How does mindfulness-based cognitive therapy work?

Mindfulness-based cognitive therapy (MBCT) is an efficacious psychosocial intervention for recurrent depression ( [Kuyken et?al., 2008], [Ma and Teasdale, 2004] and [Teasdale et?al., 2000]). To date, no compelling research addresses MBCT’s mechanisms of change. This study determines whether MBCT’s treatment effects are mediated by enhancement of mindfulness and self-compassion across treatment, and/or by alterations in post-treatment cognitive reactivity. The study was embedded in a randomized controlled trial comparing MBCT with maintenance antidepressants (mADM) with 15-month follow-up (Kuyken et al., 2008). Mindfulness and self-compassion were assessed before and after MBCT treatment (or at equivalent time points in the mADM group). Post-treatment reactivity was assessed one month after the MBCT group sessions or at the equivalent time point in the mADM group. One hundred and twenty-three patients with ≥3 prior depressive episodes, and successfully treated with antidepressants, were randomized either to mADM or MBCT. The MBCT arm involved participation in MBCT, a group-based psychosocial intervention that teaches mindfulness skills, and discontinuation of ADM. The mADM arm involved maintenance on a therapeutic ADM dose for the duration of follow-up. Interviewer-administered outcome measures assessed depressive symptoms and relapse/recurrence across 15-month follow-up. Mindfulness and self-compassion were measured using self-report questionnaire. Cognitive reactivity was operationalized as change in depressive thinking during a laboratory mood induction.MBCT’s effects were mediated by enhancement of mindfulness and self-compassion across treatment. MBCT also changed the nature of the relationship between post-treatment cognitive reactivity and outcome. Greater reactivity predicted worse outcome for mADM participants but this relationship was not evident in the MBCT group.MBCT’s treatment effects are mediated by augmented self-compassion and mindfulness, along with a decoupling of the relationship between reactivity of depressive thinking and poor outcome. This decoupling is associated with the cultivation of self-compassion across treatment.     

Fertile Ground at the Edge of Difference: Self,Other, and Potential Space: Commentary on Paper by Gillian Straker

Juliet Mitchell's wide-ranging theory of lateral dynamics proposes that displacement by a sibling, real or potential, upends a small child's identity and position as “the baby.” This trauma gives rise to the complex process of forming a personal identity in a world of similar others. The impact of lateral relationships should therefore have major implications for analytic practice. Traditionally, however, psychoanalysis has treated siblings mainly as rivals for parental love and attention, not as unconsciously meaningful beings in their own right. This paper describes some ways that Mitchell's theory has inspired clinical interventions that would not have come into focus through a lens of parent–child relatedness.     

When you fail to see what you were told to look for: Inattentional blindness and task instructions

Inattentional blindness studies have shown that an unexpected object may go unnoticed if it does not share the property specified in the task instructions. Our aim was to demonstrate that observers develop an attentional set for a property not specified in the task instructions if it allows easier performance of the primary task. Three experiments were conducted using a dynamic selective-looking paradigm. Stimuli comprised four black squares and four white diamonds, so that shape and colour varied together. Task instructions specified shape but observers developed an attentional set for colour, because we made the black–white discrimination easier than the square–diamond discrimination. None of the observers instructed to count bounces by squares reported an unexpected white square, whereas two-thirds of observers instructed to count bounces by diamonds did report the white square. When attentional set departs from task instructions, you may fail to see what you were told to look for.     

Perceptions of Children Who Lie: Influence of Lie Motive and Benefit

KILMARTIN (1994) suggested that masculine traits may result from externalizing defense style and that when unconscious and unwanted feminine traits about the self occur, they are dealt with in an external way, radier man being directiy resolved by the individual. However, this dieory has received little empirical support. Lobel and Winch (1986) measured defense style among male college students; they found mat men who scored higher in masculinity tended to score higher on acting out (finding an object to attack) and splitting (separating affect from content). Lobel and Winch concluded mat use of diese defense styles reflects avoidance of emotional expression. In turn, diese findings have been supported by research that has suggested mat men use avoidance coping strategies more man women do (McCall &; Struthers, 1994).     

