scholarly journals Metta-Based Therapy for Chronic Depression: a Wait List Control Trial

Mindfulness ◽  
2021 ◽  
Author(s):  
Ulrich Stangier ◽  
Artjom Frick ◽  
Isabel Thinnes ◽  
Elisabeth A. Arens ◽  
Stefan G. Hofmann

Abstract Objectives Current treatments for chronic depression have focused on reducing interpersonal problems and negative affect, but paid little attention to promoting prosocial motivation and positive affect. Following this treatment focus, the objective of the present study was to examine whether the combination of metta (Loving Kindness) group meditation and subsequent tailored individual therapy focusing on kindness towards oneself and others (metta-based therapy, MBT) shows greater improvements in depressive symptoms than a wait list control group in patients with chronic depression. Methods Forty-eight patients with DSM-5 persistent depressive disorder were randomly assigned to MBT or a wait list control condition. Outcome was assessed after group meditation, after subsequent individual therapy, and at 6-month follow-up. The primary outcome measure was an independent blind rating of depressive symptoms at post-test. Secondary outcome included changes in self-reported depression, behavioral activation, rumination, social functioning, mindfulness, compassion, and clinician-rated emotion regulation. Results Mixed-design analyses showed significant differences between MBT and WLC in changes from pre- to post-test in clinician-rated and self-rated depression, behavioral activation, rumination, social functioning, mindfulness, and emotion regulation. Most of the changes occurred during group meditation and were associated with large effect sizes. Improvements were maintained at 6-month follow-up. Conclusions The results provide preliminary support for the effectiveness of MBT in treating chronic depression. Trial Registration ISRCTN, ISRCTN97264476.

Trials ◽  
2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Artjom Frick ◽  
Isabel Thinnes ◽  
Ulrich Stangier

Abstract Background Depression is a widespread disorder with severe impacts for individuals and society, especially in its chronic form. Current treatment approaches for persistent depression have focused primarily on reducing negative affect and have paid little attention to promoting positive affect. Previous studies have shown that metta meditation increases positive affect in chronically depressed patients. Results from previous trials provide evidence for the efficacy of a stand-alone metta meditation group treatment in combination with mindfulness-based approaches. Further research is needed to better understand the implementation of meditation practice into everyday life. Therefore, mindfulness and metta meditation in a group setting are combined with individual cognitive behavioral therapy (CBT) into a new, low-intensity, cost-effective treatment (“MeCBT”) for chronic depression. Methods/design In this single-center, randomized, observer-blinded, parallel-group clinical trial we will test the efficacy of MeCBT in reducing depression compared to a wait-list control condition. Forty-eight participants in a balanced design will be allocated randomly to a treatment group or a wait-list control group. Metta-based group meditation will be offered in eight weekly sessions and one additional half-day retreat. Subsequent individual CBT will be conducted in eight fortnightly sessions. Outcome measures will be assessed at four time points: before intervention (T0); after group meditation (T1); after individual CBT (T2); and, in the treated group only, at 6-month follow-up (T3). Changes in depressive symptoms (clinician rating), assessed with the Quick Inventory of Depressive Symptoms (QIDS-C) are the primary outcome. We expect a significant decline of depressive symptoms at T2 compared to the wait-list control group. Secondary outcome measures include self-rated depression, mindfulness, benevolence, rumination, emotion regulation, social connectedness, social functioning, as well as behavioral and cognitive avoidance. We will explore changes at T1 and T2 in all these secondary outcome variables. Discussion To our knowledge this is the first study to combine a group program focusing on Metta meditation with state-of-the art individual CBT specifically tailored to chronic depression. Implications for further refinement and examination of the treatment program are discussed. Trial registration ISRCTN, ISRCTN97264476. Registered 29 March 2018 (applied on 14 December 2017)—retrospectively registered.


2010 ◽  
Vol 32 (1) ◽  
pp. 35-57 ◽  
Author(s):  
Steven Sandage ◽  
Everett Worthington

Undergraduate student volunteers (N=97) were randomly assigned to one of two six-hour forgiveness psychoeducational seminars or to a wait-list control group. Based on attachment theory, forgiveness was conceptualized in relation to the care-giving behavioral system (Mikulincer & Shaver, 2007). Both the Empathy Forgiveness Seminar and the Self-enhancement Forgiveness Seminar facilitated forgiveness to a greater degree than the wait-list control group at post-test and six-week follow-up. Empathy mediated changes in participants' forgiveness scores regardless of seminar condition. Shame-proneness was negatively related to post-test forgiveness scores and guilt-proneness was positively related to forgiveness at post-test and follow-up. Implications for interventions are discussed.


