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Li MJ, Black DS, Garland EL. The Applied Mindfulness Process Scale (AMPS): A process measure for evaluating mindfulness-based interventions. PERSONALITY AND INDIVIDUAL DIFFERENCES 2016; 93:6-15. [PMID: 26858469 DOI: 10.1016/j.paid.2015.10.027] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
OBJECTIVE Mindfulness-based interventions (MBIs) include the application of meditation and mind-body practices used to promote mindful awareness in daily life. Operationalizing the construct of mindfulness is important in order to determine mechanisms of therapeutic change elicited by mindfulness practice. In addition to existing state and trait measures of mindfulness, process measures are needed to assess the ways in which individuals apply mindfulness in the context of their practice. METHOD This report details three independent studies (qualitative interview, N = 8; scale validation, N = 134; and replication study, N = 180) and the mixed qualitative-quantitative methodology used to develop and validate the Applied Mindfulness Process Scale (AMPS), a 15-item process measure designed to quantify how mindfulness practitioners actively use mindfulness to remediate psychological suffering in their daily lives. RESULTS In Study 1, cognitive interviewing yielded a readily comprehensible and accessible scale of 15 items. In Study 2, exploratory factor analysis derived a potential three-factor solution: decentering, positive emotion regulation, and negative emotion regulation. In Study 3, confirmatory factor analysis verified better model fit with the three-factor structure over the one-factor structure. CONCLUSIONS AMPS functions as a measure to quantify the application of mindfulness and processes of change in the context of MBIs and general mindfulness practice.
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Affiliation(s)
- Michael J Li
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California
| | - David S Black
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California
| | - Eric L Garland
- College of Social Work & Huntsman Cancer Institute, University of Utah
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Goldin PR, Morrison A, Jazaieri H, Brozovich F, Heimberg R, Gross JJ. Group CBT versus MBSR for social anxiety disorder: A randomized controlled trial. J Consult Clin Psychol 2016; 84:427-37. [PMID: 26950097 DOI: 10.1037/ccp0000092] [Citation(s) in RCA: 110] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE The goal of this study was to investigate treatment outcome and mediators of cognitive-behavioral group therapy (CBGT) versus mindfulness-based stress reduction (MBSR) versus waitlist (WL) in patients with generalized social anxiety disorder (SAD). METHOD One hundred eight unmedicated patients (55.6% female; mean age = 32.7 years, SD = 8.0; 43.5% Caucasian, 39% Asian, 9.3% Hispanic, 8.3% other) were randomized to CBGT versus MBSR versus WL and completed assessments at baseline, posttreatment/WL, and at 1-year follow-up, including the Liebowitz Social Anxiety Scale-Self-Report (primary outcome; Liebowitz, 1987) as well as measures of treatment-related processes. RESULTS Linear mixed model analysis showed that CBGT and MBSR both produced greater improvements on most measures compared with WL. Both treatments yielded similar improvements in social anxiety symptoms, cognitive reappraisal frequency and self-efficacy, cognitive distortions, mindfulness skills, attention focusing, and rumination. There were greater decreases in subtle avoidance behaviors following CBGT than MBSR. Mediation analyses revealed that increases in reappraisal frequency, mindfulness skills, attention focusing, and attention shifting, and decreases in subtle avoidance behaviors and cognitive distortions, mediated the impact of both CBGT and MBSR on social anxiety symptoms. However, increases in reappraisal self-efficacy and decreases in avoidance behaviors mediated the impact of CBGT (vs. MBSR) on social anxiety symptoms. CONCLUSIONS CBGT and MBSR both appear to be efficacious for SAD. However, their effects may be a result of both shared and unique changes in underlying psychological processes.
