Mindfulness-Based Cognitive Therapy Improves Emotional Reactivity to Social Stress: Results from a Randomized Controlled Trial

May combine two claims.

Waitlist controls had greater anticipatory anxiety before the stressor, whereas the MBCT group did not.

“Waitlist controls showed an increase in anticipatory (pre-stressor) anxiety, which was absent in the MBCT group.”

May combine two claims.

Average anxiety rates, collapsing across time in relation to task, decreased in the MBCT group but did not decrease in the control group.

“Simple effects analyses showed that whereas average anxiety rates (collapsing across time in relation to task) decreased in the MBCT group, they did not decrease in the control group”

• AssumptionRests on an assumption: The Spielberger State-Trait Anxiety Inventory Form Y has good psychometric properties, including strong internal consistency, adequate test-retest reliability, and convergent validity.

May combine two claims.

The MBCT group showed an attenuation of negative affect/anxiety at all post-stressor time points compared to pre-treatment baseline, while post-speech anxiety levels did not change from pre-treatment among control participants.

“The MBCT group showed an attenuation of negative affect/anxiety at all post-stressor time points compared to pre-treatment baseline, while post-speech anxiety levels did not change from pre-treatment among participants in the control group.”

• AssumptionRests on an assumption: The Spielberger State-Trait Anxiety Inventory Form Y has good psychometric properties, including strong internal consistency, adequate test-retest reliability, and convergent validity.

May combine two claims.

In the MBCT group, there was no difference between pre-speech anxiety and anxiety during the speech, but significant decreases in anxiety rates were recorded at each of the other three post-speech measurement points.

“In contrast, in the MBCT group, no difference was found in pre-speech anxiety and anxiety during the speech, but significant decreases in anxiety rates were recorded at each of the other three post-speech measurement points.”

• AssumptionRests on an assumption: The Spielberger State-Trait Anxiety Inventory Form Y has good psychometric properties, including strong internal consistency, adequate test-retest reliability, and convergent validity.

May combine two claims.

In the control group, there was a significant increase in pre-speech anxiety, followed by non-significant differences at each other measurement point.

“In the control group, a significant increase in pre-speech anxiety was found, followed by non-significant differences at each other measurement points.”

• AssumptionRests on an assumption: The Spielberger State-Trait Anxiety Inventory Form Y has good psychometric properties, including strong internal consistency, adequate test-retest reliability, and convergent validity.

May combine two claims.

The MBCT group experienced similar levels of pre-task anxiety before and after treatment, i.e., they did not experience the stress sensitization that control participants experienced.

“The MBCT group experienced similar levels of pre-task anxiety before and after treatment. i.e., they did not experience stress sensitization that the control participants experienced.”

• AssumptionRests on an assumption: The Spielberger State-Trait Anxiety Inventory Form Y has good psychometric properties, including strong internal consistency, adequate test-retest reliability, and convergent validity.

May combine two claims.

Overall anxiety levels, collapsed across all TSST time points, decreased significantly for the MBCT group but not controls, when compared to pre-treatment levels.

“Overall anxiety levels (collapsed across all TSST time points) decreased significantly for the MBCT group, but not controls, when compared to pre-treatment levels.”

• AssumptionRests on an assumption: The Spielberger State-Trait Anxiety Inventory Form Y has good psychometric properties, including strong internal consistency, adequate test-retest reliability, and convergent validity.

May combine two claims.

When change in anxiety was taken into account, the direct effect of treatment on depression (c' path) decreased relative to the overall effect (c path) but remained significant (β = −.31, p < .05).

“When change in anxiety was taken into account, the direct effect of treatment on depression (c’ path) decreased in relation to the overall effect (c path), although it stayed significant (β = −.31, p < .05).”

• AssumptionRests on an assumption: The Spielberger State-Trait Anxiety Inventory Form Y has good psychometric properties, including strong internal consistency, adequate test-retest reliability, and convergent validity.

May combine two claims.

Before treatment, anxiety levels in all participants remained elevated following the speech and did not return to pre-speech baseline levels until 40 minutes after the speech had concluded.

“Before treatment, anxiety levels in all participants remained elevated following the speech, and did not return to pre-speech baseline levels until 40 minutes after the speech had concluded.”

• AssumptionRests on an assumption: The Spielberger State-Trait Anxiety Inventory Form Y has good psychometric properties, including strong internal consistency, adequate test-retest reliability, and convergent validity.

May combine two claims.

