Improvements in Executive Attention, Rumination, Cognitive Reactivity, and Mindfulness Among High-Suicide Risk Patients Participating in Adjunct Mindfulness-Based Cognitive Therapy: Preliminary Findings.
OBJECTIVE
To test changes to cognitive functioning among high-suicide risk outpatients participating in an adjunct mindfulness-based intervention combining mindfulness-based cognitive therapy and safety planning (MBCT-S).


METHODS
Ten outpatients with a 6-month history of suicide attempt or active suicidal ideation plus suicidal ideation at study entry received 9 weeks of adjunct group-based MBCT-S. Executive attention, sustained attention, visual memory, and semantic memory encoding were measured by neuropsychological assessment. Rumination, mindfulness, cognitive reactivity (defined as the tendency towards depressogenic information processing and thought content in response to mild mood deterioration), and self-compassion were assessed using self-report measures. Changes in pre- to post-treatment functioning on these constructs were analyzed by using dependent t-tests. Where significant improvements were found, correlations between changes to cognitive functioning and depression and suicidal ideation during treatment were calculated.


RESULTS
Executive attention improved with MBCT-S in high-suicide risk outpatients (Stroop interference effect = 0.39 [standard deviation (SD), 27] at baseline and 0.27 (SD, 0.15) at post-treatment, t[9] = 2.35, p = 0.04, d = 0.75). One mindfulness skill, acting with awareness, increased with MBCT-S (average change in Five Facet Mindfulness Questionnaire-acting with awareness subscale score with treatment, 3.3 [SD, 3.0], t[9] = 3.46, p < 0.01, d = 1.1). Self-reported rumination and cognitive reactivity to suicidality and hopelessness decreased among participants (Ruminative Responses Brooding subscale score change, -3.4 [SD, 1.1], t[9] = 10, p < 0.001, d = 3.2; Leiden Index of Depression Sensitivity-Revised-Hopelessness/Suicidality subscale score change, -3 [SD, 2.7], t[9] = 3.56, p < 0.01, d = 1.1). None of these changes were related to improvements in depression or reductions in suicidal ideation during treatment.


CONCLUSIONS
Findings from the present pilot study suggest that treatment with MBCT-S may improve cognitive deficits specific to suicide ideators and attempters among depressed patients. Future controlled trials using follow-up assessments are needed to determine the specificity of these improvements in cognitive functioning to MBCT-S and their durability and to formally test whether the observed improvements in cognitive functioning explain MBCT-S treatment gains.
1 Department of Psychology, William Paterson University , Wayne, NJ.|2 Molecular Imagining and Neuropathology Division, New York State Psychiatric Institute , New York, NY.
Megan S
MS
Chesin
2 Molecular Imagining and Neuropathology Division, New York State Psychiatric Institute , New York, NY.
Christopher A
CA
Benjamin-Phillips
2 Molecular Imagining and Neuropathology Division, New York State Psychiatric Institute , New York, NY.
John
J
Keilp
2 Molecular Imagining and Neuropathology Division, New York State Psychiatric Institute , New York, NY.|3 Department of Psychology, City College and Graduate Center, City University of New York , New York, NY.
Eric A
EA
Fertuck
2 Molecular Imagining and Neuropathology Division, New York State Psychiatric Institute , New York, NY.
Beth S
BS
Brodsky
2 Molecular Imagining and Neuropathology Division, New York State Psychiatric Institute , New York, NY.
Barbara
B
Stanley
D000328:Adult; D001288:Attention / Q000502:physiology*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003863:Depression / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D064866:Mindfulness; D011581:Psychological Tests; D055815:Young Adult; D000092864:Suicide Prevention