Mindfulness-based interventions for the treatment of depressive ruminationsystematic review and meta-analysis

  1. Lilisbeth Perestelo Pérez 1
  2. Jorge Barraca Mairal 2
  3. Wenceslao Peñate Castro 3
  4. Amado Rivero Santana 1
  5. Yolanda Beatriz Álvarez Pérez 4
  1. 1 Red de Investigación de Servicios de Salud en Enfermedades Crónicas
    info

    Red de Investigación de Servicios de Salud en Enfermedades Crónicas

    Madrid, España

  2. 2 Universidad Camilo José Cela
    info

    Universidad Camilo José Cela

    Villanueva de la Cañada, España

    ROR https://ror.org/03f6h9044

  3. 3 Universidad de La Laguna
    info

    Universidad de La Laguna

    San Cristobal de La Laguna, España

    ROR https://ror.org/01r9z8p25

  4. 4 Fundación Canaria Instituto de Investigación Sanitaria de Canarias
    info

    Fundación Canaria Instituto de Investigación Sanitaria de Canarias

    Las Palmas de Gran Canaria, España

Journal:
International journal of clinical and health psychology

ISSN: 1697-2600

Year of publication: 2017

Volume: 17

Issue: 3

Pages: 282-295

Type: Article

DOI: 10.1016/j.ijchp.2017.07.004 DIALNET GOOGLE SCHOLAR lock_openOpen access editor

Abstract

Background/Objective: This systematic review aims to evaluate the effect of interventions based on the mindfulness and/or acceptance process on ruminative thoughts, in patients with depression. Method: Electronic searches in Medline, Embase, Cochrane Central, PsycInfo, and Cinahl until December 2016, in addition to hand-searches of relevant studies, identified eleven studies that fulfilling inclusion criteria. Results: A meta-analysis of the effect of the intervention compared to usual care showed a significant and moderate reduction of ruminative thoughts (g=−0.59, 95% CI: −0.77, −0.41; I2=0%). Furthermore, findings suggest that mindfulness/acceptance processes might mediate changes in rumination, and that they in turn mediate in the clinical effects of interventions. A meta-analysis of three studies that compared the intervention to other active treatments (medication, behavioral activation and cognitive-behavioral therapy, respectively) showed no significant differences. Conclusions: Mindfulness-based cognitive therapy compared to usual care, produces a significant and moderate reduction in rumination. This effect seems independent of the treatment phase (acute or maintenance) or the number of past depressive episodes, and it was maintained one month after the end of treatment. However, further controlled studies with real patients that compare the most commonly used cognitive-behavioral techniques to treat ruminative thoughts to the acceptance and mindfulness techniques are needed.

