{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T05:08:12Z","timestamp":1789967292601,"version":"4.0.1"},"reference-count":71,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,11,25]],"date-time":"2024-11-25T00:00:00Z","timestamp":1732492800000},"content-version":"vor","delay-in-days":329,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Depression and Anxiety"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:p><jats:bold>Background:<\/jats:bold> Mindfulness\u2010based cognitive therapy (MBCT) is effective in reducing depressive symptoms in patients with major depressive disorder (MDD). Understanding for whom and how MBCT works may allow for improvements in treatment allocation and effectiveness. In this study, our aim was to investigate depressive rumination, content\u2010independent perseverative thinking, mindfulness skills, and self\u2010compassion as potential moderators and mediators of MBCT.<\/jats:p><jats:p><jats:bold>Methods:<\/jats:bold> In this non\u2010randomized controlled trial, patients with persistent (<jats:italic>n<\/jats:italic>\u2009=\u200953) or recurrent MDD with (<jats:italic>n<\/jats:italic>\u2009=\u200931) or without (<jats:italic>n\u2009=<\/jats:italic>\u200951) a current depressive episode were assigned to an intervention (MBCT plus treatment as usual [TAU], <jats:italic>n<\/jats:italic>\u2009=\u200994) or control group (TAU only, <jats:italic>n<\/jats:italic>\u2009=\u200940) based on the time between the date of inclusion and the start of MBCT. Assessments were carried out before, halfway, and after 8 weeks of MBCT\u2009+\u2009TAU or TAU. Latent growth models were employed to examine moderation, while cross\u2010lagged structural equation models were used to assess the mediating effects of several possible mediators of MBCT\u2010induced change in depressive symptoms and overall functional impairment.<\/jats:p><jats:p><jats:bold>Results:<\/jats:bold> MBCT\u2009+\u2009TAU was more effective in reducing depressive symptoms (and overall functional impairment than TAU with a medium [<jats:italic>d<\/jats:italic>\u2009=\u2009\u22120.54] and small [<jats:italic>d<\/jats:italic>\u2009=\u20090.44] effect size, respectively). Higher baseline levels of rumination and perseverative thinking and lower levels of self\u2010compassion moderated the effect of MBCT on depressive symptoms and overall functional impairment. Task\u2010based negative intrusive thoughts moderated the effects of MBCT on overall functional impairment. No mediators were established, particularly due to a lack of effect of MBCT on all assessed mediators at mid\u2010treatment. For interpretative purposes, a sample split (based on Johnson\u2013Newman values) showed moderate\u2010to\u2010large effects in depressive symptom reduction for those with high rumination, high perseverative thinking, and low self\u2010compassion, while negative\u2010to\u2010small nonsignificant effects were found for the opposite traits.<\/jats:p><jats:p><jats:bold>Conclusion:<\/jats:bold> In the future, MBCT allocation based on levels of rumination and self\u2010compassion might lead to a more efficient reduction in depressive symptoms. Directions for mediation analysis within the context of MBCT for depression are discussed.<\/jats:p><jats:p><jats:bold>Preregistration:<\/jats:bold> This study was initially preregistered in the Dutch National Trial Register (NL7842). However, due to the NTR no longer being available since June 2022, the trial was reregistered at ClinicalTrials.gov (<jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"https:\/\/clinicaltrials.gov\/ct2\/show\/NCT05802966\">NCT05802966<\/jats:ext-link>, dd 09\u2010Apr\u20102023). The statistical analysis plan was adjusted after the start of the trial but before the finalization of data collection (<jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"https:\/\/clinicaltrials.gov\/ct2\/show\/NCT05802966\">NCT05802966<\/jats:ext-link>; ClinicalTrials.gov).