Factors Associated with Attrition from Mindfulness-Based Cognitive Therapy in Patients with a History of Suicidal Depression
Open accessAbstract
We report data from a randomised controlled trial of mindfulness-based cognitive therapy to pilot procedures for people with a history of suicidal ideation or behaviour, focusing in particular on the variables that distinguish those who complete an adequate 'dose' of treatment, from those who drop out. Sixty-eight participants were randomised to either immediate treatment with mindfulness-based cognitive therapy (MBCT) (n = 33) or to the waitlist (n = 36) arm of the trial. In addition to collecting demographic and clinical information, we assessed participants' cognitive reactivity using the means end problem-solving task, completed before and after a mood induction procedure. Ten participants dropped out of treatment, and eight dropped out of the waitlist condition. Those who dropped out of MBCT were significantly younger than those who completed treatment, less likely to be on antidepressants, had higher levels of depressive rumination and brooding and showed significantly greater levels of problem-solving deterioration following mood challenge. None of these factors distinguished participants in the waiting list condition who remained in the study from those who dropped out. Our results suggest that individuals with high levels of cognitive reactivity, brooding and depressive rumination may find it particularly difficult to engage with MBCT, although paradoxically they are likely to have the most to gain from the development of mindfulness skills if they remain in class. Addressing how such patients can be best prepared for treatment and supported to remain in treatment when difficulties arise is an important challenge.
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A study by Crane and Williams on MBCT attrition in a community population found that those who dropped out were significantly younger, less likely to be on antidepressants, had higher levels of depressive rumination and brooding, and showed greater problem-solving deterioration following mood challenge.
“A study by Crane and Williams70 on MBCT attrition in a community population found that those who dropped out of MBCT were significantly younger than those who completed treatment, less likely to be on antidepressants, had higher levels of depressive rumination and brooding, and showed significantly greater levels of problem-solving deterioration following mood challenge.”
From Treatment Engagement and Outcomes of Mindfulness-Based Cognitive Therapy for Veterans with Psychiatric Disorders (2019) · cites this paper as [70]
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- Authors
- Crane, C., & Williams, J. M. G.
- Affiliations
- Warneford Hospital (GB)
- Corresponding author
- Crane, Catherine
- Venue
- Mindfulness
- Published
- 2010-03
- Volume
- 1
- Issue
- 1
- Pages
- 10-20
- ISSN
- 1868-8527 (ISSN-L)
- 1868-8535
- PMC
- PMC2987524
- OpenAlex
- W2155494147
- Cited by
- 123
- References
- 37
- Citations by year
- 2026: 9 · 2025: 10 · 2024: 9 · 2023: 6 · 2022: 11 · 2021: 8 · 2020: 9 · 2019: 7 · 2018: 10 · 2017: 10 · 2016: 11 · 2015: 5 · 2014: 6 · 2013: 3 · 2012: 6
- FWCI
- 4.21
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- cc-by-nc
- Locations
- Mindfulness (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Keywords
- mindfulness-based cognitive therapy, treatment discontinuation, suicidal depression, suicidal ideation, cognitive reactivity, brooding, depressive rumination, mood induction, predictors of treatment dropout, antidepressant use, treatment engagement
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