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How do Mindfulness-Based Programs Improve Depression Symptoms: Selflessness, Valence, or Valenced Self?


The current study investigated purported mechanisms by which mindfulness-based programs (MBP) improve depression symptoms, specifically, whether mindfulness-related changes in the processing of self-referential and/or emotionally valenced information are associated with improvements in depression symptoms. Four domains of the Self-Reference Task (SRT)—valence bias, self-bias, negative self-bias and positive self-bias in memory recall—were assessed before and after an 8-week MBP in 95 individuals with mild-severe depression symptoms. Associations between pre-post intervention changes in SRT biases and improvements in mindfulness skill acquisition and depression symptoms were examined. Intervention-related changes in SRT biases were also examined as a function of treatment response. Mindfulness skill acquisition from baseline to week eight was significantly associated with decreased self-bias and decreased negative self-bias. Improvement in depression symptom severity from baseline to week 20 was significantly associated with pre-to-post intervention decreases in negative valence bias and increases in positive self bias, but not changes in self-bias or negative self bias. Changes in valence bias significantly interacted with treatment response, while self biases did not. These findings suggest that MBPs decrease depression symptoms through changes in valence and valenced self rather than a global reduction in self-referential processing.

Trial registration NCT01831362

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This work was supported by the National Institutes of Health (Grant K23-AT006328-01A1); the National Institutes of Health (NIH) Science of Behavior Change Common Fund Program through an award administered by the National Center for Complementary and Integrative Health (Grant UH2AT009145); the Mind and Life Institute; Sam Harris and the Brown University Contemplative Studies Initiative. The views presented here are solely the responsibility of the authors and do not necessarily represent the official views of the NIH.

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Correspondence to Willoughby B. Britton.

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Conflict of interest

W.B.B. and J.R.L receive payments for providing trainings and education in scientific literacy, meditation safety, and trauma-informed mindfulness. W.B.B. and J.R.L are nominally affiliated with the Mindfulness Center at Brown University which generates income by offering mindfulness classes to the public. W.B.B. is a MBSR and MBCT teacher and has received financial compensation for this role. W.B.B is the founder of Cheetah House, a RI non-profit organization that provides information about meditation-related difficulties, individual consultations, and support groups, as well as educational trainings to meditation teachers, clinicians, educators and mindfulness providers. This interest has been disclosed to and is being managed by Brown University, in accordance with its Conflict of Interest and Conflict of Commitment policies.

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This study was carried out in accordance with the provisions of the World Medical Association Declaration of Helsinki.

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All participants provided written, informed consent approved by the Brown University Institutional Review Board.

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No animal studies were carried out by the authors for this paper.

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Alejandre-Lara, A.L., Canby, N.K., Wesbecher, K.D. et al. How do Mindfulness-Based Programs Improve Depression Symptoms: Selflessness, Valence, or Valenced Self?. Cogn Ther Res 46, 668–685 (2022).

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  • Mindfulness
  • Depression
  • Mechanism
  • Self-related processing
  • Emotional valence