Abstract
We examined the effects of mindfulness-based cognitive therapy (MBCT) on symptom severity of depression, complicated grief, posttraumatic stress, and working memory in elderly bereaved people with long-term bereavement-related distress. A non-randomized, controlled pilot design was used in a sample of elderly bereaved people (mean age = 77 years) with long-term bereavement-related distress. Results were compared between MBCT intervention group completers (n = 12), intervention group intention to treat (n = 18), and wait list controls (n = 18) at pre- and post-intervention and at a 5-month follow-up. Compared to wait list controls, MBCT reduced depressive symptoms significantly in intervention completers at follow-up (Hedges’ g = 0.84, p = 0.04) with significant interaction between group and time (Hedges’ g = 0.88, p = 0.02). No other significant outcome differences between groups were observed, although the interaction effect on working memory at post-intervention approached a significant level (Hedges’ g = 0.35, p = 0.09). In the wait list group, 29 % had elevated depressive symptoms both before intervention and at follow-up. In the intervention group, 50 % of the completers had elevated depressive symptoms before intervention, but 0 % had elevated symptoms at follow-up. MBCT appears to reduce depressive symptoms in this sample of elderly bereaved people, but further studies of the effects of MBCT in this population are needed for firm conclusions.
Similar content being viewed by others
References
Beck, A. T. (1976). Cognitive therapy and the emotional disorders. New York: New American Library.
Beck, A. T., Steer, R. A., & Garbin, M. G. (1988). Psychometric properties of the Beck Depression Inventory: twenty-five years of evaluation. Clinical Psychology Review, 8, 77–100.
Beck, A. T., Steer, R. A., & Brown, G. K. (1996). Manual for the revised Beck Depression Inventory. San Antonio: The Psychological Corporation.
Berntsen, D., & Rubin, D. C. (2006). The centrality of event scale: a measure of integrating a trauma into one’s identity and its relation to post-traumatic stress disorder symptoms. Behaviour Research and Therapy, 44, 219–231.
Boelen, P. A. (2009). The centrality of a loss and its role in emotional problems among bereaved people. Behavior Research and Therapy, 47, 616–622.
Bonanno, G. A., & Kaltman, S. (1999). Toward an integrative perspective on bereavement. Psychological Bulletin, 125, 760–776.
Bonanno, G. A., Boerner, K., & Worthman, C. B. (2008). Trajectories of grieving. In M. S. Stroebe, R. O. Hansson, H. Schut, & W. Stroebe (Eds.), Handbook of bereavement research and practice. Advances in theory and intervention (pp. 287–308). Washington, DC: American Psychological Association.
Carr, D. (2008). Factors that influence late-life bereavement: considering data from the Changing Life’s of Older Couples Study. In M. S. Stroebe, R. O. Hansson, H. Schut, & W. Stroebe (Eds.), Handbook of bereavement research and practice. Advances in theory and intervention (pp. 417–440). Washington, DC: American Psychological Association.
Cohen, J. (1988). Statistical power analysis for the behavioural sciences (2nd ed.). Hillsdale: Lawrence Erlbaum.
Didonna, F. (Ed.). (2009). Clinical handbook of mindfulness. New York: Springer.
Hansson, R. O., & Stroebe, M. S. (2007). Bereavement in late life. Washington, DC: American Psychological Association.
Harmer, C. J., O’Sullivan, U., Favaron, E., Massey-Chase, R., Ayres, R., Reinecke, A., et al. (2009). Effect of acute antidepressant administration on negative affective bias in depressed patients. The American Journal of Psychiatry, 166, 1178–1184.
Hedges, L. V., & Olkin, I. (1985). Statistical methods for meta-analysis. New York: Academic.
Hoffmann, S. G., Sawyer, A. T., Witt, A. A., & Oh, D. (2010). The effect of mindfulness-based therapy on anxiety and depression: a metaanalytic review. Journal of Consulting and Clinical Psychology, 78, 169–183.
Ivanovski, B., & Malhi, G. S. (2007). The psychological and neurophysiological concomitants of mindfulness forms of meditation. Acta Neuropsychiatrica, 19, 76–91.
Jacobs, S., Mazure, C., & Prigerson, H. (2000). Diagnostic criteria of complicated grief. Death Studies, 24, 185–199.
Jha, A. P., Stanley, E. A., Kiyonaga, A., Wong, L., & Gelfand, L. (2010). Examining the protective effect of mindfulness training on working memory and affective experience. Emotion, 10, 54–64.
Johanson, B. (2008). Memory and cognition in aging. In R. Woods & I. Clare (Eds.), Clinical psychology of aging (Secondth ed., pp. 33–56). Chichester: Wiley.
Kabat-Zinn, J. (1990). Full catastrophe living. How to cope with stress, pain and illness using mindfulness meditation. New York: Dell.
Kumar, S. M. (2005). Grieving mindfully. A compassionate and spiritual guide to coping with loss. Oakland: New Harbinger.
