Abstract
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.
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REFERENCES
Astin, J. A. (1997). Stress reduction through mindfulness meditation. Psychotherapy and Psychosomatics, 66, 97–106.
Baer, R. A. (2003). Mindfulness training as a clinical intervention: A conceptual and empirical review. Clinical Psychology: Science and Practice, 10, 125–143.
Beck, A. T. (1967). Depression: Clinical, experimental, and theoretical aspects. NewYork: Hoeber.
Beck, A. T., Rush, A. J., Shaw, B. F., & Emery, G. (1979). Cognitive therapy for depression. New York: Guilford Press.
Beck, A. T., Ward, C. H., Mendelson, M., Mock, J., & Erbaugh, J. (1961). An inventory for measuring depression. Archives of General Psychiatry, 4, 53–63.
Bishop, S. R. (2002). What do we really know about Mindfulness-Based Stress Reduction? Psychoso-matic Medicine, 64, 71–84.
Cane, D. B., Olinger, J., Gotlib, I. H., & Kuiper, N. A. (1986). Factor structure of the dysfunctional attitude scale in a student population. Journal of Clinical Psychology, 42, 307–309.
Cook, T. D., & Campbell, D. T. (1979). Quasi-experimentation: Design & analysis issues for field settings. Boston: Houghton Mifflin Company.
Davis, R. N., & Nolen-Hoeksema, S. (2000). Cognitive inflexibility among ruminators and nonrumina-tors. Cognitive Therapy and Research, 24, 699–711.
Fava, G. A., Ruini, C., Rafanelli, C., & Grandi, S. (2002). Cognitive behavior approach to loss of clinical effect during long-term antidepressant treatment: A pilot study. American Journal of Psychiatry, 159, 2094–2095.
Fresco, D. M., Armey, M., Mennin, D. S., Turk, C. L., & Heimberg, R. G. (2004). Brooding and pondering: Isolating the active ingredients of depressive rumination with exploratory and confirmatory factor analysis. Submited for publication.
Fresco, D. M., Frankel, A. N., Mennin, D. S., Turk, C. L., & Heimberg, R. G. (2002). Distinct and overlapping features of rumination and worry: The relationship of cognitive production to negative affective states. Cognitive Therapy and Research, 26, 179–188.
Goldenberg, D. L., Kaplan, K. H., Nadeau, M. G., Brodeur, C., Smith, S., & Schmid, C. H. (1994). A controlled study of a stress-reduction, cognitive-behavioral treatment program in fibromyalgia. Journal of Musculoskeletal Pain, 2, 53–66.
Haaga, D. A., Dyck, M. J., & Ernst, D. (1991). Empirical status of cognitive theory of depression. Psychological Bulletin, 110, 215–236.
Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (1999). Acceptance and commitment therapy: An experiential approach to behavior change. New York: Guilford Press.
Hollon, S. D., DeRubeis, R. J., Shelton, R. C., & Amsterdam, J. (2001). Cognitive therapy and the prevention of relapse in severely depressed outpatients. Paper presented at the World Congress of Behavioral and Cognitive Therapy, Vancouver, British Columbia, Canada.
Imber, S. D., Pilkonis, P. A., Sotsky, S. M., Elkins, I., Watkins, J. T., Collins, J. F., et al. (1990). Mode-specific effects among three treatments of depression. Journal of Consulting and Clinical Psychology, 58, 352–359.
Ingram, R. E., Miranda, J., & Segal, Z. V. (1998). Cognitive vulnerability to depression. New York: Guilford Press.
Jarrett, R. B., Kraft, D., Doyle, J., Foster, B. M., Eaves, G. G., & Silver, P. C. (2001). Preventing recurrent depression using cognitive therapy with and without a continuation phase. Archives of General Psychiatry, 58, 381–388.
Just, N., & Alloy, L. B. (1997). The response styles theory of depression: Tests and an extension of the theory. Journal of Abnormal Psychology, 106, 221–229.
Kabat-Zinn, J. (1982). An outpatient program in behavioral medicine for chronic pain patients based on the practice of mindfulness meditation: Theoretical considerations and preliminary results. General Hospital Psychiatry, 4, 33–47.
Kabat-Zinn, J. (1990). Full catastrophy living: Using the wisdom of your body and mind to face stress, pain, and illness. New York: Delacorte.
Kabat-Zinn, J. (1994). Wherever you go there you are: Mindfulness meditation in everyday life. New York: Hyperion.
Kabat-Zinn, J., Lipworth, L., & Burney, R. (1985). The clinical use of mindfulness meditation for the self-regulation of chronic pain. Journal of Behavioral Medicine, 8(2), 163–190.
Kabat-Zinn, J., Massion, A. O., Kristeller, J., Peterson, L. G., Fletcher, K. E., Pbert, L., et al. (1992). Effectiveness of a meditation-based stress reduction program in the treatment of anxiety disorders. American Journal of Psychiatry, 149, 936–943.