Although MBCT was associated with an overall decrease in stress-related anxiety, these changes were specific to pre- and post-stressor anxiety and not anxiety during the stressor.

“Although MBCT was associated with an overall decrease in stress-related anxiety, these changes were specific to pre- and post -stressor anxiety and not anxiety during the stressor.”

• AssumptionRests on an assumption: The Spielberger State-Trait Anxiety Inventory Form Y has good psychometric properties, including strong internal consistency, adequate test-retest reliability, and convergent validity.

Probably not a substantial claim: may not pass S3 (load-bearing).

Biological and cognitive models propose that vulnerability processes strengthen and become more autonomous with each episode, so less external stress is needed to trigger a later episode.

“Both biological (Post, 1992) and cognitive (Segal, Williams, & Teasdale, 2002) models hypothesize that individual (intra-personal) vulnerability risk processes are strengthened, and becomes more “autonomous” with each episode, such that lower levels of external provocation (stress) are needed to trigger a subsequent episode.”

• cites Post, 1992 sourceNot checked yet

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• cites Segal, Williams, & Teasdale, 2002Not checked yet

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Probably not a substantial claim: may not pass S4 (based).

Emotional reactivity to stress is a key psychopathological process behind depression's chronic and recurrent course.

“Given that emotional reactivity to stress is an important psychopathological process underlying the chronic and recurrent nature of depression”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

MBSR and MBCT are meditation-based emotion regulation programs that target emotional reactivity to stress across clinical and non-clinical groups.

“Mindfulness-based therapies such as Mindfulness-Based Stress Reduction (MBSR) and Mindfulness-Based Cognitive Therapy (MBCT) are meditation-based emotion regulation training programs that target emotional reactivity to stress in a wide range of clinical and non-clinical populations.”

• cites Segal et al., 2002Not checked yet

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May combine two claims.

About 60% of people with one prior episode have a second, and about 90% of those with three prior episodes have a fourth.

“Approximately 60% of individuals who had experienced one episode will experience a second episode whereas 90% of those who had experienced three episodes will have the fourth one (Judd, 1997; Mueller et al., 1999; Solomon et al., 2000).”

• cites Judd, 1997 sourceNot checked yet

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• cites Mueller et al., 1999 sourceNot checked yet

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• cites Solomon et al., 2000 sourceNot checked yet

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May combine two claims.

Both models converge on progressively longer or stronger negative affect, or emotional reactivity, to stress, which raises risk for a depressive episode.

“The common end result in both models is progressively prolonged or intensified negative affect or “emotional reactivity” in response to stress, that puts individuals at risk for a depressive episode.”

• cites Post, 1992 sourceNot checked yet

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• cites Segal et al., 2002Not checked yet

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Probably not a substantial claim: may not pass S3 (load-bearing).

Most theories propose that a latent progressive vulnerability interacts with negative life events.

“Most theories posit an interaction between a latent but progressive vulnerability (diathesis) and negative life events (stress) (Abramson et al., 1999; Beck, 1987; Hankin, 2008; Hankin & Abramson, 2001).”

• cites Abramson et al., 1999 sourceNot checked yet

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• cites Beck, 1987Not checked yet

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• cites Hankin, 2008 sourceNot checked yet

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Probably not a substantial claim: may not pass S3 (load-bearing).

The trial had a small sample.

“Limitations include small sample size, lack of objective or treatment adherence measures, and non-generalizability to more severely depressed populations.”

May combine two claims.

People who had MBCT showed higher cognitive reactivity than those on antidepressants, but the link between cognitive reactivity and relapse 15 months later was broken in the MBCT group but not the antidepressant group.

“Kuyken et al (2010) found that individuals who had undergone MBCT had higher cognitive reactivity than those who received ADM, but the relationship between cognitive reactivity and relapse 15 months later was decoupled in the MBCT (but not the ADM) condition.”

• cites Kuyken et al (2010) sourceNot checked yet

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Probably not a substantial claim: may not pass S3 (load-bearing).

Patients who recovered with CBT showed less cognitive reactivity to affective challenge than those who recovered with antidepressants.

“Moreover, patients who recovered with cognitive behavior therapy (CBT) showed significantly less cognitive reactivity to affective challenge than those who recovered with ADM.”

• cites Segal (2006) sourceNot checked yet

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May combine two claims.

Depressed patients in MBCT showed more negative thinking activation during dysphoric mood, yet this did not lead to affective worsening.

