Cognitive Functioning in Patients Remitted from Recurrent Depression: Comparison with Acutely Depressed Patients and Controls and Follow-up of a Mindfulness-Based Cognitive Therapy Trial
- 1.2k Downloads
Mindfulness-Based Cognitive Therapy (MBCT) is a promising intervention to prevent depressive relapse. Yet beyond efficacy studies, little is known regarding the mechanisms that could be modified through MBCT. Objectives of the present study were twofold: determine whether cognitive functioning was altered among patients remitted from depression at admission in a MBCT trial; and document possible changes during the trial and follow-up. In a cross-sectional perspective, cognitive functioning (autobiographical memory, shifting capacities, dysfunctional attitudes, mindful attention awareness and rumination habits) was first compared between 36 patients remitted from depression, 20 acutely depressed patients and 20 control participants. In a longitudinal perspective, changes in the remitted sample were explored during a MBCT plus Treatment As Usual versus Treatment As Usual randomized controlled trial and 9-month follow-up. Performances of remitted patients were similar to the ones of control participants for autobiographical memories, shifting capacities, and mindful attention awareness, whereas levels of rumination and dysfunctional attitudes were significantly elevated. Participation in the MBCT program was accompanied with a significant decrease of dysfunctional attitudes that continued up to 9-month postintervention. No other change was observed that was specific to MBCT. Results suggest that MBCT might help people to identify dysfunctional attitudes at a very early stage and to avoid engaging further in these attitudes.
KeywordsMindfulness Depression Remission Cognitive functioning
This study was supported by a grant from the Swiss National Science Foundation (Grant no. 3200BO-108432 to Guido Bondolfi, Gilles Bertschy, Jean-Michel Aubry and Martial Van der Linden). The authors would like to thank the MBCT instructors L. Bizzini, L. Myers Arrazola and B. Weber, as well as C. Gonzalez for her help in data collection. They would also like to thank Sandra Ter Pelle for her expert technical support in preparing this manuscript.
Conflict of interest
There is no conflict of interest in this research.
- American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders: DSM-IV (4th ed.). Washington: American Psychiatric Association.Google Scholar
- Beck, A. T. (1967). Depression: causes and treatment. Philadelphia: University of Pennsylvania Press.Google Scholar
- Beck, A. T., Steer, R. A., & Brown, G. K. (1996). Manual for the Beck Depression Inventory-II. San Antonio: Psychological Corporation.Google Scholar
- Beck, A. T., Steer, R. A., & Brown, G. K. (1998). BDI -II, Inventaire de dépression de Beck. Paris: Ed. du Centre de Psychologie Appliquée.Google Scholar
- Bondolfi, G., Jermann, F., Van der Linden, M., Gex-Fabry, M., Bizzini, L., Weber-Rouget, B., et al. (2010). Depression relapse prophylaxis with mindfulness-based cognitive therapy: Replication and extension in the Swiss health care system. Journal of Affective Disorders, 122(3), 224–231. doi: 10.1016/j.jad.2009.07.007.PubMedCrossRefGoogle Scholar
- Bostanov, V., Keune, P. M., Kotchoubey, B., & Hautzinger, M. (2012). Event-related brain potentials reflect increased concentration ability after mindfulness-based cognitive therapy for depression: a randomized clinical trial. Psychiatry Research, 199(3), 174–180. doi: 10.1016/j.psychres.2012.05.031.PubMedCrossRefGoogle Scholar
- Bouvard, M., Cottraux, J., Charles, S., Ciadella, P., Guerin, J., & Aimard, G. (1994). Etude de validation sur une population française de l’échelle d’attitudes dysfonctionnelles de Weissman et Beck (DAS forme A). Journal de Thérapie Comportementale et Cognitive, 4(4), 127–135.Google Scholar
- First, M. B., Spitzer, R. L., Gibbon, M., & Williams, J. B. W. (1996). Structured clinical interview for DSM-IV Axis I disorders - Patient edition (SCID-I/P, Version 2.0). New York: New york State Psychiatric Institute, Biometrics Research Department.Google Scholar
- Godfrin, K. A., & van Heeringen, C. (2010). The effects of mindfulness-based cognitive therapy on recurrence of depressive episodes, mental health and quality of life: A randomized controlled study. Behaviour Research and Therapy, 48(8), 738–746. doi: 10.1016/j.brat.2010.04.006.PubMedCrossRefGoogle Scholar
- Grossman, P. (2011). Defining mindfulness by how poorly I think I pay attention during everyday awareness and other intractable problems for psychology’s (re)invention of mindfulness: comment on Brown et al. (2011). Psychological Assessment, 23(4), 1034-1040; discussion 1041-1036. doi: 10.1037/a0022713.
