2013. Vol.4, No.6A1, 8-17
Published Online June 2013 in SciRes (http://www.scirp.org/journal/psych) http://dx.doi.org/10.4236/psych.2013.46A1002
Copyright © 2013 SciRes.
Effects of Duration and Contents of Mindfulness
Training on Depression*
Qiong Wu, Lin Shi, Zhipeng Xia, Lida Lu
Beijing Key Laboratory of Applied Experimental Psychology, School of Psychology,
Beijing Normal University, Beijing, China
Received March 16th, 2013; revised April 20th, 2013; accepted May 18th, 2013
Copyright © 2013 Qiong Wu et al. This is an open access article distributed under the Creative Commons At-
tribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the
original work is properly cited.
This study aimed to find a simple and effective mindfulness training method for intervening depression.
95 university students with moderate or severe depression participated in the study and they were divided
into three mindfulness training groups: 8-week complete group, 8-week informal group, and 4-week
group. All subjects completed Beck Depression Inventory (BDI-Ⅱ) and Five Fact Mindfulness Ques-
tionnaire (FFMQ) before the intervention, after which, 55 subjects completed the assessments once more.
Results showed the scores of specific dimensions representing mindfulness levels were different. For the
4-week group, scores of description, action aware and nonjudge significantly were improved, while the
other two groups were improved significantly on all the five dimensions, especially the informal training
group. In the discussion, it focused more on the effects of training time and training contents, and briefly
discussed the relation of subjects dropout, subjects attendance, homework completion status and interven-
tion effects. In conclusion, all the three intervention modes have magnificent intervention effects. Inte-
grated many sided, 8-week informal training is of the best effects, which may be considered as a better
mindfulness training mode henceforth, however, the comparison between the formal training and informal
training still needs further study.
Keywords: Mindfulness; Depression; Intervention; Mindfulness-Based Cognitive Therapy
The Origin of Mindfulness Training
Mindfulness, sati in Pali Language, which originated from
Southern Buddhism, is an important mode of meditation (Shaw,
2006: pp. 19, 76). In 1970s, Jon Kabat-Zinn created effective
Mindfulness-Based Stress Reduction (MBSR), which was based
on his solid specialty foundation and absorbed the nutrition and
essence of meditation in the East. Kabat-Zinn defined mindful-
ness as “paying attention in a particular way: on purpose, in the
present moment, and nonjudgmentally” (Kabat-Zinn, 1994).
Meanwhile, he also emphasizes that mindfulness training is
only to pay attention to observing the current internal and ex-
ternal experience, emotions or behaviors, while it is not to re-
spond to them immediately. Thus, the practice of mindfulness
skills could lead to the ability to experience pain sensations
without excessive emotional reactivity (Baer, 2006).
Since Kabat-Zinn published the first clinical research report
on Mindfulness-Based Stress Reduction and Chronic Pain in
1982, the mindfulness training course has gradually be widely
recognized in the USA, and many psychotherapy methods,
which take mindfulness training as core technology or is based
on mindfulness training, have been developed (Tan & Wu,
2009), such as Mindfulness-Based Cognitive Therapy (MBCT),
Dialectical Behavior Therapy (DBT) and Acceptance and Com-
mitment Therapy (ACT).
Mindfulness-Based Cognitive Therapy (MBCT) is a therapy
to prevent recurrence of depression that was developed and
worked out by Teasdale, Segal and William in 1995 by com-
bining Mindfulness-Based Stress Reduction (MBSR) and Cog-
nitive Therapy. The core skill that MBCT teaches us is that: by
awareness training, the participants realize ubiquity of “Psy-
chological operation mode”, namely, individuals’ habitual, un-
conscious and self-driven reaction mode towards thought, inner
feeling and somatesthesia. And practice to be released from
such psychological state and then convert into “existing mode”,
that is, to learn to accept and admit all current objective ex-
perience, while it does not need to respond to and change such
negative experience (Deng, 2009).
Application and Research of Mindfulness Training
So far, mindfulness training has been separated from the un-
derstanding perspective of religious belief, has become one of
the important methods in psychotherapy field, and has been
widely used in multiple clinical treatment and practical research.