“In other words, depressed patients undergoing MBCT responded with increased activation in negative thinking while in a dysphoric mood, but this increase in cognitive activation did not result in affective deterioration2.”

• cites Kuyken et al (2010) sourceNot checked yet

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Probably not a substantial claim: may not pass S3 (load-bearing).

MBCT was developed by cognitive researchers specifically for depression relapse prevention.

“MBCT was created by cognitively-oriented researchers specifically for use as depression relapse prevention (Segal et al., 2002).”

• cites Segal et al., 2002Not checked yet

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Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Major depression is recurrent and progressive, with each episode raising the chance of another.

“MDD is recurrent and progressive, with the likelihood of repeated episodes increasing with each subsequent episode.”

• cites Judd, 1997 sourceNot checked yet

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• cites Mueller et al., 1999 sourceNot checked yet

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• cites Solomon et al., 2000 sourceNot checked yet

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Classified as probably not a substantial claim.

Prior theory and research have treated cognitive reactivity as a key change process in MBCT.

“In accordance with this model, previous theoretical accounts and research have focused on cognitive reactivity as an important change process in MBCT.”

Classified as probably not a substantial claim.

The TSST reliably produces moderate psychological distress in laboratory settings.

“The Trier Social Stress Test (TSST) is a procedure that reliably produces moderate psychological distress in laboratory settings (Kirschbaum et al., 1993).”

• cites Kirschbaum et al., 1993 sourceNot checked yet

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Classified as probably not a substantial claim.

The time course of emotional reactions has recently been emphasized as important in depression research.

“Second, the time course of emotional reactions (“affective chronometry”) has been recently highlighted as important in the study of depression (Davidson, 2003; Davidson, Jackson, & Kalin, 2000).”

• cites Davidson, 2003 sourceNot checked yet

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• cites Davidson, Jackson, & Kalin, 2000 sourceNot checked yet

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May combine two claims.

The target sample was people with recurrent unipolar depression in partial or full remission with residual symptoms, because they are at high recurrence risk and MBCT has been effective for more recurrent depression.

“Consistent with Kuyken et al., (2008), the target population was individuals with a recurrent form of unipolar depression in partial or full remission with varying degrees of residual symptoms, because these individuals are considered at high risk for recurrence and because previous studies have shown that MBCT is effective for more recurrent forms of depression (Ma & Teasdale, 2004; Teasdale et a”

• cites Kuyken et al., (2008) sourceNot checked yet

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• cites Ma & Teasdale, 2004 sourceNot checked yet

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• cites Teasdale et al., 2000 sourceNot checked yet

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Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

The University of Arizona IRB approved the protocol, and all participants gave written informed consent.

“The study protocol was approved by the University of Arizona institutional review board, and all participants provided written informed consent for research participation.”

May combine two claims.

Recent studies have used social evaluative threat rather than generic emotional films, scripts, or slides, but none were clinical intervention studies.

“While more recent studies have recognized the importance of using social evaluative threat as the stressor rather than a generic emotional film, scripts or slides, (Creswell et al., 2007; Pace et al., 2009; Weinstein et al., 2009), none were intervention studies with clinical samples.”

• cites Creswell et al., 2007 sourceNot checked yet

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• cites Pace et al., 2009 sourceNot checked yet

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• cites Weinstein et al., 2009 sourceNot checked yet

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Classified as probably not a substantial claim.

Emotional reactivity and regulation can be measured in three temporal windows: before, during, and after the stressor.

“According to Davidson, emotional reactivity and regulation can occur at three distinct temporal windows: before, during and after the stressor.”

• cites Davidson, 2003 sourceNot checked yet

  Not checked in the free run.

Classified as probably not a substantial claim.

The pre- and post-treatment TSST protocols differed only in speech topic and arithmetic starting/subtraction numbers.

“Pre- and post-treatment TSST protocols differed only in the speech topic and the starting and subtraction numbers for the arithmetic task.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Prefrontal cortex activation asymmetry mainly explained eyeblink startle variability after a negative stimulus, not during it.

“For example, Jackson et al. (2003) found that prefrontal cortex activation asymmetry mostly explained variability in eyeblink startle magnitude following a negative stimulus, not during the stimulus.”

• cites Jackson et al. (2003) sourceNot checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S3 (load-bearing).

For a 10% subset of interviews, diagnostic agreement with an independent clinician for MDD exceeded 90%.