Bibliographic References

  • Aldao, A., Nolen-Hoeksema, S., & Schweizer, S. (2010).Emotion-regulation strategies across psychopathology: Ameta-analytic review. Clinical Psychology Review, 30, 217---237.http://dx.doi.org/10.1016/j.cpr.2009.11.004
  • A-Tjak, J. G. L., Davis, M. L., Morina, N., Powers, M. B., Smits, J. A.J., & Emmelkamp, P. M. G. (2015). A Meta-Analysis of the Efficacyof Acceptance and Commitment Therapy for Clinically RelevantMental and Physical Health Problems. Psychotherapy and Psy-chosomatics, 84, 30---36. http://dx.doi.org/10.1159/000365764
  • Barraca, J. (2012). Mental control from a third-wave behavior ther-apy perspective. International Journal of Clinical and HealthPsychology, 12, 109---121.
  • Batink, T., Peeters, F., Geschwind, N., van Os, J., & Wichers, M.(2013). How Does MBCT for Depression Work? Studying Cogni-tive and Affective Mediation Pathways. PLoS ONE, 8, e72778.http://dx.doi.org/10.1371/journal.pone.0072778
  • Beck, A., Steer, R., & Brown, G. (1996). Manual for the Beck Depres-sion Inventory---II. San Antonio, TX: Psychological Corporation.
  • Bieling, P. J., Hawley, L. L., Bloch, R. T., Corcoran, K. M.,Levitan, R. D., Young, L. T., Macqueen, G. M., & Segal, Z.V. (2012). Treatment-specific changes in decentering follow-ing mindfulness-based cognitive therapy versus antidepressantmedication or placebo for prevention of depressive relapse.Journal of Consulting and Clinical Psychology, 80, 365---372.http://dx.doi.org/10.1037/a0027483
  • Bockting, C. L., Hollon, S. D., Jarrett, R. B., Kuyken, W., & Dobson,K. (2015). A lifetime approach to major depressive disorder:The contributions of psychological interventions in preventingrelapse and recurrence. Clinical Psychology Review, 41, 16---26.http://dx.doi.org/10.1016/j.cpr.2015.02.003
  • Centre for Reviews and Dissemination, CRD (2006). SystematicReview of the Clinical Effectiveness of Self Care SupportNetworks in Health and Social Care. York: University of York.
  • Chiesa, A., & Serretti, A. (2011). Mindfulness based cogni-tive therapy for psychiatric disorders: A systematic reviewand meta-analysis. Psychiatry Research, 187, 441---453.http://dx.doi.org/10.1016/j.psychres.2010.08.011
  • Clarke, K., Mayo-Wilson, E., Kenny, J., & Pilling, S. (2015). Cannon-pharmacological interventions prevent relapse in adultswho have recovered from depression? A systematic reviewand meta-analysis of randomised controlled trials. ClinicalPsychology Review, 39, 58---70. http://dx.doi.org/10.1016/j.cpr.2015.04.002
  • Cohen, J. (1988). Statistical Power Analysis for the Behavioral Sci-ences (2nd ed.). New Jersey: Lawrence Erlbaum.
  • Crane, R. S., Kuyken, W., Williams, J. M. G., Hastings, R. P.,Cooper, L., & Fennell, M. J. V. (2012). Competence in Teach-ing Mindfulness-Based Courses: Concepts. Development andAssessment. Mindfulness, 3, 76---84. http://dx.doi.org/10.1007/s12671-011-0073-2
  • Deeks, J. J., Altman, D. G., & Bradburn, M. J. (2008). Statisti-cal Methods for Examining Heterogeneity and Combining Resultsfrom Several Studies in Meta-Analysis. In M. Egger, G. Davey-Smith, & D. Altman (Eds.), Systematic Reviews in Health Care(pp. 285---312). London, UK: BMJ Publishing Group.
  • Egger, M., Davey Smith, G., Schneider, M., & Minder, C.(1997). Bias in meta-analysis detected by a simple,graphical test. British Medical Journal, 315, 629---634.http://dx.doi.org/10.1136/bmj.316.7129.4691
  • Fjorback, L. O., Arendt, M., Ornbol, E., Fink, P., & Walach, H.(2011). Mindfulness-Based Stress Reduction and Mindfulness-Based Cognitive Therapy - a systematic review of randomizedcontrolled trials. Acta Psychiatrica Scandinavica, 124, 102---119.http://dx.doi.org/10.1111/j.1600-0447.2011.01704.x*
  • Geschwind, N., Peeters, F., Drukker, M., van Os, J., & Wichers, M.(2011). Mindfulness training increases momentary positive emo-tions and reward experience in adults vulnerable to depression:A randomized controlled trial. Journal of Consulting and ClinicalPsychology, 79, 618---628. http://dx.doi.org/10.1037/a0024595
  • Gotlib, I. H., & Joormann, J. (2010). Cognition and Depres-sion: Current Status and Future Directions. Annual Review ofClinical Psychology, 6, 285---312. http://dx.doi.org/10.1146/annurev.clinpsy.121208.131305