Kabat-Zinn, J., Wheeler, E., Light, T., Skillings, A., Scharf, M. J., Cropley, T. G., et al. (1998). Influence on mindfulness meditation-based stress reduction intervention on rates of skin clearing patients with moderate to severe psoriasis undergoing phototherapy (uvb) and photochemotherapy (puva). Psychosomatic Medicine, 60, 625–632.
Kendall, P., & Ingram, R. (1989). Cognitive-behavioral perspectives: Theory and research on depression and anxiety. In P. Kendall & D. Watson (Eds.), Anxiety and depression: Distinctive and overlapping features. (pp. 27–53). Orlando, FL: Academic Press.
Kristeller, J. L., & Hallett, C. B. (1999). An exploratory study of a meditation-based intervention for binge eating disorder. Journal of Health Psychology, 4, 357–363.
Kutz, I., Borysenko, J. Z., & Benson, H. (1985). Meditation and psychotherapy: A rationale for the integration of dynamic psychotherapy, the relaxation response, and mindfulness meditation. The American Journal of Psychiatry, 142, 1–8.
Kutz, I., Leserman, J., Dorrington, C., Morrison, C. H., Borysenko, J. Z., & Benson, H. (1985). Meditation as an adjunct to psychotherapy: An outcome study. Psychotherapy and Psychosomatics, 43, 209–218.
Linehan, M. M. (1993). Cognitive-behavioral treatment of borderline personality disorder. New York: Guilford Press.
Lyubomirsky, S., & Nolen-Hoeksema, S. (1995). Effects of self-focused rumination on negative thinking and interpersonal problem solving. Journal of Personality and Social Psychology, 69, 176–190.
Marlatt, G. A. (2002). Mindfulness treatment of addictive behaviors. Paper presented at the annual meeting for the Advancement of Behavior Therapy, Reno, NV.
Marlatt, G. A., & Gordon, J. R. (1985). Relapse prevention: Maintenance strategies in the treatment of addictive behaviors. NewYork: Guilford Press.
Miranda, J. (1992). Dysfunctional thinking is activated by stressful life event. Cognitive Therapy and Research, 16, 473–483.
Miranda, J., Gross, J. G., Persons, J. B., & Hahn, J. (1998). Mood matters: Negative mood induction ac-tivates dysfunctional attitudes in women vulnerable to depression. Cognitive Therapy and Research, 22, 363–376.
Miranda, J., & Persons, J. B. (1988). Dysfunctional attitudes are mood-state dependent. Journal of Abnormal Psychology, 97, 76–79.
Miranda, J., Persons, J. B., & Byers, C. N. (1990). Endorsement of dysfunctional beliefs depends on current mood state. Journal of Abnormal Psychology, 99, 237–241.
Morrow, J., & Nolen-Hoeksema, S. (1990). Effects of responses to depression on the remediation of depressive affect. Journal of Personality and Social Psychology, 58, 519–527.
Nolen-Hoeksema, S. (1987). Sex differences in unipolar depression: Evidence and theory. Psychological Bulletin, 101, 259–282.
Nolen-Hoeksema, S. (1991). Responses to depression and their effects on the duration of depressive episodes. Journal of Abnormal Psychology, 100, 569–582.
Nolen-Hoeksema, S., & Morrow, J. A. (1991). Aprospective study of depression and posttraumatic stress symptoms after a natural disaster: The 1989 Loma Prieta earthquake. Journal of Personality & Social Psychology, 61, 115–121.
Nolen-Hoeksema, S., Morrow, J., & Fredrickson, B. L. (1993). Response styles and the duration of episodes of depressed mood. Journal of Abnormal Psychology, 102, 20–28.
Paykel, E., Scott, J., Teasdale, J., Johnson, A. L., Garland, A., Moore, R., et al. (1999). Prevention of relapse in residual depression by cognitive therapy. Archives of General Psychiatry, 56, 829–835.
Posner, M. I., & Snyder, C. R. R. (1975). Attentive and cognitive control. In R. L. Solso (Ed.), Information processing and cognition: The Loyola symposium. Hillsider, NJ: Erlbaum.
Rabkin, J. G., & Klein, D. F. (1987). The clinical measurement of depressive disorders. In A. J. Marsella, R. M. A. Hirschfeld, & M. M. Katz (Eds.), The measurement of depression (pp. 30–83). New York: Guilford Press.
Robinson, M. S., & Alloy, L. B. (2003). Negative cognitive styles and stress-reactive rumination interact to predict depression: A prospective study. Cognitive Therapy and Research, 27, 275–292.
Safren, S. A., Heimberg, R. G., Lerner, J., Henin, A., Warman, M., & Kendall, P. C. (2000). Differ-entiating anxious and depressive self-statements: Combined factor structure of the Anxious Self-Statements Questionnaire and the Automatic Thoughts-Questionnaire-Revised. Cognitive Therapy and Research, 24, 327–344.