“Reliability for a subset of interviews (10%) had over 90% agreement with an independent clinician for the diagnosis of MDD.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Participants and research staff were blind to treatment condition during baseline assessment because baseline occurred before randomization.

“Because baseline assessments were conducted before randomization, participants and research personnel were blind to treatment conditions during this phase of the project.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

There is less variability in emotional reactivity during exposure to a negative stimulus and more variability after it ends.

“For example, he (Davidson, 2003) suggested less variability in emotional reactivity during an exposure to a negative affect-producing stimulus (emotion generation) and more variability in emotional reactivity after exposure to the stimulus is terminated (emotion regulation).”

• cites Davidson, 2003 sourceNot checked yet

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Classified as probably not a substantial claim.

Circadian timing influences stress reactivity.

“Laboratory assessments were scheduled in the late afternoon (around 5 pm) according to subject’s circadian time because circadian timing affects stress reactivity (Dickerson & Kemeny, 2004).”

• cites Dickerson & Kemeny, 2004 sourceNot checked yet

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Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

The Spielberger State-Trait Anxiety Inventory was initially intended to assess anxiety but has more recently been determined to measure a broader type of distress, a higher order factor of negative affect that incorporates both anxiety and depression.

“The STAI was initially intended to assess anxiety, but has been more recently determined to measure a broader type of distress, a “higher order factor of negative affect” that incorporates both anxiety (worry, distressing thoughts) and depression (dysphoric mood and negative self-appraisal (Bieling, Antony, & Swinson, 1998; Caci, Bayle, Dossios, Robert, & Boyer, 2003; Gros, Antony, Simms, & McCabe”

• cites Bieling, Antony, & Swinson, 1998 sourceNot checked yet

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• cites Caci, Bayle, Dossios, Robert, & Boyer, 2003 sourceNot checked yet

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• cites Gros, Antony, Simms, & McCabe, 2007 sourceNot checked yet

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Probably not a substantial claim: may not pass S3 (load-bearing).

People with different affective styles differ in emotional reactivity only after exposure to a negative stimulus.

“Studies from his laboratory confirmed this by showing that people with different affective styles show different patterns of emotional reactivity only following exposure to a negative stimulus.”

• cites Davidson, 2003 sourceNot checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S3 (load-bearing).

No adverse events occurred during the trial.

“No adverse events occurred during the trial.”

May combine two claims.

Only two studies found improved emotional reactivity after a standard 8-week mindfulness intervention in clinical samples, social anxiety and substance abuse, and neither used depressed patients receiving MBCT.

“Only two studies have demonstrated improved emotional reactivity (using personalized scripts) following a standard (8 week) mindfulness interventions in clinical samples (social anxiety and substance abuse) (Brewer et al., 2009; Goldin & Gross, 2010), but neither used a depressed sample undergoing MBCT.”

• cites Brewer et al., 2009 sourceNot checked yet

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• cites Goldin & Gross, 2010 sourceNot checked yet

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Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

The HRSD-24 was used only for screening and had an alpha of .77.

“The HRSD-24 was used for screening purposes only (alpha= .77).”

Probably not a substantial claim: may not pass S3 (load-bearing).

A detailed scripted TSST manual ensured consistent administration across sessions.

“A detailed, scripted manual of the TSST ensured consistent administration across sessions (Payne et al., 2006).”

• cites Payne et al., 2006 sourceNot checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S3 (load-bearing).

The sample size gave 80% power to detect a medium effect size for depression and anxiety symptom change.

“The sample size was calculated to have a power of .8 to detect a medium effect size for changes in depression and anxiety symptoms.”

Classified as probably not a substantial claim.

All laboratory sessions were run by staff blind to treatment allocation or study phase.

“All laboratory sessions were conducted by staff members that were blind to the treatment allocation or phase of the study.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

The first author, who was also the intervention therapist, recorded treatment allocation and was not blind to it.

“Treatment allocation was recorded by the first author, who was also the intervention therapist, and therefore not blind to intervention allocation.”

May combine two claims.

Many studies support a link between mindfulness and lower emotional reactivity to stress, including weaker responses to threats or quicker recovery from transient negative affect.

“A number of studies support the relationship between mindfulness and reduced emotional reactivity to stress, including attenuated emotional responses to threatening situations or faster recovery from transient negative affect”

• cites Arch & Craske, 2006, 2010Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

• cites Brewer et al., 2009 sourceNot checked yet

  Not checked in the free run.