Besides, cognitive psychology field has also begun to pay at-
tention to research of neural mechanism of mindfulness and to
the change of individuals’ cognitive system brought by mind-
*A Joint-Project for Beijing City Board of education (SYS100270661). More and more empirical study demonstrates that MBSR and
Q. WU ET AL.
MBCT have good therapeutic effect on different groups and
different diseases. Since Jon Kabat-Zinn established stress re-
duction clinic to provide MBSR, he and his colleagues have
helped over 10,000 patients with different diseases, including
heart disease, cancer, Aids, chronic pain, gastrointestinal tract
problems caused by excessive pressure, headache, high blood
pressure, sleep disturbance, anxiety and panic. MBSR can also
be used to treat working pressure and job burnout of nursing
personnel (Cohen-Katz, Wiley, Capuano, Baker, & Shapiro,
2004, 2005a, 2005b), mental distress and fatigue of those suf-
fering from rheumatic arthritis (Zangi et al., 2012), pressure and
anxiety of those suffering from breast cancer (Anna, Yvonne, &
Catherine, 2004), and dyspareunia problem of females that
suffered from sexual abuse in their childhood (Brotto, Seal, &
Rellini, 2012); and it is helpful for the response of patients suf-
fering from rheumatoid arthritis towards chronic pain and de-
pressive state, and enhance quality of life (Zautra et al., 2008),
and helpful for teenagers to reduce anxiety, depression and pain
symptoms and enhance self-esteem and sleep quality (Biegel,
Brown, Shapiro, & Schubert, 2009; see also Rood, Roelofs,
Bogels, & Alloy, 2010). Mindfulness training can improve eat-
ing pattern and adjust Cortisol Awakening Response (CAR),
and it may reduce abdominal adipose tissue as time goes on
((Daubenmier et al., 2011). In relative to MBSR, MBCT can
obviously reduce the depression recurrence risk of patients that
have suffered from depressive episodes for three or more times.
For patients that have suffered from recurrence of depression
for three or more times, MBCT can bring the recurrence rate
from 78% to 36%. Moreover, MBCT has more effective auto-
matic processing of cognitive emotions (Teasdale, Segal, Wil-
liams, Ridgeway, Soulsby, & Lau, 2000; Ma & Teasdale, 2004).
MBCT is also proved to have alleviating action on depression
and anxiety symptoms of patients with suicidal idea (Williams,
Danielle, Catherine, Melanie, & Fennell, 2006; see also Mar-
chand, 2012) and patients with bipolar disorder (Williams, 2008).
Other cognitive therapies based on mindfulness are widely used
in treating borderline personality disorder and anxiety disorder
(Segal, Williams, & Teasdale, 2001).
However, while a large number of researchers have huge en-
thusiasm on mindfulness training and widely use mindfulness
training, some problems occur accordingly. Although many re-
searches use the concept of “mindfulness training”, the specific
mindfulness intervention modes vary greatly, which is espe-
cially obvious in cognitive study.
When Anna (2004) treated patients with breast cancer, 8-
week mindfulness training that was conducted once a week and
1.5 hours each time was adopted, in which three mindfulness
trainings were mainly used: body scanning, meditation and
yoga (hatha yaga) as well as didactic, inductive and learning the
experience mode relevant to stress response (Anna, Yvonne, &
Catherine, 2004). Daubenmier and Kristeller (2011) designed a
set of novel and preliminary mindfulness intervention mode
according to MBSR, MBCT and MB-EAT (Mindfulness-Based
Eating Awareness Training), and conducted intervention for 57
fat women (average body mass index (BMI) = 31.2). Mainly
body scanning, meditation, yoga and three minutes breathing
space practice were conducted, the subjects conducted a 2.5-
hour group activity once each week, and they practiced mind-
fulness before having meals besides doing 30-minute home-
work. The cortisol awakening response of subjects had been
obviously reduced and their weights had stopped increasing.
The mindfulness training adopted by Deng Yuqin (2009) re-
ferred to the curriculum design of MBCT and MBSR. The par-
ticipants attended the mindfulness training course collectively
once a week, which lasted for 8 weeks with 1.5 - 2 hours each
time. After the intervention, participants were obviously im-
proved in symptom distress, social role performance, interper-
sonal relationship and life quality in effect evaluation scale. Shi
Zhenyan (2011) used mindfulness intervention that lasted for 4
weeks with half a day for each time. After intervention, univer-
sity students had positively improved their anxiety level, and
the maintenance effects were good.
Hoelzel and Carmody (2010) adopted 8-week MBSR train-
ing mode, with one group activity every week which lasted for
2.5 hours and practice was conducted once in the six week
which lasted 6.5 hours. It is found that the grey substances in
the hippocampus on the left side of the practicers was increased,
which were relevant to learning and memory processing, mood
adjustment, self-reference processing and thinking ability. Tang
(2007) used short-time mindfulness meditation training in the
research, the experimental group received 20-minute compre-
hensive meditation training (including mindfulness meditation)
for 5 days, with the results that the training could enhance at-
tention and self-control ability, and the scores of anxiety, de-
pression and anger had been decreased obviously; Vigour in
Profile of Mood States Scale is higher; cortisol related to pres-
sure has been obviously reduced; immunological competence
has been increased (see also Chambers, Lo, Yee, & Allen, 2008).
