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ObjectiveTo explore the barriers and facilitators of the adherence of formal practice after mindfulness-based cognitive therapy （MBCT） in psychological counseling outpatients. MethodsOne-on-one interview was conducted in 15 psychological counseling outpatients who attended MBCT at Shanghai Mental Health Center and had been out of treatment 5 months or more. Data was analyzed using thematic analysis. ResultsPoor mood， weak willpower， limited time and space， lack of companionship and supervision， and discomfort with the recording were the five factors that prevented the patients from sticking to their practice. Personality trait， trust， benefit， need for self-care， time/space arrangement， fellow practitioners， therapists， and ease and convenience of practice were the eight factors that promoted the patients to practice. ConclusionThe COM-B model helps therapists and individuals with practice needs to understand the mechanism of formal practice facilitators at a holistic level. Therapists and individuals with practice needs should be concerned about possible barriers on the adherence of formal practice.
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Objective:To explore the effectiveness of positive cognitive therapy in improving anxiety and depression, psychological distress, positive awareness, and quality of life in cancer patients, with a view to providing an experience for practical clinical application.Methods:This study was a quasi experimental study, in which 96 patients with cancer radiotherapy attending Shanghai Proton Heavy Ion Center from April 2019 to January 2021 were selected as study subjects by convenience sampling, and were divided into 47 cases in the intervention group and 49 cases in the control group according to the district group randomization method. The control group was given conventional psychological care and health education, and instructed to learn the audio and video of positive cognitive therapy at the end of the study; the intervention group was given 8 sessions of positive cognitive therapy over a period of 4 weeks. At the end of the intervention, the Pdistress Thermometer, the Generalized Anxiety Inventory, the Patient Health Questionnaire Depression Inventory, the Brief Version of the Five Factor Positive Thinking Inventory, and the European Organization for Research and Treatment of Cancer, Quality of Life Questionnaire C30 were used to compare the psychological distress, anxiety and depression, positive cognitive awareness and quality of life of the two groups.Results:After the implementation of the positive cognitive therapy intervention, the incidence rate of anxiety and depression in the intervention group was 12.8% (6/47) and 14.9% (7/47), respectively, both of which were significantly lower than the 30.6% (15/49) and 32.7% (16/49) in the control group, with statistically significant differences ( χ2=3.80, 3.89, both P<0.05); after intervention the scores on the observation, description and perceived action dimensions of the Brief Version of the Five Factor Positive Thinking Scale were (23.8 ± 6.5), (28.6 ± 5.4) and (31.3 ± 5.3) respectively, all significantly higher than those of the control group (20.0 ± 5.1), (23.7 ± 5.5) and (26.9±6.2), the differences were statistically significant ( t=2.79, 3.59, 3.21, all P<0.05); the post-intervention score on the Emotional Functioning dimension of the European Organization for Research and Treatment of Cancer Quality of Life Scale (94.3 ± 7.4) was significantly higher than that of the control group (88.8 ± 11.4), with a statistically significant difference ( t=-2.28, P<0.05). Conclusions:Positive cognitive therapy is effective in relieving anxiety and depression, increasing positive awareness, and improving emotional distress in cancer patients. It can be incorporated into the daily psychological care process of tumor patients, giving them appropriate guidance and support to help improve their psychological and quality of life.
