Mindfulness-based interventions for the prevention and treatment of depression are predicated on the idea that interoceptive awareness represents a crucial foundation for the cultivation of adaptive ways of responding to negative thoughts and mood states such as the ability to decenter. The current study used a multi-dimensional self-report assessment of interoceptive awareness, including regulatory and belief-related aspects of the construct, in order to characterize deficits in interoceptive awareness in depression, investigate whether brief mindfulness training could reduce these deficits, and to test whether the training unfolds its beneficial effects through the above-described pathway. Currently depressed patients (n = 67) were compared to healthy controls (n = 25) and then randomly allocated to receive either a brief training in mindfulness (per-protocol sample of n = 32) or an active control training (per-protocol sample of n = 28). Patients showed significant deficits across a range of regulatory and belief-related aspects of interoceptive awareness, mindfulness training significantly increased regulatory and belief-related aspects of interoceptive awareness, and reductions in depressive symptoms were mediated through a serial pathway in which training-related increases in aspects of interoceptive awareness were positively associated with the ability to decenter, which in turn was associated with reduced symptoms of depression. These results support the role of interoceptive awareness in facilitating adaptive responses to negative mood.
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This research was funded by the German Research Foundation Grant BA2255 3-1, awarded to Thorsten Barnhofer. The funders had no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; and in the decision to submit the article to Mindfulness. Thorsten Barnhofer is supported by a Heisenberg Fellowship from the German Research Foundation (BA2255 2-1).
Conflict of Interest
Thorsten Barnhofer has received honoraria or fees for lectures, workshops, courses, and educational presentations on mindfulness or mindfulness-based cognitive therapy as well as royalties for a book on mindfulness-based cognitive therapy. All other authors declare no conflicts of interest.
All procedures performed in the study were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki Declaration and its later amendments.
This research was funded by the German Research Foundation Grant BA2255 3-1, awarded to Thorsten Barnhofer. Thorsten Barnhofer is supported by a Heisenberg Fellowship from the German Research Foundation (BA2255 2-1). The funders had no role in study design; in the collection, analysis, and interpretation of data; in the writing of this report; and in the decision to submit the article.
Maria Fissler and Emilia Winnebeck contributed equally to this paper. Julia M. Huntenburg is now at the Max-Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany, Max-Planck Group for Neuroanatomy and Connectivity. Matti Gaertner is now at Charité University Medicine Berlin, Clinic for Psychiatry and Psychotherapy.
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Fissler, M., Winnebeck, E., Schroeter, T. et al. An Investigation of the Effects of Brief Mindfulness Training on Self-Reported Interoceptive Awareness, the Ability to Decenter, and Their Role in the Reduction of Depressive Symptoms. Mindfulness 7, 1170–1181 (2016). https://doi.org/10.1007/s12671-016-0559-z
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