Litz, B. T., & Maguen, S. (2008). Early intervention for trauma. In M. J. Friedman, T. M. Keane, & P. A. Resick (Eds.), Handbook for PTSD. Science and practice (pp. 306–329). New York: Guilford.
Mollica, R. F., Caspi-Yavin, Y., Bollini, P., & Truong, T. (1992). The Harvard trauma questionnaire: validating a cross-cultural Instrument for measuring torture, trauma, and posttraumatic stress disorder in Indochinese refugees. The Journal of Nervous and Mental Disease, 180, 111–116.
Mulsant, B. H., & Pollock, B. G. (2007). Psychopharmacology. In D. G. Blazer, D. C. Steffens, & E. W. Busse (Eds.), Essentials of geriatric psychiatry (pp. 293–336). Arlington: American Psychiatric.
O’Connor, M. (2010). A longitudinal study of PTSD in the elderly bereaved: prevalence and predictors. Aging & Mental Health, 14(6), 670–678.
Papadatou-Pastou, M., Miskowiak, K. W., Williams, J. M. G., Harmer, C. J., & Reinecke, A. (2012). Acute antidepressant drug administration and autobiographical memory recall: a functional magnetic resonance imaging study. Experimental and Clinical Psychopharmacology, 12, 1–9.
Piet, J., Hougaard, E., Hecksher, M. S., & Rosenberg, N. K. (2010). A randomized pilot study of mindfulness-based cognitive therapy and group cognitive behavioural therapy for young adults with social phobia. Personality and Social Science, 25, 403–410.
Piet, J., Würtzen, H., & Zachariae, R. (2012). The effect of mindfulness based therapy on symptoms of anxiety and depression adult cancer patients and survivors: a systematic review and meta-analysis. Journal of Consulting and Clinical Psychology. doi:10.1037/a0028329.
Prigerson, H. G., Maciejewski, P. K., Reynolds, C. F. I., Bierhals, A. J., Newsom, J. T., Fasiczka, A., et al. (1995). Inventory of complicated grief: a scale to measure maladaptive symptoms of loss. Psychiatry Research, 59, 65–79.
Raphael, B. (1977). Preventive intervention with the recently bereaved. Archives of General Psychiatry, 34, 1450–1454.
Schafer, J.L. & Graham, J.N. (2002). Missing data: our view of the state of the art. Psychological Methods, 7, 147–177.
Segal, Z. V., Williams, J. M. G., & Teasdale, J. D. (2002). Mindfulness-based cognitive therapy for depression. New York: Guilford.
Segal, Z. V., Teasdale, J. D., & Williams, J. M. G. (2004). Mindfulness-based cognitive therapy: theoretical rationale and empirical status. In S. C. Hayes, V. M. Folette, & M. M. Linehan (Eds.), Mindfulness and acceptance: expanding the cognitive–behavioral tradition. New York: Guilford.
Smith, A., Graham, L., & Senthinathan, S. (2007). Mindfulness-based cognitive therapy for depression in older people: a qualitative study. Aging & Mental Health, 11, 346–357.
Splevins, K., Smith, A., & Simpson, J. (2009). Do improvements in emotional distress correlate with becoming more mindful? A study of older adults. Aging & Mental Health, 13, 328–335.
Stroebe, M. S., Schut, M. S., & Stroebe, H. (2007). Health outcomes of bereavement. Lancet, 370, 1960–1973.
Unverzagt, F. V., Monahan, P. O., Moser, L. R., Zhao, Q., Carpenter, J. S., Sledge, G. W., et al. (2007). The Indiana University telephone-based assessment of neuropsychological status: a new method for large scale neuropsychological assessment. Journal of the International Neuropsychological Society, 13, 799–806.
Wechsler, D. (1997). WAIS-III administration and scoring manual. San Antonio: The Psychological Corporation.
Williams, M. (2010). Mindfulness and psychological process. Emotion, 10, 1–7.
Woods, & Clare (Eds.). (2008). Clinical psychology of aging (Secondth ed.). Chichester: Wiley.
Young, L. A., & Baime, M. J. (2010). Mindfulness-based stress reduction: effect on emotional distress in older adults. Complimentary Health Practice Review, 15, 59–64.
Zeidan, F., Johnson, S. K., Diamond, B. C., David, Z., & Goolkasian, P. (2010). Mindfulness meditation improves cognition: evidence of brief mental training. Consciousness and Cognition, 19, 597–605.
Acknowledgments
This research was funded The EGV Foundation. We would like to thank both EGV and all our participants for making this study possible.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
O’Connor, M., Piet, J. & Hougaard, E. The Effects of Mindfulness-Based Cognitive Therapy on Depressive Symptoms in Elderly Bereaved People with Loss-Related Distress: a Controlled Pilot Study. Mindfulness 5, 400–409 (2014). https://doi.org/10.1007/s12671-013-0194-x
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12671-013-0194-x