2017 ◽  
Vol 2017 ◽  
pp. 1-11 ◽  
Author(s):  
Jian Li ◽  
Natalie Riedel ◽  
Amira Barrech ◽  
Raphael M. Herr ◽  
Birgit Aust ◽  
...  

Objective. Short- and medium-term effectiveness (up to 3 years) of individual level stress management interventions (SMI) at work were demonstrated, yet long-term effectiveness remains unexplored. We therefore aimed to address this research gap. Methods. 94 male middle managers participated in a randomized wait-list controlled trial between 2006 and 2008 and in a post-trial-follow-up survey in 2015. During the first two years, all received an 18-hour psychotherapeutic SMI intervention which was based on the Effort-Reward Imbalance (ERI) model: tackling stressor on mismatch between effort and reward and promoting recovery on overcommitment. Work stress (i.e., ERI indicators) was the primary outcome, and the secondary outcome was depressive symptoms. The long-term effectiveness of the SMI was examined by mixed modeling, using an external control group (n=94). Results. Effort and reward were substantially improved with significant intervention ⁎ time interaction effects (p<0.001) compared to the external control group; effects on overcommitment and depressive symptoms were also significant (p<0.05 and p<0.01, resp.), though their trajectories in the intervention group were less sustainable. Conclusions. The effectiveness of this psychotherapeutic SMI at work based on the ERI model was observed over a 9-year period, particularly on the effort-reward ratio.


2016 ◽  
Vol 23 (8) ◽  
pp. 1112-1122 ◽  
Author(s):  
Rosa E Boeschoten ◽  
Joost Dekker ◽  
Bernard MJ Uitdehaag ◽  
Aartjan TF Beekman ◽  
Adriaan W Hoogendoorn ◽  
...  

Background: Depression in multiple sclerosis (MS) patients is common but may stay untreated. Physical limitations impede face-to-face treatment. Internet-based treatment is therefore a promising tool for treating depression in MS. Objectives: To investigate effectiveness of a guided Internet-based problem-solving treatment (IPST) for depressed MS patients. Methods: MS patients with moderate or severe depressive symptoms were randomly assigned to IPST or a wait list control. Primary outcome was the change in depressive symptoms defined by a change in sum score on the Beck Depression Inventory Second Edition (BDI-II). Assessments took place at baseline (T0), within a week after the intervention (T1), and at 4 months follow-up (T2). Analyses were based on the intention-to-treat principle. Results: A total of 171 patients were randomized to IPST ( n = 85) or a wait list control ( n = 86). T1 was completed by 152 (89%) and T2 by 131 patients (77%). The IPST group and wait list control showed large significant improvements in depressive symptoms, but no differences were found between groups at T1 ( d = 0.23; 95% confidence interval (CI) = (−4.03, 1.08); p = 0.259) and T2 ( d = 0.01; 95% CI = (−2.80, 2.98); p = 0.953). Conclusion: We found no indication that IPST for MS patients with moderate or severe depression is effective in reducing depressive symptoms compared to a waiting list. Large improvements in the wait list control were unexpected and are discussed.


2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Elnaz Hajati ◽  
Banafsheh Gharraee ◽  
Fahimeh Fathali Lavasani ◽  
Hojjatollah Farahani ◽  
Asadollah Rajab

