Johannes Michalak

Embodiment of Sadness and Depression—Gait Patterns Associated With Dysphoric Mood

Objective: To analyze gait patterns associated with sadness and depression. Embodiment theories suggest a reciprocal relationship between bodily expression and the way in which emotions are processed. Methods: In Study 1, the gait patterns of 14 inpatients suffering from major depression were compared with those of matched never-depressed participants. In Study 2, we employed musical mood induction to induce sad and positive mood in a sample of 23 undergraduates. A Fourier-based description of walking data served as the basis for the computation of linear classifiers and for the analysis of gait parameters. Results: Gait patterns associated with sadness and depression are characterized by reduced walking speed, arm swing, and vertical head movements. Moreover, depressed and sad walkers displayed larger lateral swaying movements of the upper body and a more slumped posture. Conclusion: The results of the present study indicate that a specific gait pattern characterizes individuals in dysphoric mood. ANCOVA = analysis of covariance; BDI = Beck Depression Inventory; DSM = Diagnostic and Statistical Manual of Mental Disorders; MANOVA = multivariate analysis of variance; MDD = major depressive disorder; SCID = Structured Clinical Interview for DSM-IV; SNRI = serotonin noradrenalin reuptake inhibitors; SSRI = selective serotonin reuptake inhibitors.

Mindfulness predicts relapse/recurrence in major depressive disorder after mindfulness-based cognitive therapy.

Empirical evidence for the effectiveness of mindfulness-based cognitive therapy (MBCT) is encouraging. However, data concerning the role of mindfulness in its relapse preventive effect are lacking. In our study, 25 formerly depressed patients received MBCT. Mindfulness was assessed before and immediately after MBCT using the Mindful Attention and Awareness Scale. Mindfulness significantly increased during MBCT, and posttreatment levels of mindfulness predicted the risk of relapse/recurrence to major depressive disorder in the 12-month follow-up period. Mindfulness predicted the risk of relapse/recurrence after controlling for numbers of previous episodes and residual depressive symptoms. The results provide preliminary evidence for the notion that mindfulness is an important factor in relapse prevention in major depression.

Achtsamkeitsbasierte Stressreduktion in der klinischen Anwendung

In the context of an increasing interest in mindfulness-based approaches both in clinical application as well as in the field of research the present paper introduces MBSR (Mindfulness-based Stress Reduction), illustrates the theoretical background of mindfulness practice and reviews the procedures during the cultivation of mindfulness and possible impacting factors. The article also reviews Mindfulness-based Cognitive Therapy (MBCT), which was specifically developed to prevent relapse in patients with depressive disorders. The paper ends with a conclusion for clinical practice.

Rumination as a predictor of relapse in mindfulness-based cognitive therapy for depression.

OBJECTIVES In mindfulness-based cognitive therapy (MBCT), it is proposed that training in mindfulness should reduce the tendency of formerly depressed patients to enter into ruminative thinking, thus reducing their risk of depressive relapse. However, data showing that rumination is associated with depressive relapse are lacking. METHOD In an uncontrolled study with 24 formerly depressed patients, rumination was assessed with the Ruminative Response Scale. To assess the occurrence of relapse or recurrence, the Structured Clinical Interview for DSM-IV was administered 12 months after the end of the MBCT. RESULTS Rumination significantly decreased during the MBCT course. Post-treatment levels of rumination predicted the risk of relapse of major depressive disorder in the 12-month follow-up period even after controlling for numbers of previous episodes and residual depressive symptoms. CONCLUSIONS The results provide preliminary evidence that rumination is important in the process of depressive relapse.

Mindfulness-based cognitive therapy for persistent insomnia: a pilot study.

188 gic antidepressant aminpetine, 55% still had at least some type of sexual dysfunction after 6 months compared to 4% in the control group treated with aminpetine alone [13] . More studies are needed to address the frequency, severity and nature of this problem before its neurochemical etiology can be addressed. These case studies have important clinical implications. They suggest that when patients develop sexual dysfunction as a side effect of SSRIs, clinicians should be alert to the possibility that restoration of sexual function may not correlate temporally with medication cessation. Patients are often willing to continue taking SSRIs despite sexual side effects, but the possibility of increasing the probability of dysfunction remaining after discontinuance should be taken into consideration. Such persistent side effects could even worsen the long-term prognosis of depression [14] .

