Mindfulness-Based Cognitive Therapy for the Prevention of Perinatal Depression: The Roles of Participant At-home Practice and Therapist Adherence in Participant Outcomes Open Access

Brown, Amanda Pema (2015)

Permanent URL: https://etd.library.emory.edu/concern/etds/q237hs09z?locale=en


Mindfulness Based Cognitive Therapy (MBCT) has garnered empirical support as an effective preventive intervention for depressive relapse, but the mechanisms of change are unclear. In the context of the open trial phase of a study designed to develop and provide preliminary data for the effectiveness of MBCT for Perinatal Depression (MBCT-PD), we examined the extent to which participant at-home practice and therapist adherence were associated with decreased or stable depression and anxiety symptoms, decreased levels of experiential avoidance, and increased levels of self-reported mindfulness. In a sample of 41 perinatal women, quantity of at-home practice was significantly associated with decreased depression symptoms and increased mindfulness scores at post-intervention, but was not significantly associated with post-intervention anxiety symptoms or experiential avoidance. Quantity of both formal and informal mindfulness practice was significantly related to post-intervention mindfulness scores. Engagement only in formal mindfulness practice was significantly related to post-intervention depressive symptoms. In terms of therapist adherence, adherence targeted toward participant practice was associated with participants' at-home practice behavior, suggesting that therapist emphasis on at-home practice may be important in increasing quantity of participant practice. The sole significant predictor of at-home practice that we identified was number of prior depressive episodes, such that women with two or more major depressive episodes (MDEs) practiced significantly more than women with only one MDE. Findings highlight the value of participant engagement with at-home practices in the maintenance of wellness following MBCT, as well as which participant characteristics may predict better compliance with at-home practice.

Table of Contents

I. Introduction. 1

II. Method. 17

III. Results. 28

IV. Discussion. 41

V. Conclusion. 53

VI. References. 54

VII. Appendix. 62

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