Effects of Unimodal and Multimodal Cues About Threat Locations on Target Acquisition and Workload

Two studies were conducted to examine the effects of unimodal and multimodal cueing techniques for indicating the location of threats on target acquisition, the recall of information from concurrent communications, and perceived workload. One visual, two auditory (i.e., nonspatial speech and spatial tones [3-D]), and one tactile cue were assessed in Experiment 1. Experiment 2 examined the effects of combinations of the cues assessed in the first investigation: visual + nonspatial speech, visual + spatial tones, visual + tactile, and nonspatial speech + tactile. A unimodal, “visual only” condition was included as a baseline to determine the extent to which a supplementary cue might influence changes in performance and workload. The results of the studies indicated that time to first shot and the percentage of hits can be improved and workload reduced by providing cues about target location. The multimodal cues did not yield significant improvements in performance or workload beyond that achieved by the unimodal visual cue.     

The Function of Ethnicity, Income Level, and Menstrual Taboos in Postmenarcheal Adolescents’ Understanding of Menarche and Menstruation

The purpose of this study was to examine differences in knowledge about menstruation, feelings of preparation for menarche, and menstrual attitudes of early adolescent girls from different ethnic groups and income levels. An interaction between ethnicity and income level was also investigated. Participants were 165 postmenarcheal adolescent girls’ (ages 11–15) from Pittsburgh, Pennsylvania, USA, who were categorized into four groups: higher income European Americans, lower income European Americans, higher income African Americans, and lower income African Americans. It was predicted that African Americans, lower income participants, and lower income African Americans would score lower on a menstrual knowledge test, report feeling less prepared for menarche, and report more negative menstrual attitudes (i.e., fewer positive feelings about menstruation, more negative feelings about menstruation, and less openness toward menstruation) than European Americans, higher income participants, and any other income level and ethnicity grouping. Not all hypotheses were fully supported. Participants’ lacked accurate menstrual knowledge and felt unprepared for menarche, but menstrual attitudes were ambivalent. Ethnicity and income level alone did not play a substantial role in girls’ understanding of menarche and menstruation; however, they did interact. Overall, higher income European Americans fared better than the other participants. Theories and research regarding girls’ understanding of menarche and menstruation must take sociocultural factors into account.     

Self-Regulation Deficits Explain the Link between Reactive Aggression and Internalizing and Externalizing Behavior Problems in Children

Childhood aggression is often associated with significant psychosocial maladjustment; however, adjustment difficulties may vary based on the function of aggression. The present study used the Behavior Rating Inventory of Executive Function (BRIEF; Gioia et al. Child Neuropsychology 6:235–238, 2000) to examine whether difficulties in particular domains of self-regulation serve as common mechanisms in the association between reactive (versus proactive) aggression and internalizing or externalizing adjustment problems in clinic-referred children. Reactive aggression was associated with poorer behavioral regulation and metacognition, whereas proactive aggression was not associated with poorer self-regulation. Further, the association between reactive aggression and adjustment problems, both internalizing and externalizing, was accounted for by poorer behavioral regulation and metacognitive skills. Gender, age, ADHD diagnosis, IQ, and psychotropic medication status did not account for the results. These findings suggest that self-regulation skills influence adjustment problems in reactively aggressive youth and may be important targets of intervention for such children.     

An application of protection motivation theory to riskier single-occasion drinking

Abstract

Cognitions in relation to drinking alcohol on a single occasion were explored within the framework of Protection Motivation Theory (PMT). One hundred and twenty three students provided information about their current weekend drinking, beliefs about drinking, and intentions to drink at safer limits. Data on self reported weekend drinking were gathered two weeks later from the same respondents. Analyses showed PMT components to be predictive of intentions but not of later behaviour. Perceived severity and self-efficacy related significantly to intentions for drinking at safer limits. No PMT measure differentiated between those who engaged in riskier single-occasion drinking at follow up and those whose drinking was less risky. Past behaviour was the only significant predictor of riskier single-occasion drinking at follow up. Implications for the current utility of PMT are discussed particularly in relation to respondents' reactions to newly identified health threats.