Thursday, November 24, 2011

Mindfulness-Based Cognitive Therapy for Bipolar Disorder: Effects on Cognitive Functioning

Here is a new study providing more evidence for the benefits of mindfulness based approach to therapy (specifically, MBCT):

"The study described here evaluated changes in cognitive functioning associated with MBCT in individuals with bipolar disorder who had residual mood symptoms. Prior to treatment, our sample of participants with bipolar disorder reported substantial impairment in levels of cognitive functioning. Our results indicate that patients with bipolar disorder who participated in MBCT showed improvement in executive functioning and memory to levels comparable with normative samples. Improvements were seen at post-treatment compared to before treatment, as indicated by large effect sizes on many sub-scales, but the effects of the treatment appeared to be attenuated over time. Nevertheless, improvements in many areas of cognitive functioning, particularly memory and task monitoring, were maintained at the follow-up evaluation 3 months after treatment, as indicated by small to medium effect sizes…Of note, improvements in executive functioning in the current study were maintained at especially high levels several months after completing MBCT…

It is important to note that these improvements were not accounted for by decreases in symptoms of depression, although there was evidence of some improvements in cognitive functioning associated with decreases in manic symptoms…It may be that improving the ability to observe thoughts and feelings while disengaging from interpreting their meaning frees up cognitive resources otherwise tied to focusing on one’s thoughts, resources that are useful in allowing one to plan, organize, and perform other executive functions. Similarly, awareness of one’s bodily sensations may make people cognizant of their mood and their body’s needs, making these needs less likely to go unmet and thus to interfere with their cognitive functioning…

Mindfulness appears to have positive effects on cognition, particularly through increasing the ability to maintain focus over longer periods of time. Indeed, previous research has shown that mindfulness is associated with increases in attentional control. Mindfulness meditation has also been linked to activation and increases in white matter in the anterior cingulate cortex, a region implicated in executive attention and that is impaired in individuals with bipolar disorder…

Several limitations of the present study should be noted. Appropriate caution is warranted when interpreting the results of open trials, which lack a valid comparison group. It is unclear whether MBCT would improve cognitive functioning to a greater extent than would other adjunctive, manualized treatments for bipolar disorder…The frequency of practice of the mindfulness techniques learned in MBCT was also not systematically evaluated in this study…This study was also limited by a small sample size…In addition, findings were reported from participants who completed the cognitive functioning measures, all of whom also completed the treatment trial. Therefore, the findings must be interpreted cautiously… It is also important to note that the cyclical nature of bipolar disorder may have contributed to some extent to the cognitive and mood changes observed in this study…
In addition, this study used only self-report measures of cognitive functioning…The present study also utilized a sample of bipolar patients with residual mood symptoms, rather than a sample of individuals in a current mood episode."

No comments:

Post a Comment