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Affiliation(s)
- Philippe R Goldin
- Betty Irene Moore School of Nursing, University of California, Davis
| | | | - Hooria Jazaieri
- Department of Psychology, University of California, Berkeley
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Rowe AC, Shepstone L, Carnelley KB, Cavanagh K, Millings A. Attachment Security and Self-compassion Priming Increase the Likelihood that First-time Engagers in Mindfulness Meditation Will Continue with Mindfulness Training. Mindfulness (N Y) 2016; 7:642-650. [PMID: 27217843 PMCID: PMC4859852 DOI: 10.1007/s12671-016-0499-7] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Mindfulness practice has many mental and physical health benefits but can be perceived as ‘difficult’ by some individuals. This perception can discourage compliance with mindfulness meditation training programs. The present research examined whether the activation of thoughts and feelings related to attachment security and self-compassion (through semantic priming) prior to a mindfulness meditation session might influence willingness to engage in future mindfulness training. We expected both of these primes to positively influence participants’ willingness to continue with mindfulness training. We primed 117 meditation-naïve individuals (84 female; mean age of 22.3 years, SD = 4.83) with either a self-compassion, attachment security, or a neutral control prime prior to an introductory mindfulness exercise and measured their post-session willingness to engage in further training. Both experimental primes resulted in higher willingness to engage in further mindfulness training relative to the control condition. The self-compassion prime did so indirectly by increasing state mindfulness, while the attachment security prime had a direct effect. This study supports theoretical links between self-compassion and mindfulness and reveals a causal role for these factors in promoting willingness to engage in mindfulness training. Our findings have implications for improving compliance with mindfulness intervention programs.
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Affiliation(s)
- Angela C Rowe
- School of Experimental Psychology, University of Bristol, 12a Priory Road, Bristol, BS8 1TU UK
| | - Laura Shepstone
- School of Experimental Psychology, University of Bristol, 12a Priory Road, Bristol, BS8 1TU UK
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Windgassen S, Goldsmith K, Moss-Morris R, Chalder T. Establishing how psychological therapies work: the importance of mediation analysis. J Ment Health 2016; 25:93-9. [DOI: 10.3109/09638237.2015.1124400] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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Abstract
PURPOSE OF REVIEW The article reviews the recent evidence for mindfulness-based cognitive therapy (MBCT) for patients with residual depressive symptoms or in remitted patients at increased risk for relapse. RECENT FINDINGS Randomized controlled trials have shifted focus from comparing MBCT with treatment-as-usual to comparing MBCT against interventions. These studies have provided evidence for the efficacy of MBCT on par with maintenance antidepressant pharmacotherapy and leading to a relative reduction of risk on the order of 30-40%. Perhaps fuelled by these data, recent efforts have focused on extending MBCT to novel populations, such as acutely depressed patients, those diagnosed with health anxiety, social anxiety, fibromyalgia, or multiple chemical sensitivities as well migrating MBCT to online platforms so that it is more widely available. Neuroimaging studies of patients in structured therapies which feature mindfulness meditation, have reported findings that parallel behavioral changes, such as increased activation in brain regions subsuming self-focus and emotion regulation (prefrontal cortex) and interoceptive awareness (insula). SUMMARY The current evidence base for MBCT is strongest for its application as a prophylactic intervention or for residual depressive symptoms, with early data suggesting additional indications outside the mood disorders. Future work will need to address dose-effect relationships between mindfulness practice and clinical benefits, as well as establishing the rates of uptake for online MBCT so that its benefits can be compared to in-person groups. Additionally, validating current or novel neural markers of MBCT treatment response will allow for patient matching and optimization of treatment response.