<\/jats:p>","DOI":"10.1155\/da\/3511703","type":"journal-article","created":{"date-parts":[[2024,11,25]],"date-time":"2024-11-25T14:18:53Z","timestamp":1732544333000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Rumination and Self\u2010Compassion Moderate Mindfulness\u2010Based Cognitive Therapy for Patients With Recurrent and Persistent Major Depressive Disorder: A Controlled Trial"],"prefix":"10.1155","volume":"2024","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7864-922X","authenticated-orcid":false,"given":"Jelle","family":"Lubbers","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dirk E. M.","family":"Geurts","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip","family":"Spinhoven","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mira B.","family":"Cladder-Micus","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Demi","family":"Ennen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne E. M.","family":"Speckens","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Spijker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,11,25]]},"reference":[{"key":"e_1_2_13_1_2","doi-asserted-by":"publisher","DOI":"10.1146\/annurev-publhealth-031912-114409"},{"key":"e_1_2_13_2_2","unstructured":"World-Health-Organization Depression and Other Common Mental Disorders: Global Health Estimates 2017 WHO https:\/\/apps.who.int\/iris\/bitstream\/handle\/10665\/254610\/WHO-MSD-MER-2017.2-eng.pdf."},{"key":"e_1_2_13_3_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2016.0076"},{"key":"e_1_2_13_4_2","doi-asserted-by":"publisher","DOI":"10.1037\/0022-006X.68.4.615"},{"key":"e_1_2_13_5_2","doi-asserted-by":"publisher","DOI":"10.1080\/16506073.2018.1556330"},{"key":"e_1_2_13_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12671-021-01794-3"},{"key":"e_1_2_13_7_2","doi-asserted-by":"publisher","DOI":"10.1192\/bjo.2020.118"},{"key":"e_1_2_13_8_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12671-018-1087-9"},{"key":"e_1_2_13_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpr.2017.04.008"},{"key":"e_1_2_13_10_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12144-021-02082-y"},{"key":"e_1_2_13_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpr.2015.02.001"},{"key":"e_1_2_13_12_2","doi-asserted-by":"publisher","DOI":"10.1521\/ijct.2008.1.3.192"},{"key":"e_1_2_13_13_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1745-6924.2008.00088.x"},{"key":"e_1_2_13_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpr.2009.11.004"},{"key":"e_1_2_13_15_2","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyg.2018.00756"},{"key":"e_1_2_13_16_2","volume-title":"Mindfulness-Based Cognitive Therapy for Depression: A New Approach to Preventing Relapse","author":"Segal Z. V.","year":"2013"},{"key":"e_1_2_13_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2022.10.022"},{"key":"e_1_2_13_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijchp.2017.07.004"},{"key":"e_1_2_13_19_2","doi-asserted-by":"publisher","DOI":"10.1002\/da.22788"},{"key":"e_1_2_13_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.brat.2019.103467"},{"key":"e_1_2_13_21_2","volume-title":"Wherever You Go, There You Are: Mindfulness Meditation in Everyday Life","author":"Kabat-Zinn J.","year":"2009"},{"key":"e_1_2_13_22_2","doi-asserted-by":"publisher","DOI":"10.1080\/15298860309032"},{"key":"e_1_2_13_23_2","doi-asserted-by":"publisher","DOI":"10.1146\/annurev.clinpsy.3.022806.091432"},{"key":"e_1_2_13_24_2","doi-asserted-by":"publisher","DOI":"10.1159\/000442260"},{"key":"e_1_2_13_25_2","doi-asserted-by":"publisher","DOI":"10.1080\/10705511.2020.1784738"},{"key":"e_1_2_13_26_2","unstructured":"SpijkerJ. Ruh\u00e9E. andBocktingC. et al.Multidisciplinaire Richtlijn Depressie (vierde revisie 2024). Richtlijn voor de diagnostiek behandeling en begeleiding van pati\u00ebnten met een depressieve stoornis 2024 https:\/\/richtlijnendatabase.nl\/richtlijn\/depressie\/startpagina_-_richtlijn_depressie_2024.html."},{"key":"e_1_2_13_27_2","volume-title":"Mindfulness-Based Cognitive Therapy for Depression: A New Approach to Preventing Relapse","author":"Segal Z. V.","year":"2002"},{"key":"e_1_2_13_28_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12671-011-0073-2"},{"key":"e_1_2_13_29_2","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291700035558"},{"key":"e_1_2_13_30_2","unstructured":"NolenW.andDingemansP. Meetinstrumenten Bij Stemmingsstoornissen 2004 681\u2013686 Tijdschrift Voor Psychiatrie."