Chambers (2008) guided 20 participants to have a 10-day cen-
tralized mindfulness meditation training, which showed that it
obviously enhanced working memory performance and contin-
uous attention of participants. Ortner, Kilner and Zelazo (2007)
found that 7-week mindfulness meditation training could re-
duce the emotional interference (especially negative emotional
interference) in cognitive tasks, so that individuals could focus
on cognitive tasks. Zeidan (2010) used simplified mindfulness
meditation training in the research, and after 4-day training,
participants’ visual space processing, working memory and exe-
cutive capability had been strengthened, and sustained attention
had been obviously enhanced. In the research of Semple (2010),
the participants received 4-week mindfulness practice with fre-
quency of twice a week, and they practiced twice every day
after going home, while the control group only conducted mus-
cle relaxation training. After 4 weeks, compared with control
group, the mindfulness group had higher discriminability in
signal detection tasks, and had obvious improvement in tasks
required continuous attention, but the two groups had no obvi-
ous difference in performance of the two tasks of concentricity
and restraining distractions. Lutz (2008) considered that medi-
tation could be divided into two types, namely focused atten-
tion meditation and open monitoring meditation. After practice
of the first type of meditation, it will cause nervous physiology
changes, which are demonstrated in: continuity of attention,
such as improvement of test performance in continuous tasks
and binocular rivalry tasks; selectivity of attention, such as
improvement of test performance in Posner clue tasks. And
some researchers use only 12-minute practice with attention to
breathing in the mindfulness research (Alberts & Thewissen,
To sum up, although a lot of research has demonstrated in-
Copyright © 2013 SciRes. 9
Q. WU ET AL.
tervention effects of mindfulness training in many aspects,
mindfulness training modes adopted in the research are various,
and the training arrangements have no longer been standard
MBSR and MBCT modes. In the training contents, researchers
tend to use simple meditation training to replace mindfulness
training in various forms; in time arrangement, researchers tend
to shorten training time, some research arranges 8-week group
training with once each week, some research arranges 4-week
training with twice each week, and some research arranges 10-
day or 5-day short-term training. And for MBSR method, some
research only has centralized training and does not require
practice at home, while some research has some task practiced
There are many methods for mindfulness training, and some
requires longer time, such as body scanning which lasts about
40 minutes; some mindfulness training method can be con-
ducted in daily life and some participants do not need specially
arrange time for practicing. Then, what kind of training is ef-
fective? Is the effect of short-term training different from that
of long-term training? Is the effect of formal training different
from that of informal training? The answers to these questions
are good for the application of mindfulness training.
The assumption of the research is that, if the simplified and
short-term mindfulness training is proved to be effective or its
difference from the standard intervention mode of MBCT is not
obvious, we will be able to find a shorter-term and more effec-
tive intervention mode. Meanwhile, a set of mindfulness train-
ing operation standard that is more simplified, standardized and
strictly operable can be established.
The research mainly refers to MBCT curriculum design and
it re-designs the mindfulness training, which can be divided
into three intervention groups, and can be divided into 8-week
training and 4-week training in terms of time, and can be di-
vided into complete training and informal training in terms of
contents. Besides, it will control the group variables that might
affect intervention effects. It is expected that the 8-week com-
plete mindfulness training has the best intervention effect, and
mindfulness training with simplified time or simplified content
will weaken the intervention effects.
Recruitment advertisement had been put up in many univer-
sities in Beijing, and totally 156 people apply to participate in
the research, who had never contact mindfulness practice be-
fore. The followings were the standard for selecting the appli-
cants: first, the applicants stated that they needed emotions
adjustment and they were voluntary to actively participate in
activities, second, their scores in Beck Depression Inventory
should not be lower than 14 points. Besides, the applicants with
psychotic disorder, depression and bipolar disorder should be
excluded, and applicants with expression capability should be
excluded. With preliminary talk and scale screening, the scores
of 36 people in Beck Depression Inventory were lower than 14
points and they did not meet the selecting requirements; 6 peo-
ple chose to quit after preliminary understanding the interven-
tion modes, among which 5 people could not guarantee to par-
ticipate in the group activity every week and 1 person did not
want share information in the group. 19 people could not be
contacted with after application. Finally, 95 participants par-
ticipated in the research and sign the informed consent form.
