Decreased Symptoms of Depression After Mindfulness-Based Stress Reduction: Potential Moderating Effects of Religiosity, Spirituality, Trait Mindfulness, Sex, and Age
Publication: The Journal of Alternative and Complementary Medicine
Volume 21, Issue Number 3
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.
Get full access to this article
View all available purchase options and get full access to this article.
References
1.
World Health Organization. Fact Sheet No. 369 [homepage on Internet]. October 2012. Online document at: http://www.who.int/mediacentre/factsheets/fs369/en/ Accessed December 20, 2014.
2.
World Health Organization. The global burden of disease. 2004 update. Geneva, Switzerland: World Health Organization, 2008.
3.
Kessler RC, Zhao S, Blazer DG, Swartz M. Prevalence, correlates, and course of minor depression and major depression in the National Comorbidity Survey. J Affect Disord 1997;45:19–30.
4.
Judd LL, Schettler PJ, Akiskal HS. The prevalence, clinical relevance, and public health significance of subthreshold depressions. Psychiatr Clin North Am 2002;25:685–698.
5.
Greeson J, Garland EL, Black D. Mindfulness: a transtherapeutic approach for transdiagnostic mental processes. In: The Wiley Blackwell Handbook of Mindfulness. Ie A, Ngnoumen CT, Langer EJ, eds. Vol. 2. West Sussex, UK: John Wiley & Sons, 2014:531–562.
6.
Kabat-Zinn J. Full Catastrophe Living: Using the Wisdom of Your Body and Mind to Face Stress, Pain, and Illness. New York: Bantam, 2013.
7.
Kabat‐Zinn J. Mindfulness‐based interventions in context: past, present, and future. Clin Psychol 2003;10:144–156.
8.
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;78:169–183.
9.
Khoury B, Lecomte T, Fortin G, et al. Mindfulness-based therapy: a comprehensive meta-analysis. Clin Psychol Rev 2013;33:763–771.
10.
Goyal M, Singh S, Sibinga EM, et al. Meditation programs for psychological stress and well-being: a systematic review and meta-analysis. JAMA Intern Med 2014;174:357–368.
11.
Chiesa A, Anselmi R, Serretti A. Psychological mechanisms of mindfulness-based interventions: what do we know? Holist Nurs Pract 2014;28:124–148.
12.
Shapiro SL, Carlson LE. The Art and Science of Mindfulness: Integrating Mindfulness into Psychology and the Helping Professions. Washington, DC: American Psychological Association, 2009.
13.
Kristeller JL. Mindfulness meditation. In: Principles and Practices of Stress Management. 3rd ed. Lehrer PM, Woolfolk RL, Sime WE, eds. New York: Guilford Press, 2007:393–427.
14.
Santorelli S. Heal Thyself: Lessons on Mindfulness in Medicine. New York: Random House, 2000.
15.
Koenig HG. Spirituality and Health Research: Methods, Measurements, Statistics, and Resources. West Conshohocken, PA: Templeton Press, 2011.
16.
Greeson JM, Webber DM, Smoski MJ, et al. Changes in spirituality partly explain health-related quality of life outcomes after Mindfulness-Based Stress Reduction. J Behav Med 2011;34:508–518.
17.
Kessler RC, Berglund P, Demler O, et al. Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry 2005;62:593–602.
18.
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;67:267–277.
19.
Carmody J, Reed G, Kristeller J, Merriam P. Mindfulness, spirituality, and health-related symptoms. J Psychosom Res 2008;64:393–403.
20.
Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scandinav 1983;67:361–370.
21.
Bjelland I, Dahl AA, Haug TT, Neckelmann D. The validity of the Hospital Anxiety and Depression Scale: an updated literature review. J Psychosom Res 2002;52:69–77.
22.
Underwood LG, Teresi JA. The daily spiritual experience scale: development, theoretical description, reliability, exploratory factor analysis, and preliminary construct validity using health-related data. Ann Behav Med 2002;24:22–33.
23.
Underwood LG. Ordinary spiritual experience: qualitative research, interpretive guidelines, and population distribution for the Daily Spiritual Experience Scale. Arch Psychol Relig 2006;28:181–218.
24.
Underwood LG. The daily spiritual experience scale: overview and results. Religions 2011;2:29–50.
25.
Feldman G, Hayes A, Kumar S, et al. Mindfulness and emotion regulation: the development and initial validation of the Cognitive and Affective Mindfulness Scale-Revised (CAMS-R). J Psychopathol Behav Assess 2007;29:177–190.
26.
Enders CK. Applied Missing Data Analysis. New York: Guilford Press, 2010.
