional cognitive therapy methods (Beck, Rush, Shaw, & Emery, 1979; Fresco, Moore, et al., 2007; Fresco, Segal, Buis, & Kennedy, 2007; Mennin & Fresco, 2013). However it has been suggested that the capacity to decenter may be optimally cultivated via mindfulness meditation training, through the repeated practice of observing mental phenomena (e.g., thoughts, emotions, sensations) objectively, as transient mental events, with an attitude of acceptance (Segal et al., 2002; Teasdale, 1999; Teasdale et al., 2002). "

    Full-text · Article · Feb 2016 · Psychological Assessment
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    • "Decentering or Bdefusion^ is the ability to take a detached view of one's own thoughts and emotions considering them as impermanent events of the mind (Fresco et al. 2007b). The analogy is based on the following: First, studies on the phenomenology of the ayahuasca experience emphasize the detached view of one's own thoughts and emotions that the substance elicits (Shanon 2002). "
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    ABSTRACT: Background: Ayahuasca is a psychotropic plant tea used for ritual purposes by the indigenous populations of the Amazon. In the last two decades, its use has expanded worldwide. The tea contains the psychedelic 5-HT2A receptor agonist N,N-dimethyltryptamine (DMT), plus β-carboline alkaloids with monoamine-oxidase-inhibiting properties. Acute administration induces an introspective dream-like experience characterized by visions and autobiographic and emotional memories. Studies of long-term users have suggested its therapeutic potential, reporting that its use has helped individuals abandon the consumption of addictive drugs. Furthermore, recent open-label studies in patients with treatment-resistant depression found that a single ayahuasca dose induced a rapid antidepressant effect that was maintained weeks after administration. Here, we conducted an exploratory study of the psychological mechanisms that could underlie the beneficial effects of ayahuasca. Methods: We assessed a group of 25 individuals before and 24 h after an ayahuasca session using two instruments designed to measure mindfulness capacities: The Five Facets Mindfulness Questionnaire (FFMQ) and the Experiences Questionnaire (EQ). Results: Ayahuasca intake led to significant increases in two facets of the FFMQ indicating a reduction in judgmental processing of experiences and in inner reactivity. It also led to a significant increase in decentering ability as measured by the EQ. These changes are classic goals of conventional mindfulness training, and the scores obtained are in the range of those observed after extensive mindfulness practice. Conclusions: The present findings support the claim that ayahuasca has therapeutic potential and suggest that this potential is due to an increase in mindfulness capacities.
    Full-text · Article · Nov 2015 · Psychopharmacology
    • "Fresco, Segal, Buis, and Kennedy (2007) demonstrated that, among patients with depression treated to remission, CBT responders exhibited greater gains in decentering than did medication responders. Further, post-treatment levels of decentering and low cognitive reactivity in response to an emotion challenge were associated with the lowest rates of relapse in the 18-month follow-up period (Fresco et al., 2007). Decreased decentering in response to a mood induction also seems to predict depressive relapse (Teasdale et al., 2002). "
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    ABSTRACT: Across theoretical orientations, attempts to avoid and suppress difficult psychological content are presumed to interfere with psychological functioning and diminish well-being. Thus, a common theme in psychotherapy, which transcends theoretical orientation, is the promotion of acceptance. Recently, the use of mindfulness practices, and other experiential exercises aimed at increasing acceptance, to enhance existing cognitive and behavioral therapies has gained considerable attention. The goal of this chapter is to describe the theory underlying these efforts, provide a brief history of their development, describe the clinical strategies used with these approaches, and review the research that supports these efforts. We will also suggest future directions aimed at stimulating additional research literature and informing clinical practice.
    No preview · Chapter · Dec 2014
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