Beck Depression Inventory II (BDI-II)
Beck Depression Inventory is one of the mostly widely-used
depression symptoms self-rating scales, which is used for de-
pression symptoms evaluation for both patients with various
illness and normal people. Byrne, Stewart and Lee (2004)
tested for the validity of a Chinese version of the BDI-II which
was used by some Hong Kong community (i.e., nonclinical)
adolescents. And also, Wang et al. (2011) assessed the reliabil-
ity and validity of the Chinese version of BDI-II with depressed
patients. BDI-II Chinese version includes 21 items and has
good reliability and validity, with Cronbach α coefficient of
0.94, correlation coefficient between different items of 0.18 -
0.71, correlation coefficient between different items and the
total score of BDI-II of 0.56 - 0.82, and retest correlation coef-
ficient is 0.55 (p < 0.05); the scores of BDI-II are positively
correlated with Hamilton Depression Scale (r = 0.67, p < 0.01)
(Wang et al., 2011). Therefore, it can be used as a self-rating
tool to evaluate the seriousness of depression symptoms. Each
item can be divided into four levels according to the seriousness
of symptoms with scores from 0 to 3, 0 = none, 1 = common, 2
= serious, 3 = severely serious. For example, 0 = I do not feel
sad; 1 = I feel sad; 2 = I am sad all the time and I can’t snap out
of it; 3 = I am so sad and unhappy that I can’t stand it. The total
of the scores of all items are called total score, when which is
between 0 to 4, it shows none or extremely slight depression;
when it is between 5 to 13, it is slight depression; when it is
between 14 to 20, it is moderate depression; when it is 21
points or is above 21 points, it is major depression.
Five Fact Mindfulness Questionnaire (FFMQ)
Five fact mindfulness questionnaire is compiled by Baer,
Smith, Hopkins, Krietemeyer and Toney (2006), they are 39
subjects and there are five items: observation items, describe
items, act with awareness items, nonjudge items and nonreact
items. The five fact mindfulness questionnaire is of good reli-
ability and validity and the Cronbach α of each sub-scale is:
0.83 for observe items, 0.91 for describe items, 0.87 for act
with awareness items, 0.87 for nonjudge items and 0.75 for
Five Fact Mindfulness Questionnaire (Chinese version) was
compiled by Deng and Liu in 2009, and the reliability for in-
ternal consistency of 5 items of the questionnaire: 0.746 for
observe items, 0.843 for describe items, 0.794 for act with
awareness item, 0.659 for nonjudge item and 0.448 for nonreact
item. Except for nonreact fact, the reliability of the other items
in Chinese specimen is over 0.65. The retest reliability of five
facts are between 0.436 to 0.741. In the verification fact analy-
sis in Chinese version, IFI, TLI and CFI have reached over 0.90,
Nn is close to 0.90, RMSEA is less than 0.08. In all, the reli-
ability and validity of Chinese version of FFMQ among univer-
sity students have reached psychometrics requirements (Deng,
Mindfulness Training Mode
The research adopted three mindfulness training modes: 8-
week complete mindfulness training, 8-week informal mind-
fulness training and 4-week mindfulness training. The training
content was mainly based on mindfulness cognitive therapy,
and the time and curriculum arrangement was adjusted in dif-
Copyright © 2013 SciRes.
Q. WU ET AL.
Copyright © 2013 SciRes. 11
ferent degrees. For 8-week complete mindfulness training, it
was group activity with 8-week intervention time, and all train-
ings in mindfulness cognitive therapy were conducted, and the
items were repeated for more than once inside the group; The
main differences between 8-week informal mindfulness training
and formal training were that, informal mindfulness training
emphasized practice in daily life mode and there was no formal
long-time mindfulness body scanning each day. 8-week infor-
mal mindfulness training was the group activity with interven-
tion time of 8 weeks, and all trainings in the mindfulness cogni-
tive therapy excepted body scanning are conducted, the group
repeated the items within the group for more than once; 4-week
complete mindfulness training had intervention time of 4 weeks,
and all trainings in mindfulness cognitive therapy were con-
ducted, all items only be practiced for once in the group and
refer to Figure 1 for specific curriculum arrangement.
95 subjects received test of Beck Depression Inventory and
Five Fact Mindfulness Questionnaire before entering the group,
and the test scores were taken as pretest scores before interven-
tion. There was no obvious difference between the pretest
scores among three groups before intervention. Through the use
of computers, 95 subjects were divided into three groups with
32 people, 32 people and 31 people respectively.