• cites Broderick, 2005 sourceNot checked yet

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Probably not a substantial claim: may not pass S3 (load-bearing).

The five assessment time points were chosen based on the chronometry of psychological and physiological reactivity to the TSST.

“These time points were based on the chronometry of psychological and physiological reactivity to the TSST (Dickerson & Kemeny, 2004; Kirschbaum et al., 1993; Takahashi et al., 2005).”

• cites Dickerson & Kemeny, 2004 sourceNot checked yet

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• cites Kirschbaum et al., 1993 sourceNot checked yet

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• cites Takahashi et al., 2005Not checked yet

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Classified as probably not a substantial claim.

Research staff who collected or scored post-baseline data were blind to treatment condition.

“Research personnel who collected or scored any post-baseline data also were blind to treatment conditions.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

In the current sample, the STAI had internal consistency ranging from .89 to .93 and an intra-class correlation of .93.

“In the current sample, internal consistency ranged from .89 to .93 and the intra-class correlation (ICC=.93) were high.”

• AssumptionRests on an assumption: The Spielberger State-Trait Anxiety Inventory Form Y has good psychometric properties, including strong internal consistency, adequate test-retest reliability, and convergent validity.

Probably not a substantial claim: may not pass S3 (load-bearing).

The Hamilton Rating Scale for Depression is a widely used clinician-administered interview assessment of depressive symptomatology.

“The HRSD is a widely used clinician administered interview assessment of depressive symptomatology (Gelenberg et al., 1990).”

• cites Gelenberg et al., 1990 sourceNot checked yet

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Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

The HRSD and diagnostic interviews were conducted by the first author, who was trained until achieving adequate reliability (> .90) with other raters of the same version.

“The HRSD and diagnostic interviews were conducted by the first author who was trained in administering the HSRD until an adequate level of reliability (> .90) with other raters of the same version was achieved.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Participants were block randomized to MBCT or waitlist in a 3:2 ratio without stratifying on baseline characteristics to speed adequate enrollment.

“Participants were then block randomized to either the MBCT program or waitlist control condition in a 3:2 ratio without reference (stratification) to baseline characteristics to ensure rapid and adequate enrollment in the treatment arm.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Allocation was concealed using opaque, sealed, sequentially numbered envelopes opened after baseline assessments.

“In blocks of 5, opaque, sealed letter-size envelopes with treatment allocation information were shuffled and placed in identical sequentially numbered containers and presented to the patients after successful completion of baseline assessments.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

The Beck Depression Inventory is a widely used measure of depressive symptoms with excellent psychometric properties.

“The BDI is a widely used measure of depressive symptoms and has excellent psychometric properties (Beck, Steer, & Garbin, 1988)”

• cites Beck, Steer, & Garbin, 1988Not checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S3 (load-bearing).

Many people spontaneously repair negative affect without instruction.

“Subjects were not instructed to try to alter or regulate their emotional response, although many individuals will repair negative affective states spontaneously in absence of instruction (Forgas & Ciarrochi, 2002; Hemenover, Augustine, Shulman, Tran, & Barlett, 2008).”

• cites Forgas & Ciarrochi, 2002 sourceNot checked yet

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• cites Hemenover, Augustine, Shulman, Tran, & Barlett, 2008 sourceNot checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

In the current sample, the Beck Depression Inventory had internal consistency of .81 before treatment and .90 after treatment.

“(alpha = .81. pre- treatment, .90 post-treatment).”

Probably not a substantial claim: may not pass S3 (load-bearing).

Treatment fidelity and adherence were not formally assessed.

“Although treatment fidelity and adherence were not formally assessed”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

The mean meditation minutes across all weeks was 76 ± 24% of the goal of 270 minutes per week, with a range of 79 to 308 minutes per week.

“the mean meditation minutes across all weeks was 76 ± 24% with a range of 79 to 308 minutes/week.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Before analysis, all variables were examined for normality, and no outlying cases had a significant influence on the results as assessed by Cook's Distance scores.

“Before analysis, all variables were examined for normality, and no outlying cases had significant influence on the results (as assessed by Cook’s Distance scores).”

May combine two claims.

Treatment groups and completers versus non-completers did not differ on any variable, including age, sex, use of antidepressant medications, depression severity, or previous months of depression.

“Treatment groups and completers vs non-completers did not differ on any variable including age, sex, use of antidepressant medications, depression severity or previous months of depression.”

Probably not a substantial claim: may not pass S1 (asserted). May combine two claims.