  • Hayes, S. (2004). Acceptance and Commitment Therapy, RelationalFrame Theory, and the Third Wave of Behavioral and Cogni-tive Therapies. Behavior Therapy Integrative Behavioral CouplesTherapy, 35, 639---665.
  • Hayes, S., Levin, M., Plumb-Vilardaga, J., Villatte, J., & Pistorello,J. (2013). Acceptance and Commitment Therapy and Contex-tual Behavioral Science: Examining the Progress of a DistinctiveModel of Behavioral and Cognitive Therapy. Behavior Therapy,44, 180---198. http://dx.doi.org/10.1016/j.beth.2009.08.002
  • Hayes, S., Wilson, K., Gifford, E., Follette, V., & Strosahl, K.(1996). Experimental avoidance and behavioral disorders: Afunctional dimensional approach to diagnosis and treatment.Journal of Consulting and Clinical Psychology, 64, 1152---1168.http://www.ncbi.nlm.nih.gov/pubmed/8991302
  • Hayes, S. C., Luoma, J. B., Bond, F. W., Masuda, A., & Lillis,J. (2006). Acceptance and Commitment Therapy: Model, pro-cesses and outcomes. Psychology Faculty Publications. Paper,101. http://scholarworks.gsu.edu/psych facpub
  • Hofmann, S. G., Sawyer, A. T., Witt, A. A., & Oh, D. (2010). Theeffect of mindfulness-based therapy on anxiety and depression:A meta-analytic review. Journal of Consulting and Clinical Psy-chology, 78, 169---183. http://dx.doi.org/10.1037/a0018555
  • Jermann, F., Van der Linden, M., Gex-Fabry, M., Guarin, A.,Kosel, M., Bertschy, G., Aubry, J. M., & Bondolfi, G. (2013).Cognitive Functioning in Patients Remitted from Recurrent Depression: Comparison with Acutely Depressed Patients andControls and Follow-up of a Mindfulness-Based Cognitive Ther-apy Trial. Cognitive Therapy and Research, 37, 1004---1014.http://dx.doi.org/10.1007/s10608-013-9544-1
  • Johnson, D., Mullen, D., Smith, I. D., & Wilson, A. (2016).Mindfulness in addictions. BJPscyh Advances, 22, 412---419.http://dx.doi.org/10.1192/apt.bp.114.014142
  • Kabat-Zinn, J. (1990). Full Catastrophe Living: The program of theStress Reduction Clinic at the University of Massachusetts Medi-cal Center. New York: Delta.
  • Khoury, B., Lecomte, T., Fortin, G., Masse, M., Therien, P.,Bouchard, V., Chapleau, M. A., Paquin, K., & Hofmann,S. G. (2013). Mindfulness-based therapy: A comprehen-sive meta-analysis. Clinical Psychology Review, 33, 763---771.http://dx.doi.org/10.1016/j.cpr.2013.05.005
  • Kingston, T., Dooley, B., Bates, A., Lawlor, E., & Malone, K. (2007).Mindfulness-based cognitive therapy for residual depressivesymptoms. Psychology and Psychotherapy: Theory, Researchand Practice, 80, 193---203. http://dx.doi.org/10.1348/147608306X116016
  • Liberati, A., Altman, D. G., Tetzlaff, J., Mulrow, C., Gøtzsche,P. C., Ioannidis, J. P. A., Clarke, M., Devereaux, P. J.,Kleijnen, J., & Moher, D. (2009). The PRISMA statementfor reporting systematic reviews and meta-analyses of stud-ies that evaluate health care interventions: explanation andelaboration. Journal of Clinical Epidemiology, 62, e1---e34.http://dx.doi.org/10.1016/j.jclinepi.2009.06.006
  • Manicavasagar, V., Perich, T., & Parker, G. (2012). Cogni-tive Predictors of Change in Cognitive Behaviour Therapyand Mindfulness-Based Cognitive Therapy for Depression.Behavioural and Cognitive Psychotherapy, 40, 227---232.http://dx.doi.org/10.1017/S1352465811000634
  • Marcks, B. a., & Woods, D. W. (2005). A comparison ofthought suppression to an acceptance-based technique inthe management of personal intrusive thoughts: A controlledevaluation. Behaviour Research and Therapy, 43, 433---445.http://dx.doi.org/10.1016/j.brat.2004.03.005
  • Martell, C. R., Addis, M. E., & Jacobson, N. S. (2001). Depression incontext: Strategies for guided action. New York: W. W. Norton.
  • *McIndoo, C. C., File, A. A., Preddy, T., Clark, C. G., & Hopko,D. R. (2016). Mindfulness-based therapy and behavioral acti-vation: A randomized controlled trial with depressed collegestudents. Behaviour Research and Therapy, 77, 118---128.http://dx.doi.org/10.1016/j.brat.2015.12.012
  • Moher, D., Liberati, A., Tetzlaff, J., & Altman, D. G. (2009).Preferred Reporting Items for Systematic Reviews andMeta-Analyses: The PRISMA Statement. Journal of ClinicalEpidemiology, 62, 1006---1012. http://dx.doi.org/10.1016/j.jclinepi.2009.06.005
  • Montgomery, K. L., Kim, J. S., & Franklin, C. (2011). Acceptanceand commitment therapy for psychological and physiological ill-nesses: A systematic review for social workers. Health & SocialWork, 36, 169---181. http://dx.doi.org/10.1093/hsw/36.3.169