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Objective:To evaluate the effect of mindfulness-base cognitive therapy (MBCT) in improving patients with depression, and to explore its effect on patients early maladaptive schemas (EMSs).Methods:Sixty patients with depressive disorder were included in the pre- and post-control design, and MBCT treatment was carried out for 8 weeks. The Hamilton depression scale-17 (HAMD-17), Hamilton anxiety scale (HAMA), five facet mindfulness questionnaire (FFMQ), and Young schema questionnaire-short form (YSQ-SF) were used for evaluation. The scores of the three time points were compared by one-way repeated measure ANOVA and Kruskal Wallis test. Pearson correlation analysis and multiple linear regression analysis were used to explore the relationship between the improvement degree of depression and anxiety symptoms, as well as the changes of mindfulness level and schema.Results:There were significant differences in the total scores of HAMD-17, HAMA and FFMQ at baseline((15.4±5.0), (21.0±9.6), (115.8±11.7)), 4 weeks after intervention((11.4±6.7), (15.9±10.1), (121.9±14.2)) and 8 weeks((11.0±6.2), (15.4±8.7), (122.6±15.5)) after intervention ( F=25.22, 20.95, 14.02, all P<0.01). Further pairwise comparison, compared with baseline, the total scores of HAMD-17 and HAMA in patients with depression decreased (all P<0.05), and the total scores of FFMQ increased (all P<0.05) in 8 weeks and 4 weeks after treatment.There were no significant differences in the total scores of HAMD-17, HAMA and FFMQ between 8 weeks and 4 weeks after treatment (all P>0.05). There were significant differences on the scores of the emotional deprivation, abandonment/instability, failure, vulner ability to harm or illness, enmeshment/undeveloped self, unrelenting standards/hypercriticalness, and entitlement/grandiosity subscales in the YSQ-SF( H=2.00-17.11, all P<0.05). Regression analysis showed that the FFMQ total score difference has a linear relationship with the HAMA total score difference ( β=-0.363). There was a linear relationship between the emotional deprivation scale score difference and the HAMD-17 total score difference ( β=-0.292). Dependence/incompetence and submission scale score difference showed a linear relationship with the HAMA total score difference ( β=0.334, 0.278). Conclusion:MBCT can improve the anxiety and depression symptoms of patients with depression, and the improvement of some EMSs may be the mechanism of MBCT in the treatment of depression.
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Abstract Introduction Depression is one of the most important psychiatric disorders, and the rate of recurrence is high. The heavy cost burden of depression is probably due to treatment-resistant depression. The purpose of this study was to determine the effectiveness of mindfulness-based cognitive therapy (MBCT) in patients with treatment-resistant depression (TRD). Method The present study was a quasi-experimental study conducted with twenty-four patients with treatment-resistant depression. Participants were selected by purposive sampling and randomly assigned to two groups, an experimental group and a control group. The experimental group received MBCT and antidepressants, while the control group received antidepressants only. The Hamilton and Beck Depression Inventory, Self-Compassion Scale, Thought Rumination Scale, and Mindfulness Scale were administered. The treatment program was conducted in eight sessions; with a follow-up period of one month subsequent to treatment termination. Data were analyzed using descriptive statistics (mean and standard deviation) and inferential statistics (analysis of variance for repeated measures and Bonferroni's post-hoc test). Results The results showed that MBCT significantly reduced depression and ruminative thinking in the experimental group and also improved mediators such as mindfulness and self-compassion. Patients maintained gains over the one month follow-up period (p < 0.01). Conclusion The present study provides additional evidence for the effectiveness of MBCT for TRD.
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Adult , Female , Humans , Male , Young Adult , Self Concept , Empathy , Depressive Disorder, Treatment-Resistant/therapy , Mindfulness , Rumination, Cognitive , Treatment Outcome , Empathy/physiology , Depressive Disorder, Treatment-Resistant/physiopathology , Mindfulness/methods , Rumination, Cognitive/physiologyABSTRACT
Objective·To explore the performance characteristics of the psychotherapy relationship in mindfulness-based cognitive therapy between the psychotherapists and patients with obsessive-compulsive disorder (OCD),and the strategies to promote the curative effect in mindfulness-based cognitive therapy.Methods·Three psychotherapists in Shanghai Mental Health Center and two groups of mindfulness-based cognitive therapy for OCD groups (a total of 11 people who completed treatment and 2 people dropped off) were selected.All the patients had mild to moderate OCD.The transcripts were transcribed into verbatim and coded using interpretative phenomenological analysis.Results·The psychotherapy relationship in subjective experience of patients with OCD showed warm emotional support,professional authority and individual requirements.The psychotherapy relationship in subjective experience of the therapist was manifested as equal companion,relatively mild and fuzzy distance.Strategies to promote efficacy from a therapeutic relationship perspective was profession to trust (especially for example),to promote emotional experience and to accept disappointment and negative emotions.Conclusion·Increasing the use of effective strategies can promote the establishment and positive development of therapeutic relationship in mindfulness-based cognitive therapy for OCD and promote the effectiveness of treatment.
