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Formal home practice important for depression

Posted: 10.30.2014 | by AMRA

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Home meditation practice has long been a cornerstone of mindfulness-based interventions, but questions as to how much home practice is needed remain unanswered. Crane et al. [Behavior Research and Therapy] studied the home practice of 99 Mindfulness-Based Cognitive Therapy (MBCT) participants to address this question. All of the mostly Caucasian, female, middle-aged participants had three or more prior episodes of major depression, but were asymptomatic at the start of the study.

Their formal and informal home practice was assessed using weekly self-report diaries. “Formal home practice” meant engaging in daily forty-minute guided meditations using MBCT-provided compact discs. “Informal home practice” included less structured practices such as mindfulness of routine activities or attending to the breath when stressed.

Participants indicated whether they had engaged in home practice on any given day by ticking off diary checkboxes. The duration of formal home practice was quantified (an average of 21 minutes daily for the sample), but informal home practice was measured only by whether practice had occurred on any given day or not.

The researchers found that major depression relapse rates were negatively associated with the amount of formal home practice. By the end of one year, 58% of the participants who practiced less than 3 times a week had major depressive relapses, while only 39% of those who practiced 3 or more times a week relapsed.

Consistent formal home mindfulness practice reduced the risk of relapse by nearly 50%. While the amount of formal and informal home practice was highly correlated (r=0.82, p<0.001), the amount of informal practice was not significantly related to relapse risk, perhaps owing to the inability to quantify its actual duration.

The findings support […]

November 5th, 2014|News|

MBRP reduces substance use at 12 months

Posted: 04.07.2014 | by AMRA

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An estimated 40% to 60% of substance abusers relapse following treatment, emphasizing the need for the development of more effective relapse prevention and harm reduction approaches. Bowen et al. [JAMA Psychiatry] evaluated the effectiveness of three substance abuse relapse prevention programs among 286 participants who had just completed either an inpatient or intensive outpatient substance abuse program.

Participants, who were predominantly male (70%) and ethnically diverse (51% non-Hispanic White, 21% non-Hispanic Black, 11% Hispanic, and 13% Mixed /Other), were randomly assigned to either 1) a treatment as usual (TAU) condition based on a 12-Step model, 2) an 8-week cognitive-behavioral relapse prevention program (RP) emphasizing motivation, coping skills, and avoiding triggers for relapse, and 3) an 8-week Mindfulness-Based Relapse Prevention Program (MBRP) emphasizing using mindfulness skills to tolerate negative moods and urges.

Primary outcome measures were the number of days until a first lapse in drug use or heavy drinking (defined as 4 or more drinks for women and 5 or more drinks for men) and the number of days during which drug use or heavy drinking occurred. The outcomes were assessed by self-report, but 70% of the participants were subject to court-mandated drug and alcohol screens which by and large agreed with their self-reports (only 5% of the screens were positive when participants denied substance use).

There were no significant differences in the attrition rates between treatments, and no differences between treatments at 3 month follow-up in terms of either the number of days until first drug or heavy drinking lapse or the number of days of drug use or heavy drinking; all three groups had fairly high abstinence rates.

Over the 12 […]

April 7th, 2014|News|

MBCT Helps Those With History of Trauma

Posted: 01.20. 2014 | by AMRA

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Mindfulness-Based Cognitive Therapy (MBCT) is a well-established prophylactic treatment against relapse in major depressive disorder (MDD), but issues persist over which depressive patients benefit most.

Previous research suggests that MBCT may only prevent depressive relapse in a vulnerable subgroup of people with MDD. This group includes people with the most frequent episodes, earliest onsets, greatest levels of childhood adversity, and most persistent residual symptoms. In addition, prior research has not dismantled MBCT to discover whether its mindfulness training component is absolutely necessary for its effectiveness. Williams et al. [Journal of Consulting and Clinical Psychology] addressed these issues by comparing MBCT with Cognitive Psychological Education (CPE), an 8-week group treatment which included MBCT’s cognitive educational component while excluding mindfulness training embedded in meditation practice.

The authors randomly assigned 274 currently remitted patients with a history of three or more episodes of MDD to either MBCT, CPE, or treatment-as-usual (TAU). At 12-month follow-up, roughly half of each group had suffered a relapse (as defined by meeting the full diagnostic criteria for MDD for at least a two week time period), and there were no significant differences in the relapse rates between the two treatment groups. Participants with higher residual symptoms at baseline and/or stronger histories of childhood trauma were significantly more likely to relapse.

When the study compared participants with higher levels of childhood trauma to those with lower levels, the participants with higher levels benefited significantly more from MBCT than from TAU, with relapse rates of 41 (MBCT), 54 (CPE) and 65 (TAU) respectively. No significant differences between treatment groups emerged for participants with low levels of childhood trauma. These results further clarify those who […]

January 28th, 2014|News|