Fundamentals of Mental Health

Fundamentals of Mental Health

Effectiveness of Mindfulness-Based Cognitive Therapy (MBCT) on cognitive avoidance, rumination and emotional regulation in depressed individuals

Document Type : Research Paper

Authors
Somayeh Afshar 1
Negar Asgharipour Zahmati 2
Fatemeh Alidoosti 3
1 Ph.D. student in psychology, Department of Psychology, Bojnourd Branch, Islamic Azad University, Bojnourd, Iran.
2 Ph.D. in clinical psychology, Associate professor, Psychiatry and Behavioral Sciences Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
3 Assistant professor, Department of Psychology, Faculty of Humanities, Khayyam University, Mashhad, Iran.
10.22038/JFMH.2024.76456.3098
Abstract
Introduction: Regarding the prevalence of depression and the necessity of effective treatments, the present study aimed to investigate the effectiveness of cognitive therapy based on mindfulness on rumination, cognitive avoidance, and emotional regulation in depressed people.
 
Materials and Methods: The statistical population of this research consists of all the people who were referred to the psychology and counseling clinic of Mashhad University in 2021 and were diagnosed with depression through a clinical interview. The cases were selected using the convenient sampling method. They were randomly assigned into two mindfulness treatment and control groups. Research tools included Beck Depression Inventory-II (BDI-II), Ruminative Response Scale (RRS), Emotional Regulation Questionnaire (ERQ), Cognitive Avoidance Questionnaire (CAQ), and Structured Clinical Interviews for Mental Disorders (SCID-5CV). The data were analyzed by aiding descriptive statistics, the Kolmogorov-Smirnov test, and covariance analysis.
 
Results: The findings reveal a significant difference in the mean scores of rumination (P< 0.001), emotional regulation (P< 0.001), and cognitive avoidance (P< 0.001) between the experimental and control groups; this means that therapeutic intervention reduces the intensity of cognitive avoidance, emotionally dysregulation, and rumination in depressed people.
 