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@#Objective To observe the effect of mindfulness-based cognitive therapy (MBCT) on dysphagia after stroke. Methods From October, 2017 to March, 2018, 60 stroke patients with dysphagia were randomly divided into control group (n = 30) and experimental group (n = 30). Both groups received routine swallowing training, while the experimental group received MBCT in addition, for eight weeks. They were investigated the compliance, and assessed with Kubota Drinking Water Test (KDWT) and Hospital Anxiety and Depression Scale (HADS) before and after intervention. Results The compliance improved in the experimental group after intervention (χ2 = 19.000, P < 0.001), and it was better in the experimental group than in the control group (χ2 = 8.044, P < 0.05). While the scores of KDWT improved in both groups (Z > 1.970, P < 0.05), and improved more in the experimental group than in the control group (Z = -2.093, P < 0.05); the scores of HADS improved in both groups (t > 9.510, P < 0.001), the total scores and the subscale scores of anxiety and depression improved more in the experimental group than in the control group (t > 2.133, P < 0.05). Conclusion MBCT could increase the compliance in swallowing training for stroke patients with dysphagia to improve their swallowing function, anxiety and depression .
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@#Objective To observe the effect of mindfulness-based cognitive therapy (MBCT) on dysphagia after stroke. Methods From October, 2017 to March, 2018, 60 stroke patients with dysphagia were randomly divided into control group (n = 30) and experimental group (n = 30). Both groups received routine swallowing training, while the experimental group received MBCT in addition, for eight weeks. They were investigated the compliance, and assessed with Kubota Drinking Water Test (KDWT) and Hospital Anxiety and Depression Scale (HADS) before and after intervention. Results The compliance improved in the experimental group after intervention (χ2 = 19.000, P < 0.001), and it was better in the experimental group than in the control group (χ2 = 8.044, P < 0.05). While the scores of KDWT improved in both groups (Z > 1.970, P < 0.05), and improved more in the experimental group than in the control group (Z = -2.093, P < 0.05); the scores of HADS improved in both groups (t > 9.510, P < 0.001), the total scores and the subscale scores of anxiety and depression improved more in the experimental group than in the control group (t > 2.133, P < 0.05). Conclusion MBCT could increase the compliance in swallowing training for stroke patients with dysphagia to improve their swallowing function, anxiety and depression .
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Objective: To explore the performance characteristics of the psychotherapy relationship in mindfulness-based cognitive therapy between the psychotherapists and patients with obsessive-compulsive disorder (OCD), and the strategies to promote the curative effect in mindfulness-based cognitive therapy. Methods: Three psychotherapists in Shanghai Mental Health Center and two groups of mindfulness-based cognitive therapy for OCD groups (a total of 11 people who completed treatment and 2 people dropped off) were selected. All the patients had mild to moderate OCD. The transcripts were transcribed into verbatim and coded using interpretative phenomenological analysis. Results: The psychotherapy relationship in subjective experience of patients with OCD showed warm emotional support, professional authority and individual requirements. The psychotherapy relationship in subjective experience of the therapist was manifested as equal companion, relatively mild and fuzzy distance. Strategies to promote efficacy from a therapeutic relationship perspective was profession to trust (especially for example), to promote emotional experience and to accept disappointment and negative emotions. Conclusion: Increasing the use of effective strategies can promote the establishment and positive development of therapeutic relationship in mindfulness-based cognitive therapy for OCD and promote the effectiveness of treatment.
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OBJECTIVES: We aimed to examine whether mindfulness skills are mediating the improvements of depressive symptoms in patients with mood disorders who practiced Mindfulness-Based Cognitive Therapy (MBCT). METHODS: A total of 19 patients with mood disorder were included in this study. The participants were divided into two subgroups: a normal to mild depression group and a moderate depression group. The participants completed questionnaires to assess depressive symptoms, anxiety, quality of life, suicidal idea, and mindfulness skills which were measured by the Five Facets of Mindfulness Questionnaire (FFMQ) before and after MBCT course. RESULTS: The moderate depression group showed improvements through MBCT in depressive symptoms and suicidal idea, but not in anxiety and quality of life. The normal to mild depression group showed no significant change through MBCT. The improvement of depressive symptoms in the moderate depression group was predictable by improvements of the five facets of mindfulness, especially by ‘observe’ and ‘non-react’ components. CONCLUSIONS: This study showed that currently depressive patients with moderate severity but not with normal to mild severity benefit from MBCT in reducing depressive symptoms and suicidal idea. The improvement of depressive symptoms was mediated by improved mindfulness skills through MBCT.
