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Facets of Mindfulness Predict Depressive and Anxiety Symptom Improvement Above CBT Skills

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Abstract

Mindfulness training is increasingly being incorporated into traditional cognitive behavioral therapy (CBT) approaches. Although the acquisition and use of both CBT and mindfulness skills have been independently linked with positive therapeutic outcomes, the additional therapeutic benefit provided by mindfulness skills above and beyond traditional CBT skills (e.g., behavioral activation, cognitive reappraisal) is unclear. The present study tested the incremental predictive validity of mindfulness skills above CBT skills in predicting depressive and anxiety symptom improvement within a psychiatric hospital unit incorporating training in both CBT and mindfulness skills. Adult patients (N = 134, mean age = 34.0, 47.8% females, 90.3% White) with depression and anxiety receiving combined psychotherapeutic and pharmacological treatment at a psychiatric hospital completed repeated assessments of CBT skills (Cognitive Behavioral Therapy-Skills Checklist), mindfulness skills (Five Facet Mindfulness Questionnaire), and both depressive (Patient Health Questionnaire-9) and anxiety (Generalized Anxiety Disorder Scale-7) symptoms. We tested whether mindfulness skills and/or CBT skills predicted depressive and anxiety symptom improvement. Higher levels of both mindfulness skills (rs = − .15 to − .51) and CBT skills (rs = − .12 to − .21) were cross-sectionally associated with lower depressive and anxiety symptoms. However, while controlling for CBT skills, two mindfulness facets (nonreactivity to inner experience and acting with awareness) predicted subsequent depressive (ts < − 2.49, ps < .014) and anxiety (ts < − 2.31, ps < .022) symptom improvement, thus demonstrating incremental predictive validity. Findings suggest the potential therapeutic benefits of mindfulness skills training for depressed and anxious patients within the context of short-term, intensive psychiatric treatment.

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Acknowledgments

The authors of this manuscript wish to thank the numerous staff and patients of the Behavioral Health Partial Program at McLean Hospital for their support of this project.

Funding

Funding for the study was provided by the Behavioral Health Partial Program and McLean Hospital. The first author (Webb) was funded by a NIMH National Research Service Award (NRSA; 1F32MH099810-01) and a Career Development Award (K23; K23MH108752-01).

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  1. Center for Depression, Anxiety & Stress Research, Harvard Medical School, McLean Hospital, Department of Psychiatry, 115 Mill Street, Belmont, MA, 02478, USA

    Christian A. Webb, Courtney Beard, Marie Forgeard & Thröstur Björgvinsson

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  1. Christian A. Webb
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  2. Courtney Beard
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  3. Marie Forgeard
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  4. Thröstur Björgvinsson
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Contributions

CAW: designed and executed the study, conducted the data analyses, and wrote the paper. CB: collaborated with the design of the study and writing of the paper. MF: contributed to data analyses and wrote part of the procedures and results. TB: collaborated in the design of the study, and writing and editing of the final manuscript.

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Correspondence to Christian A. Webb.

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This study was approved by the McLean Hospital IRB and was therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

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Informed consent was obtained from all individual participants included in the study.

Conflict of Interest

The authors declare that they have no conflict of interest.

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Webb, C.A., Beard, C., Forgeard, M. et al. Facets of Mindfulness Predict Depressive and Anxiety Symptom Improvement Above CBT Skills. Mindfulness 10, 559–570 (2019). https://doi.org/10.1007/s12671-018-1005-1

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