Davidson (2003) hypothesized that greater prefrontal control of the amygdala, or decoupling from self-referential elaboration, would result in greater capacity to regulate negative emotion and specifically to decrease the duration of negative affect once it arises, hastening affective recovery.

“Davidson (2003) hypothesized that the greater prefrontal control of the amygdala (Brefczynski-Lewis et al., 2007; Creswell et al., 2007; Farb et al., 2007; Goldin & Gross, 2010; Taylor et al., 2011; Way et al., 2010), or the decoupling from self-referential elaboration (Farb et al., 2010; Farb et al., 2007; Grant et al., 2011; Taylor et al., 2011) would result in greater capacity to regulate”

• cites Davidson (2003) sourceNot checked yet

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Classified as probably not a substantial claim.

It has been proposed that the broad therapeutic effects of mindfulness meditation are mediated by strengthening prefrontal attention and emotion regulation systems.

“It has been proposed that the broad therapeutic effects of mindfulness meditation are mediated by strengthening prefrontal attention and emotion regulation systems (Chambers et al., 2009; Creswell et al., 2007; Davidson & Lutz, 2008; Hofmann & Asmundson, 2008; Teasdale et al., 1995; Way et al., 2010).”

• cites Chambers et al., 2009 sourceNot checked yet

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• cites Creswell et al., 2007 sourceNot checked yet

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• cites Davidson & Lutz, 2008 sourceNot checked yet

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Probably not a substantial claim: may not pass S3 (load-bearing).

Baseline HRSD scores were entered as a covariate to control for initial depression in all analyses.

“In accordance with Hamilton and Dobson (2002), we controlled for initial depression in all of our analyses, by entering baseline HRSD scores as a covariate.”

• cites Hamilton and Dobson (2002) sourceNot checked yet

  Not checked in the free run.

May combine two claims.

Our data suggest that MBCT can effectively target such reactivity and that this effect at least partially mediates improvement in residual depressive symptoms, which reliably predicts relapse.

“Our data suggests that MBCT can effectively target such reactivity and that this effects at least partially mediates improvement in residual depressive symptoms which reliably predicts relapse.”

• AssumptionRests on an assumption: The Spielberger State-Trait Anxiety Inventory Form Y has good psychometric properties, including strong internal consistency, adequate test-retest reliability, and convergent validity.

May combine two claims.

Anticipatory anxiety affects the intensity of response to subsequent stressors and plays an important role in anxiety disorders and mortality risk.

“because anticipatory anxiety affects the intensity of response to subsequent stressors and plays an important role in anxiety disorders (Grillon, Ameli, Foot, & Davis, 1993), and mortality risk (Peterson, Seligman, Yurko, Martin, & Friedman, 1998).”

• cites Grillon, Ameli, Foot, & Davis, 1993 sourceNot checked yet

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• cites Peterson, Seligman, Yurko, Martin, & Friedman, 1998 sourceNot checked yet

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Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Twenty-six (90%) MBCT and 19 (82%) waitlisted participants completed all assessments, for a total of 45.

“Twenty-six (90%) MBCT and 19 (82%) waitlisted participants completed all assessments (total n=45).”

Classified as probably not a substantial claim.

A broad range of emotional disturbances characterized by persistent negative affect are associated with poor emotional regulation, high emotional reactivity, and/or poor prefrontal control.

“In addition to depression, a broad range of emotional disturbances characterized by persistent negative affect are associated with poor emotional regulation, high emotional reactivity and/or poor prefrontal control (Baxter et al., 1989; Bench, Friston, Brown, Frackowiak, & Dolan, 1993; Clark, Chamberlain, & Sahakian, 2009; Couyoumdjian et al., 2009; Hemenover, 2003; Mayberg et al., 1999; Meyer et”

• cites Baxter et al., 1989 sourceNot checked yet

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• cites Bench, Friston, Brown, Frackowiak, & Dolan, 1993 sourceNot checked yet

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• cites Clark, Chamberlain, & Sahakian, 2009 sourceNot checked yet

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Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Sessions were conducted by the first author, who had more than 10 years (approximately 3000 hours) of mindfulness practice and extensive training in MBSR and MBCT.

“Sessions were conducted by the first author who had more than 10 years (approximately 3000 hours) of mindfulness practice experience and has received extensive training in delivery of the program through the Center for Mindfulness Mindfulness-Based Stress Reduction Instructor Certification Program at University of Massachusetts Medical School, and through MBCT training with Dr. Zindel Segal, the”

Probably not a substantial claim: may not pass S3 (load-bearing).