Background: The prevalence of diabetes is on the rise, and the lack of regular self-care activities can exacerbate this disease. Therefore, finding effective and short-term treatments is needed for these patients. Objectives: The purpose of this study was to investigate the effectiveness of acceptance-based emotion regulation group therapy in controlling diabetes in patients with type 2 diabetes. Methods: This experimental study included the three stages of pre-test, post-test, and six-month after follow-up, as well as a control group. The statistical sample consisted of 33 patients with type 2 diabetes referred to the Iranian Diabetes Association, of whom 16 patients were allocated to the intervention group and 17 to the control group. The study was conducted in Tehran in 2019 - 2020. Acceptance-based emotion regulation group therapy lasted 14 weeks, during which some aspects of acceptance and commitment therapy, dialectical therapy, and emotion-focused treatment were combined and provided to the patients. The questionnaires used were the Summary of Diabetes Self-care activities (SDSCA) and Diabetes Dependent Quality of Life scale. Also, a structured DSM-V clinical interview was performed, and glycosylated hemoglobin (HbA1c) was measured. To analyze the data, mixed design ANOVA was run in SPSS version 21. Results: The findings revealed that the mean difference between pre-test and post-test in the experimental group was significant for the variables of HbA1c, quality of life, and self-care while the mean difference between the post-test and follow-up was not significant for HbA1c (P = 0.17) and quality of life (P = 0.27), indicating the stability of the therapeutic effect after six months of the intervention. Based on the present findings, acceptance-based emotion regulation group therapy led to a decrease in HbA1c and an increase in self-care and quality of life in patients with type 2 diabetes. Conclusions: Our results showed that acceptance-based emotion regulation group therapy improved self-care, quality of life, and HbA1c in type 2 diabetic patients, so it can be used as a complementary intervention along with medical treatments.


Author(s):  
Vanessa B. Puetz ◽  
Essi Viding ◽  
Ferdinand Hoffmann ◽  
Mattia I. Gerin ◽  
Molly Sharp ◽  
...  

Abstract Objectives Childhood maltreatment is associated with altered neural reactivity during autobiographical memory (ABM) recall and a pattern of overgeneral memory (OGM). Altered ABM and OGM have been linked with psychopathology and poorer social functioning. The present study investigated the association between altered ABM and subsequent socio-emotional functioning (measured two years later) in a sample of adolescents with (N = 20; maltreatment group, MT) and without (N = 17; non-MT group) documented childhood maltreatment histories. Method At baseline, adolescents (aged 12.6 ± 1.45 years) were administered the Autobiographical Memory Test to measure OGM. Participants also recalled specific ABMs in response to emotionally valenced cue words during functional MRI. Adolescents in both groups underwent assessments measuring depressive symptoms and prosocial behavior at both timepoints. Regression analyses were carried out to predict outcome measures at follow-up controlling for baseline levels. Results In the MT group, greater OGM at baseline significantly predicted reduced prosocial behavior at follow-up and showed a trend level association with elevated depressive symptoms. Patterns of altered ABM-related brain activity did not significantly predict future psycho-social functioning. Conclusions The current findings highlight the potential value of OGM as a cognitive mechanism that could be targeted to reduce risk of depression in adolescents with prior histories of maltreatment.


2019 ◽  
Vol 48 (3) ◽  
pp. 376-381
Author(s):  
Stine Bjerrum Moeller ◽  
Stephen F. Austin ◽  
Morten Hvenegaard ◽  
Morten Kistrup ◽  
Stine Gran ◽  
...  

AbstractBackground:One-third of patients with depression do not respond satisfactorily to treatment, and approximately 20% of all patients treated for depression develop a chronic depression. One approach to more effective treatment of chronic and treatment-resistant depression is to target rumination – an underlying mechanism implicated in the development and maintenance of depression.Aim:The purpose of this uncontrolled group study was to investigate the feasibility of individual rumination-focused cognitive behavioural therapy (RfCBT) for patients with chronic and treatment-resistant depression.Method:A total of 10 patients with chronic and treatment-resistant depression were offered 12–16 individual sessions of RfCBT. The primary outcome was depressive symptoms as measured by Hamilton Depression Scale at pre-, post- and 3-month follow-up. Secondary symptoms measured included self-reported rumination and worry.Results:There was a significant reduction in depressive symptoms (p < 0.05), rumination (p < 0.01) and worry (p < 0.5) from pre- to post-treatment. Half of the participants (n = 5) showed significant reliable change on levels of depressive symptoms post-treatment. The reduction in depressive symptoms, rumination and worry were maintained at follow-up.Conclusions:RfCBT was associated with significant reductions in depressive symptoms in a small sample with chronic and treatment-resistant depression. Despite limitations of being a small uncontrolled study with limited follow-up, these results are promising in a difficult to treat population. RfCBT warrants further systematic evaluation.


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