Die deutsche Version der Mindful Attention and Awareness Scale (MAAS) Psychometrische Befunde zu einem Achtsamkeitsfragebogen

Zusammenfassung. Theoretischer Hintergrund: Achtsamkeit ist eine bestimmte Form der Aufmerksamkeitslenkung, die durch drei Merkmale gekennzeichnet ist: (1) absichtsvoll (2), im gegenwartigen Moment und (3) nicht wertend. Therapieansatze, in denen die Forderung von Achtsamkeit eine zentrale Rolle einnimmt, werden in letzter Zeit zunehmend eingesetzt. Fragestellung: Wie gut sind die Gutekriterien der deutschen Ubersetzung der „Mindful Attention Awareness Scale” (MAAS)? Methode: Die 15 Items der MAAS wurden ubersetzt. An einer Stichprobe von 469 studentischen Versuchspersonen wurden die dimensionale Struktur, Reliabilitat und Validitat der Skala uberpruft. Ergebnisse: In Ubereinstimmung mit den Ergebnissen zur amerikanischen Originalfassung zeigte die deutschsprachige Version der MAAS eine eindimensionale Struktur, eine interne Konsistenz von α = .83 und Zusammenhange mit psychopathologischer Belastung und subjektivem Wohlbefinden. Schlussfolgerungen: Mit der deutschen Ubersetzung der MAAS liegt ein Fragebog...

The Psychometric Properties of the Kentucky Inventory of Mindfulness Skills in Clinical Populations

The Kentucky Inventory of Mindfulness Skills (KIMS) is a well-validated multidimensional questionnaire measuring dimensions of mindfulness on four scales: Observing, Describing, Act With Awareness, and Accept Without Judgment. Even though the KIMS has been used in several clinical studies no information is available about the psychometric properties in different clinical samples. The present study includes two clinical samples: a German sample of people diagnosed with borderline personality disorder, posttraumatic stress disorder, or major depression and an English sample of people diagnosed with recurrent depression. Results of confirmatory factor analysis offer good support for the hypothesized model of four correlated factors, whereas the model of one general underlying mindfulness factor as a second order construct was not confirmed. Furthermore, our analyses revealed that the KIMS scales show high internal consistency and that all KIMS scales are sensitive to change in a subsample of participants taking part in Mindfulness-Based Cognitive Therapy.

Personal goals of psychotherapy patients: The intensity and the “why” of goal-motivated behavior and their implications for the therapeutic process

The current study examined how the intensity and “why” of goal-motivated behavior were linked to the psychopathological state of psychotherapy outpatients and the session outcome. The level of goal motivation was assessed by measuring different expectancy-value aspects of idiographically generated personal goals; the “why” of motivation was measured by assessing the degree of self-determination of these goals. For 31 outpatients, goal characteristics and measures of psychopathology (i.e., questionnaires measuring symptoms and functional impairments) were assessed before therapy started; for 41 patients, these were assessed in the middle phase of therapy. Session outcome was assessed from the perspective of the therapists and the patients. Patients who were more optimistic about attaining valued goals and more intrinsically oriented showed lower levels of psychopathology and more positive session outcomes.

Achtsamkeit («Mindfulness») als Therapieprinzip in Verhaltenstherapie und Verhaltensmedizin

Mindfulness as a Treatment Principle in Behaviour Therapy ‘Mindfulness’ is defined as paying attention in a certain way: on purpose, in the present moment and non-judgementally. Historically, mindfulness practice was developed in Buddhist meditation practice. In the last two decades, mindfulness-based elements were integrated into cognitive-behavioural treatment. In the present article, mindfulness as a therapeutic principle is presented and parallels and differences between cognitive-behavioural treatment approaches and mindfulness are outlined. Several approaches of cognitive behaviour therapy and behaviour medicine that incorporate mindfulnessbased elements are discussed. These approaches include ‘mindfulness-based stress reduction’ according to J. Kabat-Zinn, ‘mindfulness-based cognitive therapy for depression’ according to Segal, M. Williams and J. Teasdale, ‘dialectical behaviour therapy for borderline personality disorder’ according to M. Linehan as well as the use of mindfulness-based elements in the treatment of substance abuse according to A. Marlatt. Empirical work supporting the efficacy of these approaches is reviewed. The article concludes with a discussion of further research implications.

Achtsamkeit und Akzeptanz in der Psychotherapie Gegenwärtiger Forschungsstand und Forschungsentwicklung

Es wird ein Uberblick zum Forschungsstand und zu Forschungsentwicklungen im Bereich achtsamkeits- und akzeptanzbasierter Ansatze gegeben. Dabei werden drei Forschungsstrange beschrieben: (1) Wirksamkeitsuntersuchungen zur “Mindfulness-Based Stress Reduction” (MBSR), zur “Mindfulness-Based Cognitive Therapy” (MBCT), zur “Dialektisch-Behavioralen Therapie bei Borderlinestorungen” (DBT) und zur “Acceptance and Commitment Therapy” (ACT); (2) Psychometrische Verfahren zur empirischen Erfassung von Achtsamkeit; (3) Untersuchungen aus dem Bereich der psychologischen Grundlagenforschung und neurobiologische Arbeiten. Der Artikel schliest mit einer Diskussion der Besonderheiten einer wissenschaftlichen Analyse von Achtsamkeit und Akzeptanz und einem Forschungsausblick.