Kuyken et al. (2010) findings that self-compassion mediates MBCT's effects on outcome support this hypothesis.

“Kuyken et al. (2010) findings that self-compassion mediate MBCT’s effects on outcome support this hypothesis.”

• cites Kuyken et al. (2010) sourceNot checked yet

  Not checked in the free run.

May combine two claims.

The findings from this study add to the growing support for emotion regulation models of mindfulness and integrate MBCT for depression within larger affective neuroscience models of meditation.

“The findings from this study add to the growing support for these emotion regulation models of mindfulness, and integrate MBCT for depression within larger affective neuroscience models of meditation.”

• AssumptionRests on an assumption: The Spielberger State-Trait Anxiety Inventory Form Y has good psychometric properties, including strong internal consistency, adequate test-retest reliability, and convergent validity.

May combine two claims.

Rapid recovery after the stressor has passed is adaptive, as prolonged arousal and negative affect can deplete the organism's resources and increase risk for depression.

“Rapid recovery after the stressor has passed is also adaptive, as prolonged arousal and negative affect can deplete the organism’s resources and increase risk for depression.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Although the current study demonstrates that MBCT reduces emotional reactivity, it does not address the mechanism of action or how this reduction is accomplished.

“although the current study demonstrates that MBCT reduces emotional reactivity, it does not address the mechanism of action, or how this reduction is accomplished.”

• AssumptionRests on an assumption: The Spielberger State-Trait Anxiety Inventory Form Y has good psychometric properties, including strong internal consistency, adequate test-retest reliability, and convergent validity.

Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

This study is the first to use a potent, standardized laboratory-based social evaluative stressor before and after a randomized controlled trial of MBCT in a depressed population.

“This study is the first to use a potent, standardized laboratory-based social evaluative stressor before and after a randomized controlled trial of MBCT in a depressed population.”

May combine two claims.

In depression, the potentiation or prolongation of negative affect, which may indicate poor prefrontal control of the amygdala and/or activation of negative cognitive schemas, is associated with higher likelihood of current and future depression as well as poor treatment response, and is therefore a central treatment target.

“In depression, the potentiation or prolongation of negative affect, which may be indicative of poor prefrontal control of the amygdala, and/or activation of negative cognitive schemas (cognitive reactivity) (De Raedt & Koster, 2010) is associated with higher likelihood of current and future depression as well as poor treatment response (Cohen et al., 2005; Cohen et al., 2008; Myin-Germeys et al.,”

• cites De Raedt & Koster, 2010 sourceNot checked yet

  Not checked in the free run.

• cites Cohen et al., 2005 sourceNot checked yet

  Not checked in the free run.

• cites Cohen et al., 2008 sourceNot checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S3 (load-bearing).

Of 52 participants who completed baseline assessments, 23 were randomized to waitlist and 29 to MBCT.

“Of the 52 participants that completed baseline assessments, 23 were randomized to waitlist and 29 to MBCT.”

May combine two claims.

Emotional reactions to stress, including negative affect and physiological arousal, are adaptive up to a point and need not be eliminated.

“This is consistent with the idea that emotional reactions to stress, including negative affect and physiological arousal, are adaptive (up to a point) and need not be eliminated (Mayne, 2001; McEwen & Seeman, 1999).”

• cites Mayne, 2001Not checked yet

  Not checked in the free run.

• cites McEwen & Seeman, 1999Not checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S3 (load-bearing).

The 27 completers reported engaging in formal mindfulness meditation practice an average of 39.94 ± 10 minutes per day, 5.2 ± 1.2 days per week.

“Outside of class, the 27 completers reported engaging in formal MM practice an average of 39.94 ± 10 minutes/day, 5.2 ± 1.2 days/week.”

Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing).

This study also addressed the emotional component of MBCT's theoretical framework, which may have broader applications than a depression-specific cognitive reactivity focus.

“This study also addressed the emotional component of MBCT’s theoretical framework which may have broader applications than depression-specific cognitive reactivity focus.”

Classified as probably not a substantial claim. May combine two claims.

The distribution of the indirect effect often deviates from normality, especially in small samples, so bootstrapping yields more accurate 95% confidence intervals for the indirect effect.

