Decentering and Relapse/Recurrence in MBCT for Depression in Adults

NCT05111665 | Completed

• 1 other identifier: H07-03046
• Study Type: interventional
• Target: 227
• Locations: 1 country
• Sites: 1

Brief Summary

Objective: "Decentering" is defined as the ability to observe one's thoughts and feelings as temporary, objective events in the mind, and is increasingly regarded as a candidate mechanism in mindfulness-based interventions. The current study sought to examine the role of decentering, and other related variables, in the efficacy of Mindfulness-based cognitive therapy (MBCT) as compared to two active comparison conditions. Method: Formerly depressed individuals (N = 227), randomly assigned to MBCT (n = 74), relaxation group therapy (RGT; n = 77) or treatment-as-usual (TAU; n = 76), completed self-report measures of decentering and symptoms of depression at pre-, mid-, and post-treatment, and relapse was assessed at 3, 6, 9, and 12 months, post-treatment.

Conditions

Depression; Depressive Disorder, Major; Depression in Remission

Outcome Measures

Primary Outcomes (2)

• Major depressive disorder (MDD) relapse/recurrence - incidence of

  Number of participants meeting criteria for relapse/recurrence of MDD during follow-up

  12- month post-treatment follow-up

• Change in major depressive disorder (MDD) relapse/recurrence - time to relapse/recurrence

  Change in relapse/recurrence of MDD (i.e., survival) across follow-up

  3-, 6-, 9-, and 12- month post-treatment follow-up

Secondary Outcomes (1)

• Change in Beck Depression Inventory - Second Edition total scores

  Pre-, mid- (i.e., at week 4 of MBCT), and post-treatment (i.e., after 8 weeks of MBCT)

Study Arms (3)

Mindfulness-based Cognitive Therapy (MBCT)

EXPERIMENTAL

Remitted depressed participants received eight-weekly, two-hour MBCT sessions (Segal et al., 2013). This program combines MBSR meditation practices (e.g., body scan, mindful stretching, mindfulness of breath/body/sounds/thoughts) with traditional CT techniques (e.g., psychoeducation about depression symptoms and automatic thoughts, exercises designed to demonstrate how the nature of one's thoughts change with one's mood, questioning of automatic thoughts and creating a relapse prevention plan). Finally, participants engaged in a daily meditation practice and homework exercises directed at integrating the application of awareness skills into daily life. Each MBCT group was led by a masters-level clinician who was an active MBCT/Mindfulness-Based Stress Reduction (MBSR) instructor.

Behavioral: Mindfulness-based Cognitive Therapy (MBCT)

Relaxation Group Therapy (RGT)

ACTIVE COMPARATOR

The revised edition of the Changeways Relaxation Programme (Paterson, 1997) served as the active control condition to control for non-specific group factors including group participation, expectation of change or therapeutic contact and attention. The rationale was that relaxation can be used to better manage life stressors which precipitate depressive episodes. Participants received eight-weekly, two-hour relaxation training sessions. This group program combines psychoeducation regarding the effects of stress, diaphragmatic breathing, progressive muscle relaxation, passive relaxation and imagery. It also incorporates time for participants to discuss the events of the week to facilitate the supportive aspect of group participation. Finally, participants were asked to engage in daily exercises to practice the various relaxation strategies. Each RGT group was led by a doctoral-level therapist.

Behavioral: Relaxation Group Therapy (RGT)

Treatment as usual (TAU)

PLACEBO COMPARATOR

Participants randomized to the TAU group were instructed that participants would receive MBCT at the end of the follow-up period and to seek help from their family doctors or other sources as the normally would, should the participants encounter symptomatic deterioration or other difficulties over the course of the study. At the end of the follow-up phase, participants in the TAU and RGT group were offered the opportunity to receive MBCT.

Behavioral: Treatment as usual (TAU)

Interventions

Mindfulness-based Cognitive Therapy (MBCT) BEHAVIORAL

Mindfulness-based Cognitive Therapy (MBCT)

Relaxation Group Therapy (RGT) BEHAVIORAL

Relaxation Group Therapy (RGT)

Treatment as usual (TAU) BEHAVIORAL

Treatment as usual (TAU)

Eligibility Criteria

• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

• a Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM IV-TR; American Psychiatric Association (APA), diagnosis of major depressive disorder (MDD) without psychotic features, in Full Remission;
• three or more prior major depressive episodes;
• age between 18 and 65 years;
• cognitive reactivity (CR) or mood-activated dysfunctional beliefs score greater than or equal to eight (see assessment procedure below);
• a score of less than 10 on the Hamilton Rating Scale for Depression (HRSD);
• minimum of a 10 week period free of psychotropic medication other than stable dosage of antidepressant medication for a minimum of four weeks;
• fluency in English; An increased cognitive reactivity score of eight points or more and,
• ability to give informed consent and complete questionnaires unassisted.

You may not qualify if:

• a diagnosis of bipolar disorder (past or present), schizophreniform disorders, substance abuse or dependence (current or within the past six months), borderline or antisocial personality disorder, or neurocognitive disorders;
• current psychotherapy or counselling more frequently than twice per month;
• current practice of meditation more than once per week or yoga more than twice per week;
• electroconvulsive therapy within the past six months; or
• self-reported ingestion of alcohol or other psychoactive substances within the past 48 hrs.

Sponsors & Collaborators

• University of British Columbia: lead

Study Sites (1)

Mark Lau

Vancouver, British Columbia, V6J 5C6, Canada

Location

Related Publications (1)

• Moore MT, Lau MA, Haigh EAP, Willett BR, Bosma CM, Fresco DM. Association between decentering and reductions in relapse/recurrence in mindfulness-based cognitive therapy for depression in adults: A randomized controlled trial. J Consult Clin Psychol. 2022 Feb;90(2):137-147. doi: 10.1037/ccp0000718.

  PMID: 35343725 DERIVED

MeSH Terms

Conditions

Depression; Depressive Disorder, Major

Interventions

Mindfulness-Based Cognitive Therapy; Therapeutics

Condition Hierarchy (Ancestors)

Behavioral Symptoms; Behavior; Depressive Disorder; Mood Disorders; Mental Disorders

Intervention Hierarchy (Ancestors)

Mindfulness; Cognitive Behavioral Therapy; Behavior Therapy; Psychotherapy; Behavioral Disciplines and Activities

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, INVESTIGATOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principle Investigator

Study Record Dates

• First Submitted: October 4, 2021
• First Posted: November 8, 2021
• Study Start: February 14, 2008
• Primary Completion: October 31, 2008
• Study Completion: October 31, 2008
• Last Updated: November 8, 2021

Record last verified: 2021-10

Locations

CA (1)