Central Institute of Mental Health Mannheim, Heidelberg University.
Central Institute of Mental Health Mannheim, Heidelberg University.
Behav Ther. 2023 Sep;54(5):902-915. doi: 10.1016/j.beth.2023.04.002. Epub 2023 May 8.
Rumination has been proposed as an important risk factor for depression, whereas mindful attention is considered a protective form of self-focusing. Experimental studies have demonstrated differential effects of these modes when induced in the lab. However, their impact on daily life processes is poorly understood, particularly in individuals vulnerable to depressive relapses. The aim of our study was to examine short- and longer-term effects of repeated brief rumination and mindful self-focus inductions during daily life on momentary mood, cognitions, and cortisol in patients with remitted depression (rMDD) as well as in healthy individuals, and to identify their potential differential effects in these groups. The study involved repeated short ambulatory inductions of a ruminative or a mindful self-focus during daily life with additional assessments of momentary mood, rumination, self-acceptance, and cortisol over 4 consecutive days in a sample of patients with rMDD (n = 32, ≥2 lifetime episodes, age 19-55 years) and matched healthy controls (n = 32, age 21-54 years). Multilevel models revealed differential immediate effects of the two induction modes on all momentary mood and cognitive outcomes (all p's < .001), but not on cortisol. Detrimental effects of rumination over mindful self-focus inductions were particularly strong for cognitions in the patient group. Longer-term effects of the inductions over the day were lacking. This study underlines immediate deteriorating effects of an induced ruminative compared to a mindful self-focus on momentary mood and cognitions during daily life in patients with rMDD and in healthy individuals. The observed stronger rumination-related reactivity in patients suggests heightened cognitive vulnerability. Understanding rumination- and mindfulness-based mechanisms of action in real-life settings can help to establish mechanism-based treatment options for relapse prevention in depression.
反刍被认为是抑郁的一个重要风险因素，而正念注意被认为是一种自我关注的保护形式。实验研究已经证明了在实验室中诱导这些模式时会产生不同的效果。然而，它们对日常生活过程的影响知之甚少，特别是在易发生抑郁复发的个体中。我们的研究目的是检验在日常生活中反复进行短暂的反刍和正念自我关注诱导对缓解期抑郁症（rMDD）患者和健康个体的即时情绪、认知和皮质醇的短期和长期影响，并确定它们在这些群体中的潜在差异影响。该研究涉及在日常生活中反复进行短暂的反刍或正念自我关注诱导，并在 4 天内对 rMDD 患者（n=32，有≥2 次发作史，年龄 19-55 岁）和匹配的健康对照组（n=32，年龄 21-54 岁）的即时情绪、反刍、自我接纳和皮质醇进行额外评估。多层次模型显示，两种诱导模式对所有即时情绪和认知结果的即时影响存在差异（所有 p 值均<.001），但对皮质醇无影响。在患者组中，反刍对认知的影响比正念自我关注的影响更为不利。在一天中，诱导的长期影响是缺乏的。这项研究强调了在 rMDD 患者和健康个体的日常生活中，与正念自我关注相比，诱导的反刍会立即对即时情绪和认知产生恶化影响。观察到的患者中与反刍相关的反应性更强，表明认知脆弱性更高。了解现实生活中基于反刍和正念的作用机制有助于为预防抑郁症复发建立基于机制的治疗选择。