“because the distribution of the indirect effect often deviates from normality, especially in small samples (MacKinnon, Lockwood, & Williams, 2004) the bootstrapping approach yields more accurate 95% confidence intervals for the indirect effect.”

• cites MacKinnon, Lockwood, & Williams, 2004 sourceNot checked yet

  Not checked in the free run.

May combine two claims.

The authors have previously demonstrated that this MBCT intervention was efficacious in reducing residual depression symptoms and increasing mindfulness compared to controls.

“we have previously demonstrated that this MBCT intervention was efficacious in reducing residual depression symptoms, and increasing mindfulness (Mindful Attention Awareness scores), compared to controls (Shahar et al., 2010).”

• cites Shahar et al., 2010 sourceNot checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S3 (load-bearing).

The high number of exclusion criteria may limit the ability to generalize to more severely depressed samples or other clinical populations.

“However, the high number of exclusion criteria may limit the ability to generalize to more severely depressed samples or other clinical populations.”

Probably not a substantial claim: may not pass S3 (load-bearing).

The MBCT group's previously reported increase in mindfulness and improvement in depression is consistent with other studies where high quality MBCT was administered.

“While the MBCT group’s previously reported increase in mindfulness and improvement in depression is consistent with other studies where high quality MBCT was administered”

Probably not a substantial claim: may not pass S3 (load-bearing).

The present study has several other limitations, most notably the small sample size and the limited statistical power.

“The present study has several other limitations, most notably the small sample size and the limited statistical power.”

Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing).

Because self-report measures like the STAI are sensitive to bias and demand characteristics, use of objective measures would lend convergent validity to these findings.

“Because self-report measures, like the STAI, are sensitive to bias and demand characteristics, use of objective measures would lend convergent validity to these findings.”

• AssumptionRests on an assumption: The Spielberger State-Trait Anxiety Inventory Form Y has good psychometric properties, including strong internal consistency, adequate test-retest reliability, and convergent validity.

May combine two claims.

Individuals with 3 or more episodes and residual symptoms represent the population that most benefits from MBCT as well as those at highest risk for recurrence.

“Individuals with 3+ episodes and residual symptoms represent the population that most benefits from MBCT (Ma & Teasdale, 2004; Teasdale et al., 2000) as well as those at highest risk for recurrence.”

• cites Ma & Teasdale, 2004 sourceNot checked yet

  Not checked in the free run.

• cites Teasdale et al., 2000 sourceNot checked yet

  Not checked in the free run.

May combine two claims.

Prolonged negative affect in response to stress is a marker of depression vulnerability and treatment response.

“Given that prolonged negative affect in response to stress is a marker of depression vulnerability (Cohen et al., 2005; Gillihan et al., 2010) and treatment response (Cohen et al., 2008; Davidson et al., 2002)”

• cites Cohen et al., 2005 sourceNot checked yet

  Not checked in the free run.

• cites Gillihan et al., 2010 sourceNot checked yet

  Not checked in the free run.

• cites Cohen et al., 2008 sourceNot checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S3 (load-bearing).

The use of an 8-week mindfulness course limits the ability to speculate on the effects of other forms of meditation or the effects of longer durations of training.

“The use of an 8-week mindfulness course limits the ability to speculate on the effects of other forms of meditation or the effects of longer durations of training.”

May combine two claims.

By providing evidence of faster affective recovery in a stress-sensitive chronically depressed sample, this study strengthens the empirical basis for applying mindfulness-based approaches to depressed samples, as well as other conditions with poor affect regulation.

“By providing evidence of faster affective recovery in a (stress-sensitive) chronically depressed sample, this study strengthens the empirical basis for applying mindfulness-based approaches to depressed samples, as well as other conditions with poor affect regulation.”

• AssumptionRests on an assumption: The Spielberger State-Trait Anxiety Inventory Form Y has good psychometric properties, including strong internal consistency, adequate test-retest reliability, and convergent validity.

Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based). May combine two claims.

The classic limitations of a wait-list control design include the possibility of expectancy effects and differential attrition.

“The classic limitations of a wait-list control design include the possibility of expectancy effects and differential attrition.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

While the current study suggests that MBCT decreases emotional reactivity to social stress, the clinical significance is unknown.

“While the current study suggests that MBCT decreases emotional reactivity to social stress, the clinical significance is unknown.”

• AssumptionRests on an assumption: The Spielberger State-Trait Anxiety Inventory Form Y has good psychometric properties, including strong internal consistency, adequate test-retest reliability, and convergent validity.