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Access to autobiographical memory as an emotion regulation strategy and its relation to dispositional mindfulness. ACTA ACUST UNITED AC 2016. [DOI: 10.1016/j.mincom.2016.09.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Griffin KH, Johnson JR, Kitzmann JP, Kolste AK, Dusek JA. Outcomes of a Multimodal Resilience Training Program in an Outpatient Integrative Medicine Clinic. J Altern Complement Med 2015; 21:628-37. [DOI: 10.1089/acm.2015.0130] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Kristen H. Griffin
- Integrative Health Research Center, Penny George Institute for Health and Healing, Allina Health, Minneapolis, MN
| | - Jill R. Johnson
- Integrative Health Research Center, Penny George Institute for Health and Healing, Allina Health, Minneapolis, MN
| | - Jennifer P. Kitzmann
- Integrative Health Research Center, Penny George Institute for Health and Healing, Allina Health, Minneapolis, MN
| | - Alison K. Kolste
- Integrative Health Research Center, Penny George Institute for Health and Healing, Allina Health, Minneapolis, MN
| | - Jeffery A. Dusek
- Integrative Health Research Center, Penny George Institute for Health and Healing, Allina Health, Minneapolis, MN
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Bodenlos JS, Wells SY, Noonan M, Mayrsohn A. Facets of Dispositional Mindfulness and Health Among College Students. J Altern Complement Med 2015; 21:645-52. [DOI: 10.1089/acm.2014.0302] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Affiliation(s)
| | - Stephanie Y. Wells
- San Diego State University/University of California San Diego, San Diego, CA
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Dalen J, Brody JL, Staples JK, Sedillo D. A Conceptual Framework for the Expansion of Behavioral Interventions for Youth Obesity: A Family-Based Mindful Eating Approach. Child Obes 2015; 11:577-84. [PMID: 26325143 PMCID: PMC4599132 DOI: 10.1089/chi.2014.0150] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Currently, over 30% of US youth are overweight and 1 in 6 have metabolic syndrome, making youth obesity one of the major global health challenges of the 21st century. Few enduring treatment strategies have been identified in youth populations, and the majority of standard weight loss programs fail to adequately address the impact of psychological factors on eating behavior and the beneficial contribution of parental involvement in youth behavior change. METHODS A critical need exists to expand treatment development efforts beyond traditional education and cognitive-behavioral programs and explore alternative treatment models for youth obesity. Meditation-based mindful eating programs represent a unique and novel scientific approach to the current youth obesity epidemic given that they address key psychological variables affecting weight. RESULTS The recent expansion of mindfulness programs to include family relationships shows the immense potential for broadening the customarily individual focus of this intervention to include contextual factors thought to influence youth health outcomes. CONCLUSIONS This article provides an overview of how both mindful eating and family systems theory fits within a conceptual framework in order to guide development of a comprehensive family-based mindful eating program for overweight youth.
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Affiliation(s)
- Jeanne Dalen
- Oregon Research Institute, Center for Family and Adolescent Research, Albuquerque, NM.,University of New Mexico Health Sciences Center, Albuquerque, NM
| | - Janet L. Brody
- Oregon Research Institute, Center for Family and Adolescent Research, Albuquerque, NM
| | | | - Donna Sedillo
- Oregon Research Institute, Center for Family and Adolescent Research, Albuquerque, NM
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Mindfulness-based cognitive therapy vs. psycho-education for patients with major depression who did not achieve remission following antidepressant treatment. Psychiatry Res 2015; 226:474-83. [PMID: 25744325 DOI: 10.1016/j.psychres.2015.02.003] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2014] [Revised: 02/05/2015] [Accepted: 02/09/2015] [Indexed: 12/28/2022]
Abstract
Mindfulness-based cognitive therapy (MBCT) showed efficacy for currently depressed patients. However, most of the available studies suffer from important methodological shortcomings, including the lack of adequate control groups. The present study aims to compare MBCT with a psycho-educational control group designed to be structurally equivalent to the MBCT program but excluding the main putative "active ingredient" of MBCT (i.e., mindfulness meditation practice) for the treatment of patients with major depression (MD) who did not achieve remission following at least 8 weeks of antidepressant treatment. Out of 106 screened subjects, 43 were randomized to receive MBCT or psycho-education and were prospectively followed for 26 weeks. MD severity was assessed with the Hamilton Rating Scale for Depression (HAM-D) and the Beck Depression Inventory-II (BDI-II). Measures of anxiety, mindfulness, and quality of life were also included. All assessments were performed at baseline, 4, 8, 17 and 26-weeks. Both HAM-D and BDI scores, as well as quality of life and mindfulness scores, showed higher improvements, which were particularly evident over the long-term period, in the MBCT group than in the psycho-education group. Although limited by a small sample size, the results of this study suggest the superiority of MBCT over psycho-education for non-remitted MD subjects.
