Who experiences depressive symptoms following mindfulness-based stress reduction and why?

Patricia Lynn Dobkin, Qinyi Zhao, Kaveh Monshat


Background: A small percentage of patients screen positive for depression following a mindfulness-based program. We identified patient characteristics associated with this outcome in order to understand this phenomenon.

Methods: Depressive symptoms, stress, mindfulness, coping with illness and sense of coherence were measured in 126 patients with various medical and psychological conditions pre- and post- Mindfulness-Based Stress Reduction (MBSR). 

Results: Fewer patients (27% vs. 49%) screened positive for depression post-MBSR. Both pre- and post-MBSR patients who were depressive following MBSR scored lower on meaningfulness, comprehensibility, and manageability (sense of coherence), higher on emotional coping and lower on palliative and distraction coping. Smaller positive changes (e.g. stress) occurred in these patients as well. Viewing life as less meaningful pre-MBSR predicted more symptoms of depression post-MBSR.

Conclusions: Patients who suffered depressive symptoms following the program were unable to reappraise their lives in such a way as to become stress resilient. 


MBSR, depression, mindfulness, MBCT

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Chiesa A, Serretti A. Mindfulness-based stress reduction for stress management in healthy people: a review and meta-analysis. J Altern Complement Med. 2009;15:593-600.

Chiesa A, Serretti A. Mindfulness based cognitive therapy for psychiatric disorders: a systematic review and meta-analysis. Psychiatry Res. 2011;187:441-453.

Chiesa A, Serretti A: Mindfulness-based interventions for chronic pain: A systematic review of the evidence. J Altern Complement Med. 2011;17:83-93.

Didonna F (Ed.). Clinical Handbook of Mindfulness. New York, NY: Springer; 2009.

Germer CK, Siegel RD, Fulton PR (Eds.). Mindfulness and Psychotherapy. New York, NY: The Guilford Press; 2005.

McCown D, Reibel D, Micozzi MS: Teaching Mindfulness: A Practical Guide for Clinicians and Educators, third edition. New York, NY: Springer; 2010.

National Collaborating Centre for Mental Health: Nice clinical guideline 90. Depression: The treatment and management of depression in adults. London, UK: National Institute for Health and Clinical Excellence; 2009.

Bohlmeijer E, Prenger R, Taal E, Cuijpers P. The effects of mindfulness-based stress reduction therapy on mental health of adults with a chronic medical disease: a meta-analysis. J Psychosom Res. 2010;68:539-44.

Grossman P, Niemann L, Schmidt S, Walach H. Mindfulness-based stress reduction and health benefits. A meta-analysis. J Psychosom Res. 2004;57:35-43.

Marchand WR. Mindfulness-based stress reduction, mindfulness-based cognitive therapy, and Zen meditation for depression, anxiety, pain, and psychological distress. J Psychiatr Pract. 2012;18:233-52.

Merkes M. Mindfulness-based stress reduction for people with chronic diseases. Aust J Prim Health. 2010;16:200-10.

Piet J, Wurtzen H, Zachariae R. The effect of mindfulness-based therapy on symptoms of anxiety and depression in adult cancer patients and survivors: a systematic review and meta-analysis. J Consult Clin Psychol. 2012;80:1007-20.

Toneatto T, Nguyen L: Does mindfulness meditation improve anxiety and mood symptoms? A review of the controlled research. Can J Psychiatry. 2007;52:260-66.

Hofmann SG, Sawyer AT, Witt AA, Oh D: The effect of mindfulness-based therapy on anxiety and depression: A meta-analytic review. J Consult Clin Psychol. 2010;78:169-83.

Dobkin PL, Irving JA, Amar S. For whom may participation in a Mindfulness-Based Stress Reduction program be contraindicated? Mindfulness. 2011;1-7.

Zhao Q, Bernardi N, Dobkin PL. Promoting Resilience with The Mindfulness-Based Stress Reduction Program in Patients with Chronic Illness. Presented at the First International Congress on Whole Person Care. October 19, 2013. Montreal, Quebec, Canada.

Kabat-Zinn J. Full Catastrophe Living: Using the wisdom of your body and mind to face stress, pain, and illness. New York: Delacorte Press; 1990.

Radloff LS. The CES-D scale: A self-report depression scale for research in the general population. App Psychol Measure. 1977;7:189-98.

Cohen S, Kamarock T, Mermelstein R. A global measure of perceived stress. J Health Soc Behav. 1983;24:385-95.