  • Morris, S. B. (2008). Estimating effect sizes from pretest-posttest-control group designs. Organizational Research Methods, 11,364---386.
  • Najmi, S., Riemann, B. C., & Wegner, D. M. (2009). Managingunwanted intrusive thoughts in obsessive-compulsive disorder:relative effectiveness of suppression, focused distraction, andacceptance. Behaviour Research and Therapy, 47, 494---503.http://dx.doi.org/10.1016/j.brat.2009.02.015
  • Nolen-Hoeksema, S., & Morrow, J. (1991). A prospective studyof depression and posttraumatic stress symptoms after anatural disaster: The 1989 Loma Prieta earthquake. Jour-nal of Personality and Social Psychology, 61, 115---121.http://dx.doi.org/10.1037//0022-3514.61.1.115
  • Ost, L.-G. (2008). Efficacy of the third wave of behavioral therapies:A systematic review and meta-analysis. Behaviour Researchand Therapy, 46, 296---321. http://dx.doi.org/10.1016/j.brat.2007.12.005
  • Ost, L.-G. (2014). The efficacy of Acceptance and Commit-ment Therapy: An updated systematic review and meta-analysis. Behaviour Research and Therapy, 61, 105---121.http://dx.doi.org/10.1016/j.brat.2014.07.018
  • Piet, J., & Hougaard, E. (2011). The effect of mindfulness-based cognitive therapy for prevention of relapse in recur-rent major depressive disorder: A systematic review andmeta-analysis. Clinical Psychology Review, 31, 1032---1040.http://dx.doi.org/10.1016/j.cpr.2011.05.002
  • Powers, M. B., Zum Vörde Sive Vörding, M. B., & Emmelkamp,P. M. G. (2009). Acceptance and Commitment Therapy: AMeta-Analytic Review. Psychotherapy and Psychosomatics, 78,73---80. http://dx.doi.org/10.1159/000190790
  • Raes, F., Hermans, D., & Eelen, P. (2003). De Nederlandstalige versievan de Ruminative Response Scale (RRS-NL) en de Ruminationon Sadness Scale (RSS-NL) (The Dutch version of the RuminativeResponse Scale (RRS-NL) and the Rumination on Sadness Scale(RSS-NL)). Gedragstherapie, 36, 97---104.
  • Ruiz, F. J. (2012). Acceptance and Commitment Therapy ver-sus Traditional Cognitive Behavioral Therapy: A SystematicReview and Meta-analysis of Current Empirical Evidence. Inter-national Journal of Psychology & Psychological Therapy, 12,333---357.
  • Rush, A. J., Gullion, C. M., Basco, M. R., Jarrett, R. B., & Trivedi,M. H. (1996). The Inventory of Depressive Symptomatology (IDS):psychometric properties. Psychological Medicine, 26, 477---486.http://dx.doi.org/10.1017/S0033291700035558
  • Schoenberg, P. L. A., & Speckens, A. E. M. (2014). Modula-tion of induced frontocentral theta (Fm-θ) event-related(de-)synchronisation dynamics following mindfulness-basedcognitive therapy in Major Depressive Disorder. Cognitive Neurodynamics, 8, 373---388. http://dx.doi.org/10.1007/s11571-014-9294-0
  • *Schuver, K. J., & Lewis, B. A. (2016). Mindfulness-based yogaintervention for women with depression. Complementary Ther-apies in Medicine, 26, 85---91. http://dx.doi.org/10.1016/j.ctim.2016.03.003
  • Segal, Z. V., Williams, J. M. G., & Teasdale, J. D. (2002).Mindfulness-based cognitive therapy for depression. New York:Guilford Press.*Shahar, B., Britton, W. B., Sbarra, D. A., Figueredo, A.J., & Bootzin, R. R. (2010). Mechanisms of Change inMindfulness-Based Cognitive Therapy for Depression: Pre-liminary Evidence from a Randomized Controlled Trial.International Journal of Cognitive Therapy, 3, 402---418.http://dx.doi.org/10.1521/ijct.2010.3.4.402
  • Trapnell, P., & Campbell, J. (1999). Private self-consciousness andthe five-factor model of personality: distinguishing ruminationfrom reflection. Journal of Personality and Social Psychology,76, 284---304.
  • *Van Aalderen, J. R., Donders, a. R. T., Giommi, F., Spinhoven, P.,Barendregt, H. P., & Speckens, a. E. M. (2012). The efficacyof mindfulness-based cognitive therapy in recurrent depressedpatients with and without a current depressive episode: A ran-domized controlled trial. Psychological Medicine, 42, 989---1001.http://dx.doi.org/10.1017/S0033291711002054
  • Van Vugt, M. K., Hitchcock, P., Shahar, B., & Britton, W. (2012).The Effects of Mindfulness-Based Cognitive Therapy on Affec-tive Memory Recall Dynamics in Depression: A MechanisticModel of Rumination. Frontiers in Human Neuroscience, 6http://dx.doi.org/10.3389/fnhum.2012.00257Wegner, D. M. (1994). Ironic processes of mental control. Psycho-logical Review, 101, 34---52.