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Humans , Anxiety , Cognitive Behavioral Therapy , Depression , Mindfulness , Mood Disorders , Negotiating , Quality of LifeABSTRACT
OBJECTIVE: Intolerance of uncertainty (IU) is a transdiagnostic construct in various anxiety and depressive disorders. However, the relationship between IU and panic symptom severity is not yet fully understood. We examined the relationship between IU, panic, and depressive symptoms during mindfulness-based cognitive therapy (MBCT) in patients with panic disorder. METHODS: We screened 83 patients with panic disorder and subsequently enrolled 69 of them in the present study. Patients participating in MBCT for panic disorder were evaluated at baseline and at 8 weeks using the Intolerance of Uncertainty Scale (IUS), Panic Disorder Severity Scale-Self Report (PDSS-SR), and Beck Depression Inventory (BDI). RESULTS: There was a significant decrease in scores on the IUS (p<0.001), PDSS (p<0.001), and BDI (p<0.001) following MBCT for panic disorder. Pre-treatment IUS scores significantly correlated with pre-treatment PDSS (p=0.003) and BDI (p=0.003) scores. We also found a significant association between the reduction in IU and PDSS after controlling for the reduction in the BDI score (p<0.001). CONCLUSION: IU may play a critical role in the diagnosis and treatment of panic disorder. MBCT is effective in lowering IU in patients with panic disorder.
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Humans , Anxiety , Cognitive Behavioral Therapy , Depression , Depressive Disorder , Diagnosis , Panic Disorder , Panic , UncertaintyABSTRACT
PURPOSE: Although the effectiveness of Mindfulness-Based Cognitive Therapy (MBCT) for panic disorder (PD) has been studied previously, data on the predictors of treatment outcomes in MBCT for PD are scarce. MATERIALS AND METHODS: Eighty patients with PD were screened to analyze treatment outcomes such as MBCT completion, treatment response, and remission after undergoing MBCT for PD. Sociodemographic characteristics, comorbid personality disorders, and baseline medication doses were examined. The study administered the Panic Disorder Severity Scale, Hamilton Anxiety Rating Scale, Hamilton Depression Rating Scale and Anxiety Sensitivity Inventory-Revised to patients at baseline and at eight weeks. RESULTS: Sixty-five participants were enrolled in the present study. Comorbid personality disorder was significantly associated with MBCT non-completion. We found that anxiety sensitivity (AS) improvement after an eight week MBCT program was a statistically significant factor associated with treatment response. Using logistic regression analysis, AS improvement after MBCT showed significant association with PD remission after MBCT. CONCLUSION: Comorbid personality disorders of participants could be a potential predictor of MBCT non-completion. Furthermore, AS improvement after MBCT may predict treatment response and remission after MBCT for PD. However, better designed studies with a larger number of patients are needed to confirm our findings.
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Adult , Female , Humans , Male , Middle Aged , Young Adult , Cognitive Behavioral Therapy/methods , Mindfulness/methods , Panic Disorder/therapy , Socioeconomic FactorsABSTRACT
OBJECTIVES: Mindfulness-base cognitive therapy (MBCT) has been used to treat patients with depression to prevent relapse. The purpose of this study was to examine the effectiveness of Mindfulness- Base Cognitive Therapy for patients who suffer with generalized anxiety disorder or panic disorder for 1 year. METHODS: 19 patients with generalized anxiety disorder or panic disorder were assigned to receive MBCT for a period of 8 weeks. The Hamilton Anxiety Rating Scale (HAM-A), the Hamilton Depression Rating Scale (HAM-D), the Beck Anxiety Inventory (BAI) and the Beck Depression Inventory (BDI) were used at 0 weeks, 8 weeks and 1 year to assess the results. RESULTS: MBCT demonstrated significantly decreases on all the anxiety scale scores (HAM-A, p=0.00 ; BAI, p=0.00) and depressive scale scores (HAM-D, p=0.00 ; BDI, p=0.00). The patients who received 8-week of MBCT showed a higher remission rate (15/19, 78%) during the 1-year followup period. CONCLUSION: MBCT may be effective at relieving the anxiety and depressive symptoms of patients who suffer with generalized anxiety disorder or panic disorder for 1 year. However, further well-designed controlled trials are needed to assess the value of MBCT.