TOPLINE:

In a German crossover trial of patients with major depressive disorder (MDD), an eight-session mindfulness-based emotion regulation training (MBERT) led to a greater decrease in daily stress and rumination than treatment as usual (TAU).

METHODOLOGY:

• Researchers conducted a randomised, crossover, active waitlist-controlled trial at the University Hospital of Tübingen and included 40 adults diagnosed with MDD (4925 complete data entries).
• Participants either received an eight-session MBERT, with each session lasting approximately 60-90 minutes and teaching a four-step strategy of focused attention, benevolent acceptance, cognitive reappraisal, and mindful distancing, or continued with TAU over two successive 4- to 5-week phases, then crossed over to the alternate condition.
• Primary outcomes were mean within-person changes in daily stress levels and rumination, each assessed two times a day using the Ecological Momentary Assessment (EMA): stress over the last 5 hours rated on a 0%-100% scale and rumination rated using six adapted items (three modified items of the Ruminative Response Scale and three modified items of the Perseverative Cognitions Questionnaire).
• Secondary outcomes included self-efficacy, self-kindness, mindful distancing, and sleep quality, all measured using the EMA.

TAKEAWAY:

• MBERT vs TAU led to significant improvements in rumination (P = .003), self-efficacy (P = .001), self-kindness (P < .001), and mindful distancing (P < .001).
• Sleep quality increased more during MBERT than during TAU, whereas the frequency of reported stress-evoking events declined over the study.
• Self-efficacy, self-kindness, and mindful distancing mutually reinforced each other and predicted lower levels of next-assessment stress more strongly during MBERT (interaction P < .05).

IN PRACTICE:

"We demonstrated that the effectiveness of MBERT could not only be seen in pre-post comparisons but also continuously in patients' daily lives. In doing so, the temporal changes in self-efficacy, self-kindness, and mindful distancing appear to go hand in hand, reducing the perception of stress later on, which provides valuable evidence for further considering these variables as a motor of change in psychotherapy and paving the way to an enhanced psychotherapy. Furthermore, this is additionally supported by increased resilience against stress-eliciting triggers throughout psychotherapy, leading to less ruminative behavior and stress even when stressful life events may occur," the authors wrote.

SOURCE:

This study was led by Hendrik Laicher, Department of Psychiatry and Psychotherapy, University Hospital of Tübingen, Tübingen, Germany. It was published online on August 30 in Scientific Reports.

LIMITATIONS:

This study was limited by its exploratory nature. The small sample size and time-lagged segment analysis methodology may not have fully captured the temporal dynamics of change. Additional limitations included the influence of concurrent treatments. Although the randomised groups showed no significant differences in additional treatments, various factors such as therapeutic alliance and individual patient parameters complicated the analysis of psychotherapy mechanisms.

DISCLOSURES:

This study was funded by the fortune funding program at the University of Tübingen. The authors reported having no relevant conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.