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Mindfulness-Based Cognitive Therapy and Self-Discrepancy in Recovered Depressed Patients with a History of Depression and Suicidality

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Abstract

Long-term vulnerability to depression is related to the presence of perceived discrepancies between the actual self and ideal self-guides. This study examined the immediate effects of an 8-week course of Mindfulness-Based Cognitive Therapy (MBCT) on self-discrepancies in individuals currently in recovery, with a history of affective disorder that included suicidal ideation and behaviour. Results indicated significant time × group interactions for both ideal self similarity and ideal self likelihood ratings, primarily accounted for by increases in self-discrepancy from pre-test to post-test in the waiting list group which were not seen in those receiving MBCT. Changes in self-discrepancy were not associated with changes in residual depressive symptoms, but in the MBCT group there was a significant association between increases in ideal self similarity and the adoption of more adaptive ideal self-guides post treatment. MBCT may protect against increases in self-discrepancy in people vulnerable to relapse to depression and may also facilitate a shift in the goals of self-regulation.

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Notes

  1. We repeated the analyses of the effects of treatment on ideal self similarity and ideal self likelihood carrying forward baseline data for any participants who did not have time 2 data, and additionally including participants who were allocated to immediate treatment but attended 3 or fewer sessions. A mixed between (baseline, follow-up), within (MBCT, waitlist) ANOVA for ideal self similarity revealed no significant main effects of time or group (Fs < 1), but identified a significant time × group interaction, F(1, 63) = 7.19, P = .015. A mixed between (baseline, follow-up), within (MBCT, waitlist) ANOVA for ideal self likelihood identified a trend towards a main effect of time F (1, 62) = 2.93, P = .09 and a significant time × group interaction F (1, 62) = 5.41, P = .02. The findings of these ‘intention-to treat’ analyses are therefore wholly consistent with the findings of analyses based on the smaller group of participants who attended an adequate dose of treatment and returned for a follow-up assessment providing complete data.

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Acknowledgments

This research was supported by the Wellcome Trust GR 067797.

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Authors and Affiliations

  1. Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, UK, OX3 7JX

    Catherine Crane, Thorsten Barnhofer, Danielle S. Duggan, Melanie V. Fennell & J. Mark G. Williams

  2. Institute of Psychiatry, De Crespigny Park, Denmark Hill, London, SE5 8AF, UK

    Silvia Hepburn

Authors
  1. Catherine Crane
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  2. Thorsten Barnhofer
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  3. Danielle S. Duggan
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  4. Silvia Hepburn
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  5. Melanie V. Fennell
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  6. J. Mark G. Williams
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Corresponding author

Correspondence to Catherine Crane.

Appendix

Appendix

In the current study the ‘ought self’ was described as “the kind of person you believe you have a duty or obligation to be, or that you believe people think you should be. It’s defined by the personality characteristics you think you ought to possess, or feel obligated to possess. It’s not necessary that you have these characteristics now, only that you believe you ought to have them”.

The ‘ideal self’ was described as “The kind of person you’d really like to be. It’s defined by the personality characteristics you would ideally like to have. It’s not necessary that you have these characteristics now, only that you believe you want to have them.”

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Crane, C., Barnhofer, T., Duggan, D.S. et al. Mindfulness-Based Cognitive Therapy and Self-Discrepancy in Recovered Depressed Patients with a History of Depression and Suicidality. Cogn Ther Res 32, 775–787 (2008). https://doi.org/10.1007/s10608-008-9193-y

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