Santorelli, S. (1999). Heal thy self: Lessons on mindfulness in medicine. NewYork: Bell Tower.
Segal, Z. V., & Ingram, R. E. (1994). Mood priming and construct activation in tests of cognitive vulnerability to unipolar depression. Clinical Psychology Review, 14, 663–695.
Segal, Z. V., Williams, J. M., Teasdale, J. D., & Gemar, M. (1996). A cognitive science perspective on kindling and episode sensitization in recurrent affective disorder. Psychological Medicine, 26, 371–380.
Segal, Z. V., Williams, J. M. G., & Teasdale, J. D. (2002). Mindfulness based cognitive therapy for depression: A new approach to preventing relapse. New York: Guildford Press.
Segerstrom, S. C., Tsao, J. C. I., Alden, L. E., & Craske, M. G. (2000). Worry and rumination: Repetitive thought as a concomitant and predictor of negative mood. Cognitive Therapy and Research, 24, 671–688.
Spasojevi?, J., & Alloy, L. B. (2001). Rumination as a common mechanism relating depressive risk factors to depression. Emotion, 1, 25–37.
Speca, M., Carlson, L. E., Goodey, E., & Angen, M. (2000). A randomized, wait-list controlled clinical trial: The effect of a mindfulness meditation-based stress reduction program on mood and symptoms of stress in cancer outpatients. Psychosomatic Medicine, 2, 613–622.
Spielberger, C. D., Gorush, R. L., Lushene, R. E., Vagg, P. R., & Jacobs, G. A. (1983). Manual for The State-Trait Anxiety Inventory (Form Y). Palo Alto, CA: Consulting Psychologist Press.
Spitzer, R. L., Williams, J. B.W., Gibbon, M., & First, M. B. (1992). The structured clinical interview for the DSM-III-R (SCID) I: History, rationale, and description. Archives of General Psychiatry, 49, 624–629.
Teasdale, J. D. (1988). Cognitive vulnerability to persistent depression. Cognition and Emotion, 2, 247–274.
Teasdale, J. T., Segal, Z. V., & Williams, J. M. G. (1995). How does cognitive therapy prevent depressive relapse and why should attentional control (mindfulness) training help? Behaviour Research and Therapy, 33, 25–39.
Teasdale, J. T., Segal, Z. V., Williams, J. M. G., Ridgeway, V. A., Soulsby, J. M., & Lau, M. A. (2000). Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy. Journal of Consulting and Clinical Psychology, 68, 615–623.
Treynor, W., Gonzalez, R., & Nolen-Hoeksema, S. (2003). Rumination reconsidered: A psychometric analysis. Cognitive Therapy and Research, 27, 247–259.
Valentine, E. R., & Sweet, P. L. G. (1999). Meditation and attention: A comparison of the effects of concentrative and mindfulness meditation on sustained attention. Mental Health, Religion & Culture, 2, 59–70.
Watkins, E., & Baracaia, S. (2002). Rumination and social problem-solving in depression. Behaviour Research and Therapy, 40, 1179–1189.
Weissman, A. N. (1979). The Dysfunctional Attitude Scale: A validation study. Dissertation Abstracts International, 40 1389B–1390B. (University Microfilms No. 79-19, 533)
Weissman, A. N., & Beck, A. T. (1978). Development and validation of the Dysfunctional Attitude Scale: A preliminary investigation. Paper presented at the meeting of the Association for the Advancement of Behavior Therapy, Chicago.
Williams, J. M. G., Teasdale, J. D., Segal, Z. V., & Soulsby, J. (2000). Mindfulness-based cognitive therapy reduces overgeneral autobiographical memory in formerly depressed patients. Journal of Abnormal Psychology, 109, 150–155.
Yin, P., & Fan, X. (2000). Assessing the reliability of Beck Depression Inventory scores: Reliability generalization across studies. Educational and Psychological Measurement, 60, 201–223.
Zachary, R. (1986). Shipley Institute of Living Scale, Revised Manual (4th ed.). Los Angeles: Western Psychological Services.
Zuroff, D. C., Blatt, S. J., Sanislow, C. A., III, Bondi, C. M., & Pilkonis, P. A. (1999). Vulnerability to depression: Reexamining state dependence and relative stability. Journal of Abnormal Psychology, 108, 76–89.
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Ramel1, W., Goldin, P.R., Carmona, P.E. et al. The Effects of Mindfulness Meditation on Cognitive Processes and Affect in Patients with Past Depression. Cognitive Therapy and Research 28, 433–455 (2004). https://doi.org/10.1023/B:COTR.0000045557.15923.96
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DOI: https://doi.org/10.1023/B:COTR.0000045557.15923.96