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Cited by 11Mindfulness and Compassion InterventionsTreatment of Major DepressionAnxiety, Depression, Psychometrics, Treatment, Cognitive Processes

Does mindfulness-based cognitive therapy with tapering support reduce risk of relapse/recurrence in major depressive disorder by enhancing positive affect? A secondary analysis of the PREVENT trial.

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Dunn, Barnaby D., Warbrick, Laura, Hayes, Rachel, Montero-Marin, Jesus, Reed, Nigel, Dalgleish, Tim, Kuyken, Willem·2024·Journal of Consulting and Clinical Psychology
DOI 10.1037/ccp0000902
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Abstract

OBJECTIVE: Mindfulness-based cognitive therapy (MBCT) is a viable alternative to maintenance antidepressant medication (M-ADM) to reduce risk of relapse/recurrence (RR) in recurrent depression, but its mechanism of action is not yet fully articulated. This secondary analysis of the PREVENT trial examined if MBCT with support to taper medication (MBCT-TS) reduces risk of RR in part by enhancing positive affect (PA). METHOD: In a single-blind, parallel, group randomized controlled trial, adults with ≥3 prior depressive episodes, but not currently in episode and who were taking M-ADM, were randomized to receive either MBCT-TS or ongoing maintenance M-ADM. The primary outcome was RR over 24-month follow-up. Levels of positive affect were assessed at intake and posttreatment. The original PREVENT trial was preregistered (ISRCTN 26666654), but this secondary analysis was not. RESULTS: Four hundred and twenty-four individuals (predominantly female and of White British ethnicity) were recruited, with 212 randomized to each arm. MBCT-TS led to significantly greater PA relative to M-ADM at posttreatment assessment (Δ = 2.78, 95% CI [1.47, 4.08], p < .001). RR was experienced during follow-up by 194 individuals (100 M-ADM; 94 MBCT-TS). Greater intake PA predicted a reduced hazard of RR across treatments (p < .001; hazard ratio = .96, 95% CI [0.94, 0.98]). In individuals who had not relapsed by posttreatment with complete data (121 M-ADM; 145 MBCT-TS), greater increase in PA from intake to posttreatment mediated reduced risk of subsequent RR (p = .04). CONCLUSIONS: These findings suggest that greater levels of PA predict reduced risk of RR and that MBCT-TS in part acts to protect from RR when withdrawing from M-ADM by increasing PA. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

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  • MBCT is a cost-efficient prevention strategy for recovered depressed patients as it helps with rumination, self-criticism and positive affect.

    “while being a cost-efficient prevention strategy for recov -ered depressed patients as it helps with rumination, self-criticism and positive affect (Dunn et al., 2024; Montero-Marin et al., 2024; Michalak et al., 2015; Teasdale et al., 2000).”

    From Mapping mindfulness in psychotherapy: a scoping review on conceptualization, applications, and research directions (2026) · cites this paper as Dunn et al., 2024

    The Results (p. 1) and Discussion (p. 9) report that MBCT with tapering support increased positive affect and that this increase mediated reduced relapse/recurrence risk in adults with recurrent depression. Our copy does not establish that it is cost-efficient or that its preventive effect works through reduced rumination or self-criticism; the study also specifically examined MBCT with medication-tapering support. (LLM, conf=0.86)

    Experimental — accuracy not yet measured

  • MBCT has been found to be more effective than treatment as usual (TAU) in reducing depressive symptoms.

    “MBCT has been found to be more effective than treatment as usual (TAU) in reducing depressive symptoms”

    From Mapping mindfulness in psychotherapy: a scoping review on conceptualization, applications, and research directions (2026) · cites this paper as Dunn et al., 2024

    The study description (p. 1) compares MBCT with tapering support against maintenance antidepressant medication, measuring positive affect and relapse/recurrence—not depressive-symptom reduction against treatment as usual. The Discussion (p. 7) reports a lower relapse/recurrence risk only at posttreatment, with no significant difference at later follow-ups. Searches for treatment as usual and depressive-symptom reduction found no passage establishing the claimed comparison. (LLM, conf=0.74)

    Experimental — accuracy not yet measured

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Cited by

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Authors
Dunn, B. D., Warbrick, L., Hayes, R., Montero-Marin, J., Reed, N., Dalgleish, T., & Kuyken, W.
Affiliations
  • University of Exeter (GB)
  • MRC Cognition and Brain Sciences Unit (GB)
  • University of Oxford (GB)
ORCID
Venue
Journal of Consulting and Clinical Psychology
Publisher
American Psychological Association (APA)
Published
2024-09
Volume
92
Issue
9
Pages
619-629
ISSN
  • 0022-006X (ISSN-L)
  • 1939-2117
DOI
10.1037/ccp0000902
OpenAlex
W4403507914
Cited by
11
References
0
Citations by year
2026: 4 · 2025: 6 · 2024: 1
FWCI
5.51
Type
journal article
Language
en
Open access
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  • Journal of Consulting and Clinical Psychology (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Apollo (University of Cambridge) (submittedVersion, cc-by)
  • Figshare (submittedVersion, cc-by)
  • Open Research Exeter (University of Exeter) (submittedVersion, cc-by)
Funders
National Institute of Health Research Health Technology Assessment Programme (08/56/01)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
  • Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Keywords
mindfulness-based cognitive therapy, major depressive disorder, relapse prevention, positive affect, antidepressant tapering, recurrent depression, PREVENT trial, mechanism of action, mediation analysis
MeSH terms
Adult, Affect, Antidepressive Agents, Depressive Disorder, Major, Major Depressive Disorder, Female, Humans, Male, Middle Aged, Recurrence, Cognitive Behavioral Therapy, Single-Blind Method, Treatment Outcome, Secondary Prevention, Mindfulness

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

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