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Rodriguez MA, Xu W, Wang X, Liu X. Self-Acceptance Mediates the Relationship between Mindfulness and Perceived Stress. Psychol Rep 2015; 116:513-22. [DOI: 10.2466/07.pr0.116k19w4] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Previous research has shown that the effects of mindfulness-based interventions and increased trait mindfulness are associated with reduced stress. Further research is needed to understand the mechanisms by which mindfulness-based interventions exert their beneficial effect on decreased stress. The purpose of the present study was to examine the role of self-acceptance in the relationship between trait mindfulness and perceived stress among a sample of 132 students from Beijing, China. Results revealed that self-acceptance was found to partially mediate the relationship between mindfulness and stress. Limitations, clinical implications, and directions for future research are identified.
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Affiliation(s)
- Marcus A. Rodriguez
- Beijing Key Laboratory of Learning and Cognition, Department of Psychology, Capital Normal University, Beijing, Department of Psychology and Neuroscience, Duke University
| | - Wei Xu
- Beijing Key Laboratory of Learning and Cognition, Department of Psychology, Capital Normal University, Beijing
| | - Xiaoming Wang
- Beijing Key Laboratory of Learning and Cognition, Department of Psychology, Capital Normal University, Beijing
| | - Xinghua Liu
- Beijing Key Laboratory of Learning and Cognition, Department of Psychology, Capital Normal University, Beijing
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How do mindfulness-based cognitive therapy and mindfulness-based stress reduction improve mental health and wellbeing? A systematic review and meta-analysis of mediation studies. Clin Psychol Rev 2015; 37:1-12. [DOI: 10.1016/j.cpr.2015.01.006] [Citation(s) in RCA: 876] [Impact Index Per Article: 97.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2014] [Revised: 12/16/2014] [Accepted: 01/22/2015] [Indexed: 01/17/2023]
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Greeson JM, Smoski MJ, Suarez EC, Brantley JG, Ekblad AG, Lynch TR, Wolever RQ. Decreased symptoms of depression after mindfulness-based stress reduction: potential moderating effects of religiosity, spirituality, trait mindfulness, sex, and age. J Altern Complement Med 2015; 21:166-74. [PMID: 25695903 PMCID: PMC4365440 DOI: 10.1089/acm.2014.0285] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Mindfulness-based stress reduction (MBSR) is a secular meditation training program that reduces depressive symptoms. Little is known, however, about the degree to which a participant's spiritual and religious background, or other demographic characteristics associated with risk for depression, may affect the effectiveness of MBSR. Therefore, this study tested whether individual differences in religiosity, spirituality, motivation for spiritual growth, trait mindfulness, sex, and age affect MBSR effectiveness. METHODS As part of an open trial, multiple regression was used to analyze variation in depressive symptom outcomes among 322 adults who enrolled in an 8-week, community-based MBSR program. RESULTS As hypothesized, depressive symptom severity decreased significantly in the full study sample (d=0.57; p<0.01). After adjustment for baseline symptom severity, moderation analyses revealed no significant differences in the change in depressive symptoms following MBSR as a function of spirituality, religiosity, trait mindfulness, or demographic variables. Paired t tests found consistent, statistically significant (p<0.01) reductions in depressive symptoms across all subgroups by religious affiliation, intention for spiritual growth, sex, and baseline symptom severity. After adjustment for baseline symptom scores, age, sex, and religious affiliation, a significant proportion of variance in post-MBSR depressive symptoms was uniquely explained by changes in both spirituality (β=-0.15; p=0.006) and mindfulness (β=-0.17; p<0.001). CONCLUSIONS These findings suggest that MBSR, a secular meditation training program, is associated with improved depressive symptoms regardless of affiliation with a religion, sense of spirituality, trait level of mindfulness before MBSR training, sex, or age. Increases in both mindfulness and daily spiritual experiences uniquely explained improvement in depressive symptoms.