Conclusion: Based on the results, mindfulness-based cognitive therapy can be used to treat depression by reducing rumination and cognitive avoidance and improving emotional regulation.
Keywords
Cognitive avoidance
Depression
Emotional regulation
Mindfulness-based cognitive therapy
Rumination
  1. American Psychiatric Association. Diagnostic and statistical manual of mental disorders (5th ed). Washington, DC: American Psychiatric Press; 2013.
  2. Sadeghirad B, Haghdoost A, Amin-Esmaeili M, Ananloo E, Ghaeli P, Rahimi Movaghar A, et al. Epidemiology of major depressive disorder in Iran: A systematic review and meta-analysis. Int J Prev Med 2010; 1(2): 81-91.
  3. Sadock BJ, Sadock VA. Synopsis of psychiatry: behavioral sciences/clinical psychiatry. Philadelphia: Wolters Kluwer; 2015.
  4. Hooshi N, Khodabakhshi Kolaei A. [The effectiveness of group counselling based on mindfulness on the quality of sleep and rumination of the elderly]. Journal of assessment and research in counselling and psychology 2020; 1(3): 35-51. (Persian)
  5. Sedighi K, Saffarian Toosi M, Khadivi G. [Effectiveness of mindfulness based cognitive therapy on anxiety and depression of divorced women]. Journal of research in behavioural sciences 2021; 19(1): 149-58. (Persian)
  6. Yang H, Zhou X, Xie L, Sun J. The effect of emotion regulation on emotional eating among undergraduate students in China: The chain mediating role of impulsivity and depressive symptoms. PLoS ONE 2023; 18(6): e0280701.
  7. Hosseinpour H, Akbari M, Hassani J, Zargar F. [The effectiveness of drug therapy combined with short-term treatment of mindfulness in the quality of disability caused by migraine and improving the quality of sleep]. Journal of neuroscience- Khatam healing 2020; 2: 18-28. (Persian)
  8. Sanada K, Montero-Marin J, Barceló-Soler A, Ikuse D, Ota M, Hirata A, et al. Effects of mindfulness-based interventions on biomarkers and low-grade inflammation in patients with psychiatric disorders: A meta-analytic review. Int J Molec Sci 2020; 21(7): 2484.
  9. Krieger T, Altenstein D, Baettig I, Doerig N, Holtforth MG. Self-compassion in depression: Associations with depressive symptoms, rumination, and avoidance in depressed outpatients. Behav Ther 2013; 44: 501-13.
  10. Fan J, Li W, Lin M, Li X, Deng X. Effects of mindfulness and fatigue on emotional processing: An event-related potentials study. Front Behav Neurosci 2023; 17: 1175067.
  11. Borg WR, Gall J. [Quantitative and qualitative research methods in educational sciences and psychology]. Nasr AR. (translator). Tehran: SAMT; 2011. (Persian)
  12. Michael B, First M, Janet B, Williams D, Rhonda S, Karg P, et al. Structured Clinical Interview for DSM-5® Disorders—Clinician Version (SCID-5-CV). Washington D.C.: American Psychiatric Association;
  13. Dobson KS, Mohammad Khani P. [Psychometric characteristics Beck Depression Inventory-2 in a large sample of patients with major depressive disorder]. Iranian journal of rehabilitation in mental disorders 2007; 8: 80-86. (Persian)
  14. Nolen-Hoeksema S, Morrow J. Response Styles Questionnaire [Database record]. APA PsycTests; 1991. Available from: https://psycnet.apa.org/doiLanding?doi=10.1037%2Ft03823-000
  15. Yook K, Kim K-H, Suh SY, Lee KS. Intolerance of uncertainty, worry, and rumination in major depressive disorder and generalized anxiety disorder. J Anxiety Disord 2010; 24: 623-8.
  16. Bagherinejad B, Salehi Fadardi J, Tabatabai SM. [The relationship between rumination and depression in a sample of Iranian students]. Research in clinical psychology and counseling 2010; 11(1): 28-36. (Persian)
  17. Gross JJ, Thompson RA. Emotion regulation: Conceptual foundations. In: Gross JJ. (editor). Handbook of emotion regulation. New York: Guilford; 2007: 3-24.
  18. Bigdeli A, Najafy M, Rostami M. [The relation of attachment styles, emotional regulation and resilience to well-being among students of medical sciences]. Iranian journal of medical education 2013; 13: 721-9. (Persian)
  19. Sexton KA, Dugas MJ. The cognitive avoidance questionnaire: Validation of the English translation. J Anxiety Disord 2008; 22: 355-70.
  20. Barghi Irani Z, Mohammadi O, Bagian Koulemarz MJ, Bakhti M. [The role of cognitive avoidance and decisional procrastination in predicting social anxiety among students]. Social psychology research 2015; 4: 17-35. (Persian)
  21. Nikroo B, Shahabizadeh F, Nasri M. The effectiveness of Mindfulness-Based Cognitive Therapy (MBCT) and Acceptance and Commitment Therapy (ACT) in sleep quality of students with test anxiety. Journal of fundamentals of mental health 2022; 24(6): 383-90.
  22. Li P, Mao L, Hu M, Lu Z, Yuan X, Zhang Y, et al. Mindfulness on rumination in patients with depressive disorder: A systematic review and meta-analysis of randomized controlled trials. Int J Environ Res Public Health 2022; 19(23): 16101.
  23. Mousavi MS, Tabatabaienejad FS, Benitaba SM. [The effect of positive mindfulness therapy and cognitive-behavioral therapy on rumination and psychological well-being of depressed students in rehabilitation school]. Journal of educational development of Jundishapour 2022; 13(2): 436-58. (Persian)
  24. Shih VW, Chan W-C, Tai O-K, Wong H-L, Cheng CP, Wong CS. Mindfulness-based cognitive therapy for late-life depression: A randomised controlled trial. East Asian Arch Psychiatry 2021; 31(2): 27-35.
  25. Barmal F, Salehi Faderdi J, Tabibi Z. [The effectiveness of mindfulness training on mental rumination, problem solving, and cognitive regulation of emotion in people with depression]. Psychological studies 2017; 14(2): 91-107. (Persian)
  26. Mao L, Li P, Wu Y, Luo L, Hu M. The effectiveness of mindfulness-based interventions for ruminative thinking: A systematic review and meta-analysis of randomized controlled trials. J Affect Disord 2023; 321: 83-95.
  27. Shahsavari Googhari Z, Hafezi F, Asgari P, Heidari A. [The effectiveness of mindfulness-based cognitive therapy and acceptance and commitment therapy on medical science students’ subjective well-being, psychological distress, and emotion regulation]. Journal of Shahrekord University of Medical Sciences 2022; 24: 35-41. (Persian)
  28. Musaa ZA, Lamb SK, Mukhtarc FBM, Yanc SK, Olalekand OT, Geoke SK. Effectiveness of mindfulness-based cognitive therapy on the management of depressive disorder: Systematic review. Int J Afr Nurs Sci 2020; 12: 100200.
  29. Khadem S, Fakhri MK, Emadian SO. [The effectiveness of mindfulness based cognitive therapy on rumination, perfectionism, and thought-action fusion of women suffering from obsessive-compulsive disorder]. Journal of adolescent and youth psychological studies 2023; 4(4): 147-63. (Persian)
  30. Gharib Dost M, Nasri K, Behfar M, Tayebi A. [Determining the effectiveness of mindfulness-based cognitive therapy on cognitive avoidance and marital intimacy in women with obsessive-compulsive disorder]. Journal of disability studies 2022; 12: 260. (Persian)
  31. Powers A, Lathan EC, Dixon HD, Mekawi Y, Hinrichs R, Carter S, et al. Primary care-based mindfulness intervention for posttraumatic stress disorder and depression symptoms among black adults: A pilot feasibility and acceptability randomized controlled trial. Psychol Trauma 2023; 15(5): 858-67.
  32. Garcia-Toro M, Aguilar-Latorre A, Garcia A, Navarro-Guzmán C, Gervilla E, Seguí A, et al. Mindfulness skills and experiential avoidance as therapeutic mechanisms for treatment-resistant depression through mindfulness-based cognitive therapy and lifestyle modification. Front Psychol 2023; 14: 1008891.
Fundamentals of Mental Health
Volume 26, Issue 2
2024
Pages 123-131