- Hölzel, B. K., Lazar, S. W., Gard, T., Schuman-Olivier, Z., Vago, D. R., & Ott, U. (2011). How does mindfulness meditation work? Proposing mechanisms of action from a conceptual and neural perspective. Perspectives on Psychological Science, 6(6), 537–559. doi: 10.1177/1745691611419671.CrossRefGoogle Scholar
- Ingram, R. E., Miranda, J., & Segal, Z. V. (1998). Cognitive vulnerability to depression. New York: Guilford Press.Google Scholar
- Jermann, F., Billieux, J., Larøi, F., d’Argembeau, A., Bondolfi, G., Zermatten, A., et al. (2009). Mindful attention awareness scale (MAAS): Psychometric properties of the French translation and exploration of its relations with emotion regulation strategies. Psychological Assessment, 21(4), 506–514. doi: 10.1037/a0017032.PubMedCrossRefGoogle Scholar
- Jermann, F., Billieux, J., Bizzini, L., Van der Linden, M., & Bondolfi, G. (2010). Rumination-Reflection Questionnaire (RRQ) : Psychometric properties of the French translation and exploration of the relationships between the RRQ and depressive symptoms and mindfulness. Paper presented at the VI World Congress of Behavioural and Cognitive Therapies (WCBCT), Boston.Google Scholar
- Jersild, A. T. (1927). Mental set and shift. Archives of Psychology, 14, 89.Google Scholar
- Miyake, A., Friedman, N. P., Emerson, M. J., Witzki, A. H., Howerter, A., & Wager, T. D. (2000). The unity and diversity of executive functions and their contributions to complex “Frontal Lobe” tasks: A latent variable analysis. Cognitive Psychology, 41(1), 49–100. doi: 10.1006/cogp.1999.0734.PubMedCrossRefGoogle Scholar
- Montgomery, C., Fisk, J. E., Newcombe, R., & Murphy, P. N. (2005). The differential effects of ecstasy/polydrug use on executive components: shifting, inhibition, updating and access to semantic memory. Psychopharmacology (Berl), 182(2), 262–276. doi: 10.1007/s00213-005-0065-9.CrossRefGoogle Scholar
- Pellet, J., Bobon, D. P., Mormont, I., Lang, F., & Massardier, A. (1980). Etude de princeps de validation française de la MADRS, sous-échelle Dépression de la CPRS Comptes-rendus du Congrès de psychiatrie et de neurologie de langue française Reims, 25–28 juin. Paris: Masson.Google Scholar
- Segal, Z. V., Teasdale, J. D., Williams, J. M. G., & Gemar, M. C. (2002a). The mindfulness-based cognitive therapy adherence scale: Inter-rater reliability, adherence to protocol and treatment distinctiveness. Clinical Psychology and Psychotherapy, 9, 131–138. doi: 10.1002/cpp.320.CrossRefGoogle Scholar
- Segal, Z. V., Williams, J. M. G., & Teasdale, J. D. (2002b). Mindfulness-based cognitive therapy for depression: a new approach to preventing relapse. New York: Guilford Press.Google Scholar
- Segal, Z. V., Bieling, P., Young, T., MacQueen, G., Cooke, R., Martin, L., et al. (2010). Antidepressant monotherapy vs sequential pharmacotherapy and mindfulness-based cognitive therapy, or placebo, for relapse prophylaxis in recurrent depression. Archives of General Psychiatry, 67(12), 1256–1264. doi: 10.1001/archgenpsychiatry.2010.168.PubMedCrossRefGoogle Scholar
- Teasdale, J. D., 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(4), 615–623. doi: 10.1037/0022-006X.68.4.615.PubMedCrossRefGoogle Scholar
- Weissman, A. N., & Beck, A. T. (1978). Development and validation of the dysfunction attitude scale: A preliminary investigation. Toronto: Paper presented at the Proceedings of the meeting of the American Education Research Association.Google Scholar