27.
Cohen J, Cohen P, West SG, Aiken LS. Applied Multiple Regression/Correlation Analysis for the Behavioral Sciences. 3rd ed. Mahwah, NJ: Lawrence Erlbaum Associates, 2003.
28.
Rosenthal R, Rosnow RL. Essentials of Behavioral Research: Methods and Data Analysis. Vol. 2. New York: McGraw-Hill, 1991.
29.
Cohen J. Statistical Power Analysis for the Behavioral Sciences. 2nd ed. Hillsdale, NJ: Lawrence Erlbaum Associates, 1988.
30.
Kabat-Zinn J. An outpatient program in behavioral medicine for chronic pain patients based on the practice of mindfulness meditation: theoretical considerations and preliminary results. Gen Hosp Psychiatry 1982;4:33–47.
31.
Reibel DK, Greeson JM, Brainard GC, Rosenzweig S. Mindfulness-based stress reduction and health-related quality of life in a heterogeneous patient population. Gen Hosp Psychiatry 2001;23:183–192.
32.
Williams KA, Kolar MM, Reger BE, Pearson JC. Evaluation of a wellness-based mindfulness stress reduction intervention: a controlled trial. Am J Health Promot 2001;15:422–432.
33.
Carmody J, Baer RA. Relationships between mindfulness practice and levels of mindfulness, medical and psychological symptoms and well-being in a mindfulness-based stress reduction program. J Behav Med 2008;31:23–33.
34.
Cordon SL, Brown KW, Gibson PR. The role of mindfulness-based stress reduction on perceived stress: preliminary evidence for the moderating role of attachment style. J Cogn Psychother 2009;23:258–269.
35.
Arch JJ, Ayers CR. Which treatment worked better for whom? Moderators of group cognitive behavioral therapy versus adapted mindfulness based stress reduction for anxiety disorders. Behav Res Ther 2013;51:434–442.
36.
Walsh R, Shapiro SL. The meeting of meditative disciplines and Western psychology: a mutually enriching dialogue. Am Psychologist 2006;61:227–239.
37.
Shapiro SL, Schwartz GE, Santerre C. Meditation and positive psychology. In: Handbook of Positive Psychology. Snyder CR, Lopez SJ, eds. New York: Oxford University Press, 2002:632–645.
38.
Deyo M, Wilson KA, Ong J, Koopman C. Mindfulness and rumination: does mindfulness training lead to reductions in the ruminative thinking associated with depression? EXPLORE: J Sci Healing 2009;5:265–271.
39.
Ramel W, Goldin PR, Carmona PE, McQuaid JR. The effects of mindfulness meditation on cognitive processes and affect in patients with past depression. Cogn Ther Res 2004;28:433–455.
40.
Hawley LL, Schwartz D, Bieling PJ, et al. Mindfulness practice, rumination and clinical outcome in mindfulness-based treatment. Cogn Ther Res 2014;38:1–9.
41.
Segal ZV, Williams JMG, Teasdale JD. Mindfulness-Based Cognitive Therapy for Depression. New York: Guilford Press, 2012.
42.
Myers DG. The funds, friends, and faith of happy people. Am Psychologist 2000;55:56–67.
43.
Astin JA. Stress reduction through mindfulness meditation. Psychother Psychosom 1997;66:97–106.
44.
Nyklíček 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;35:331–340.
45.
Shapiro SL, Schwartz GE, Bonner G. Effects of mindfulness-based stress reduction on medical and premedical students. J Behav Med 1998;21:581–599.
46.
Grossman P. Defining mindfulness by how poorly I think I pay attention during everyday awareness and other intractable problems for psychology's (re)invention of mindfulness: comment on Brown et al. (2011). Psychol Assess 2011;23:1034–1040.
Information & Authors
Information
Published In
The Journal of Alternative and Complementary Medicine
Volume 21 • Issue Number 3 • March 2015
Pages: 166 - 174
PubMed: 25695903
Copyright
Copyright 2015, Mary Ann Liebert, Inc.
History
Published online: 11 March 2015
Published in print: March 2015
Published ahead of print: 19 February 2015
Topics
Authors
Author Disclosure Statement
Dr. Wolever has an investment in and is the chief scientific advisor for eMindful, a company that provides live online mindfulness classes. No competing financial interests exist for the other authors.
Metrics & Citations
Metrics
Citations
Export Citation
Export citation
Select the format you want to export the citations of this publication.
View Options
Access content
To read the fulltext, please use one of the options below to sign in or purchase access.⚠ Society Access
If you are a member of a society that has access to this content please log in via your society website and then return to this publication.