Cohen S, Williamson GM: Perceived Stress in a Probability Sample of the United States; in Spacapan S, Oskamp S (eds). The Social Psychology of Health. Newbury Park, CA, USA: Sage; 1988. p. 31-67.

Endler NS, Parker JDA. Coping with Health, Injuries and Problems (CHIP). Manual. Toronto, Canada: Multi-health Systems; 2000.

Antonovsky A. Unraveling The Mystery of Health - How People Manage Stress and Stay Well. San Fransisco, USA: Jossey-Bass Publishers; 1987.

Eriksson M, Lindstrom B. Validity of Antonovsky's sense of coherence scale: a systematic review. J Epidemiol Community Health. 2005;59:460-6.

Brown KW, Ryan RM. The benefits of being present: mindfulness and its role in psychological well-being. J Pers Soc Psychol. 2003;84:822-48.

Hölzel BK, Lazar SW, Gard T, Schuman-Olivier Z, Vago DR, Ott U. How does mindfulness meditation work? Proposing mechanisms of action from a conceptual and neural perspective. Perspect Psychol Science. 2011;6:537-59.

Nyklicek I, Kuijpers KF. Effects of mindfulness-based stress reduction intervention on psychological well-being and quality of life: is increased mindfulness indeed the mechanism? Ann Behav Med. 2008;35:331-40.

Shapiro SL, Carlson LE, Astin JA, Freedman B. Mechanisms of mindfulness. J Clin Psychol. 2006;62:373-86.

Shapiro SL, Brown KW, Thoresen C, Plante TG. The moderation of mindfulness-based stress reduction effects by trait mindfulness: results from a randomized controlled trial. J Clin Psychol. 2011;67:267-77.

Garland EL, Gaylord SA, Fredrickson BL. Positive Reappraisal Mediates the Stress-Reductive Effects of Mindfulness: An Upward Spiral Process. Mindfulness. 2011;2:59-67.

Kerr CE, Josyula K, Littenberg R. Developing an observing attitude: an analysis of meditation diaries in an MBSR clinical trial. Clin Psychol Psychother. 2011;18:80-93.

Dobkin PL. Mindfulness-based stress reduction: what processes are at work? Complement Ther Clin Pract. 2008;14:8-16.

Williams JM. Mindfulness and psychological process. Emotion. 2010;10:1-7.

Campbell TS, Labelle LE, Bacon SL, Faris P, Carlson LE. Impact of Mindfulness-Based Stress Reduction (MBSR) on attention, rumination and resting blood pressure in women with cancer: a waitlist-controlled study. J Behav Med. 2012;35:262-71.

Michalak J, Holz A, Teismann T. Rumination as a predictor of relapse in mindfulness-based cognitive therapy for depression. Psychol Psychother. 2011 Jun;84(2):230-6.

Jain S, Shapiro SL, Swanick S, Roesch SC, Mills PJ, Bell I, Schwartz GE. A randomized controlled trial of mindfulness meditation versus relaxation training: effects on distress, positive states of mind, rumination, and distraction. Ann Behav Med. 2007;33:11-21.

Irving JA, Williams G, Chen A, Park J, Dobkin PL. Mindfulness-Based Medical Practice (MBMP). A mixed-methods study exploring benefits for physicians enrolled in an 8-week adapted MBSR program. Presented at the AMA-CMA-BMA International Conference on Physician Health (ICPH). Montreal, Quebec, Canada; 2012.

Hollis-Walker L, Colosimo K. Mindfulness, self-compassion, and happiness in non-mediators: A theoretical and empirical examination. Personality and Individual Differences.2011;50:222-7.

Finucane A, Mercer SW. An exploratory mixed methods study of the acceptability and effectiveness of Mindfulness-Based Cognitive Therapy for patients with active depression and anxiety in primary care. BMC Psych. 2006;6:14.

Teasdale JD, Segal ZV, Williams JM, Ridgeway VA, Soulsby JM, Lau MA. Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy. J Consult Clin Psychol. 2000;68:615-23.

Ma SH, Teasdale JD. Mindfulness-based cognitive therapy for depression: replication and exploration of differential relapse prevention effects. J Consult Clin Psychol. 2004;72:31-40.

Geschwind N, Peeters F, Huibers M, van OJ, Wichers M. Efficacy of mindfulness-based cognitive therapy in relation to prior history of depression: randomised controlled trial. Br J Psych. 2012;201:320-5.

Eisendrath S, Chartier M, McLane M. Adapting Mindfulness-Based Cognitive Therapy for Treatment-Resistant Depression: A Clinical Case Study. Cogn Behav Pract. 2011;18:362-70.


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