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Affiliation(s)
- Jeffrey M. Greeson
- Duke Integrative Medicine, Duke University Medical Center, Durham, NC
- Department of Psychiatry & Behavioral Sciences, Duke University School of Medicine, Durham, NC
- Department of Psychiatry, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA
| | - Moria J. Smoski
- Department of Psychiatry & Behavioral Sciences, Duke University School of Medicine, Durham, NC
| | - Edward C. Suarez
- Duke Integrative Medicine, Duke University Medical Center, Durham, NC
- Department of Psychiatry & Behavioral Sciences, Duke University School of Medicine, Durham, NC
| | - Jeffrey G. Brantley
- Duke Integrative Medicine, Duke University Medical Center, Durham, NC
- Department of Psychiatry & Behavioral Sciences, Duke University School of Medicine, Durham, NC
| | - Andrew G. Ekblad
- Department of Psychiatry, McMaster University, Hamilton, Ontario, Canada
- Broadleaf Health, Guelph, Ontario, Canada
| | - Thomas R. Lynch
- School of Psychology, University of Southampton, Southampton, United Kingdom
| | - Ruth Quillian Wolever
- Duke Integrative Medicine, Duke University Medical Center, Durham, NC
- Department of Psychiatry & Behavioral Sciences, Duke University School of Medicine, Durham, NC
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Tsafou KE, De Ridder DT, van Ee R, Lacroix JP. Mindfulness and satisfaction in physical activity: A cross-sectional study in the Dutch population. J Health Psychol 2015; 21:1817-27. [PMID: 25631662 DOI: 10.1177/1359105314567207] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Both satisfaction and mindfulness relate to sustained physical activity. This study explored their relationship. We conducted a cross-sectional study with 398 Dutch participants who completed measures on trait mindfulness, mindfulness and satisfaction with physical activity, physical activity habits, and physical activity. We performed mediation and moderated mediation. Satisfaction mediated the effect of mindfulness on physical activity. Mindfulness was related to physical activity only when one's habit was weak. The relation of mindfulness with satisfaction was stronger for weak compared to strong habit. Understanding the relationship between mindfulness and satisfaction can contribute to the development of interventions to sustain physical activity.
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Affiliation(s)
| | | | - Raymond van Ee
- Philips Research Laboratories, The Netherlands Radboud University, The Netherlands
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Pots WTM, Meulenbeek PAM, Veehof MM, Klungers J, Bohlmeijer ET. The efficacy of mindfulness-based cognitive therapy as a public mental health intervention for adults with mild to moderate depressive symptomatology: a randomized controlled trial. PLoS One 2014; 9:e109789. [PMID: 25333885 PMCID: PMC4198116 DOI: 10.1371/journal.pone.0109789] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2014] [Accepted: 09/06/2014] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE Although there has been growing evidence for the efficacy of mindfulness-based cognitive therapy (MBCT) for different clinical populations, its effectiveness as a public mental health intervention has not been studied. The present study evaluates a community-based MBCT intervention for adults with mild to moderate depressive symptomatology in a large multi-site, pragmatic randomized controlled trial. METHOD The participants with mild to moderate depressive symptomatology were recruited from the general population and randomized to the MBCT intervention (n = 76) or to a waiting list control group (n = 75). Participants completed measures before and after the intervention. Participants in the experimental condition also completed these measures at a 3-month follow-up. RESULTS In the experimental condition significant reductions in depression, anxiety, and experiential avoidance, and improvements in mindfulness and emotional- and psychological mental health were found, compared to the waiting list (effect sizes Cohen's d = 0.31-0.56). These effects were sustained at the 3-month follow-up. The likelihood of a clinically significant change in depressive symptoms was significantly higher for the MBCT group [odds ratio (OR) 3.026, p<0.01 at post-treatment; NNT = 5.10]. DISCUSSION MBCT as a public mental health intervention for adults with mild to moderate depressive symptoms seems effective and applicable in a natural setting. TRIAL REGISTRATION Nederlands Trial Register NTR2096.
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Affiliation(s)
- Wendy T. M. Pots
- University of Twente, Department of Psychology, Health & Technology, Enschede, the Netherlands
- Dimence, Community Mental Health Center, Almelo, the Netherlands
- * E-mail:
| | - Peter A. M. Meulenbeek
- University of Twente, Department of Psychology, Health & Technology, Enschede, the Netherlands
- GGNET, Community Mental Health Center, Warnsveld, the Netherlands
| | - Martine M. Veehof
- University of Twente, Department of Psychology, Health & Technology, Enschede, the Netherlands
| | - Jorinde Klungers
- GGNET, Community Mental Health Center, Warnsveld, the Netherlands
| | - Ernst T. Bohlmeijer
- University of Twente, Department of Psychology, Health & Technology, Enschede, the Netherlands
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