},{"key":"e_1_2_13_31_2","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1099-0879(199612)3:4<249::AID-CPP106>3.0.CO;2-S"},{"key":"e_1_2_13_32_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF03077465"},{"key":"e_1_2_13_33_2","doi-asserted-by":"publisher","DOI":"10.1037\/0022-3514.61.1.115"},{"key":"e_1_2_13_34_2","doi-asserted-by":"publisher","DOI":"10.1023\/A:1023910315561"},{"key":"e_1_2_13_35_2","first-page":"205","article-title":"\u2019Reflection\u2019en\u2019brooding\u2019als Subtypes Van Rumineren: Een Herziening Van De Ruminative Response Scale","volume":"42","author":"Raes F.","year":"2009","journal-title":"Gedragstherapie"},{"key":"e_1_2_13_36_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbtep.2010.12.003"},{"key":"e_1_2_13_37_2","doi-asserted-by":"publisher","DOI":"10.1177\/1073191111408231"},{"key":"e_1_2_13_38_2","doi-asserted-by":"publisher","DOI":"10.1002\/cpp.702"},{"key":"e_1_2_13_39_2","doi-asserted-by":"publisher","DOI":"10.1016\/0005-7967(83)90121-3"},{"key":"e_1_2_13_40_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10608-019-09997-8"},{"key":"e_1_2_13_41_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.brat.2009.10.006"},{"key":"e_1_2_13_42_2","doi-asserted-by":"publisher","DOI":"10.1037\/a0013473"},{"key":"e_1_2_13_43_2","doi-asserted-by":"publisher","DOI":"10.1080\/02699931.2015.1124843"},{"key":"e_1_2_13_44_2","doi-asserted-by":"publisher","DOI":"10.1186\/s40345-022-00269-1"},{"key":"e_1_2_13_45_2","unstructured":"Clinical trial registration: Cognition in Mindfulness; Negativity and Depression (CogMiND) 2023 ClinicalTrials.govhttps:\/\/clinicaltrials.gov\/study\/NCT05802966."},{"key":"e_1_2_13_46_2","doi-asserted-by":"publisher","DOI":"10.1080\/10705519509540009"},{"key":"e_1_2_13_47_2","doi-asserted-by":"publisher","DOI":"10.1037\/a0014699"},{"key":"e_1_2_13_48_2","doi-asserted-by":"publisher","DOI":"10.1080\/15427600902911247"},{"key":"e_1_2_13_49_2","doi-asserted-by":"publisher","DOI":"10.1037\/a0038889"},{"key":"e_1_2_13_50_2","volume-title":"Mplus User\u2019s Guide","author":"Muth\u00e9n L. K.","year":"2017"},{"key":"e_1_2_13_51_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ausmj.2017.02.001"},{"key":"e_1_2_13_52_2","doi-asserted-by":"publisher","DOI":"10.1207\/s15327906mbr4003_5"},{"key":"e_1_2_13_53_2","doi-asserted-by":"publisher","DOI":"10.1037\/0021-9010.88.5.879"},{"key":"e_1_2_13_54_2","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.158.6.848"},{"key":"e_1_2_13_55_2","doi-asserted-by":"publisher","DOI":"10.1177\/00131644211003261"},{"key":"e_1_2_13_56_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.janxdis.2022.102599"},{"key":"e_1_2_13_57_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.psychres.2015.02.003"},{"key":"e_1_2_13_58_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.brat.2011.01.007"},{"key":"e_1_2_13_59_2","doi-asserted-by":"publisher","DOI":"10.1177\/1094428115627498"},{"key":"e_1_2_13_60_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2023.05.023"},{"key":"e_1_2_13_61_2","doi-asserted-by":"publisher","DOI":"10.1002\/da.22369"},{"key":"e_1_2_13_62_2","doi-asserted-by":"publisher","DOI":"10.1136\/ebnurs-2019-103145"},{"key":"e_1_2_13_63_2","doi-asserted-by":"publisher","DOI":"10.1093\/abm\/kaaa066"},{"key":"e_1_2_13_64_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12671-023-02083-x"},{"key":"e_1_2_13_65_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2021.08.086"},{"key":"e_1_2_13_66_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijchp.2024.100445"},{"key":"e_1_2_13_67_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12671-020-01442-2"},{"key":"e_1_2_13_68_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijchp.2023.100392"},{"key":"e_1_2_13_69_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2013.06.014"},{"key":"e_1_2_13_70_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.janxdis.2015.05.001"},{"key":"e_1_2_13_71_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2018.08.037"}],"container-title":["Depression and Anxiety"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/da\/3511703","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,25]],"date-time":"2024-11-25T14:19:01Z","timestamp":1732544341000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1155\/da\/3511703"}},"subtitle":[],"editor":[{"given":"Muhammad","family":"Asif","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2024,1]]},"references-count":71,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2024,1]]}},"alternative-id":["10.1155\/da\/3511703"],"URL":"https:\/\/doi.org\/10.1155\/da\/3511703","archive":["Portico"],"relation":{},"ISSN":["1091-4269","1520-6394"],"issn-type":[{"value":"1091-4269","type":"print"},{"value":"1520-6394","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,1]]},"assertion":[{"value":"2024-04-11","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-10-19","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-11-25","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"3511703"}}