The three groups of subjects received three different mind-
fulness trainings respectively, and the interventions began in the
same week. The interventions were focused on group activities
which took place once every week with two hours each time.
Meanwhile, the subjects were required to complete homework
which cost about 30 minutes every day and which cost about 40
minutes for 4-week group. For the specific arrangement of each
activity, refer to Table 1. At the end of each curriculum, the
subjects would receive some reading materials and be arranged
the homework. The activity venue for the three groups was the
same fixed activity room with comfortable environment.
The mindfulness training for the three groups was instructed
by the same instructor, who was the author of the thesis. The
instructor had participated in Kabat-Zinn Mindfulness-based
Stress Reduction Workshop, grasped mindfulness training skills,
known the progress of mindfulness research and had practiced
mindfulness for one year. Training progress in each week was
supervised by a supervisor, who had been engaged in depres-
sion treatment for years and was doing relevant research in
mindfulness training. Besides, a research assistant was assigned
for each group.
After mindfulness training was over, the remaining subjects
in the three groups were respectively 16, 19 and 20 people, and
the dropout rates were 50%, 40.6% and 38.7% respectively, and
refer to Tabl e 2 for details. The remaining 55 subjects received
tests of Beck Depression Inventory and Five Fact Mindfulness
Questionnaire again which were taken as posttest scores. The
situations of the subjects during the intervention can be seen in
There is no missing data among the subjects. All data are
handled with by SPSS17.0 statistical software, and the total
Week 8-week complete mindfulness group 8-week informal mindfulness group 4-week mindfulness group
1 Introduction; Stretching; Body scan; Introduction; Stretching; Introduction; Stretching; Body scan;
The Raisin Exercise;
2 Body scan; Breathing meditation;
The Raisin Exercise;
The Raisin Exercise ;
Walking mindfully; Breath space;
3 Breathing meditation;
Walking mindfully; Stretching;
Walking mindfully; Stretching;
Sitting meditation-30’; Sharing the
links between mood and thoughts;
4 Walking mindfully; Sittingmeditation-15’;
Walking mindfully; Sitting meditation-15’;
Reading poetry; Recognizing relapse;
Suggestions; New start
Sharing the links between mood and thoughts;
Sitting meditation-30’; Sharing the links between
mood and thoughts; Breath space-coping;
6 Sitting meditation-40’; Reading poetry; Sitting meditation-40’; Reading poetry;
7 Body scan; Recognizing relapse; Suggestions Breathing meditation;
Recognizing relapse; Suggestions
8 Summary; New start Summary; New start
Contents of the three mindfulness training curriculums.
Descriptive statistics results of subjects.
N Male Female
Depression degree in
pretest M (SD)
rate M (SD)
status M (SD)
8-week complete group 16 6 10 21.64 (2.62) 22.00 (4.29) 6.50 (0.82) 3.35 (0.82)
8-week informal group 19 8 11 21.44 (1.63) 21.42 (5.46) 6.58 (0.90) 3.58 (0.87)
4-week group 20 8 12 22.43 (2.38) 20.10 (3.61) 3.80 (0.41) 3.16 (1.12)
In total 55 22 33 21.86 (2.23) 21.11 (4.50) 3.36 (0.95)
Q. WU ET AL.
number of the three groups of subjects for final analysis is 55.
Subject Ch a racteristic s
Among 55 subjects, there are 33 female subjects and 22 male
subjects with average age of 21.9 (SD = 2.23). The average
depression score of subjects in the pretest is 21.11 (SD = 4.50).
According to standard for evaluation of Beck Depression In-
ventory, the subjects are basically in the in-between position of
moderate depression and major depression. Refer to Table 2 for
During the intervention, the first two groups attended the ac-
tivity for 8 weeks, and the third group attended the activity for
4 weeks. In calculating the average time of each group of sub-
jects to attend the activity, 8-week complete group attended the
activity for 6.50 times on average, 8-week informal group at-
tended the activity for 6.58 times on average and 4-week group
attended the activity for 3.80 times on average.
For weekly homework, the subjects needed make a record
according to required format, then the instructor and assistant
graded it with 1 to 5 points according to the performance of the
homework of subjects, the higher the grade was, the better the
performance was. And the average grade evaluated by two
evaluators would be taken as the score for the homework. After
the group activity was over, we made a statistics of the comple-
tion status of homework, and calculated average score of each
group. The average score for 8-week complete group is 3.35,
the average score for 8-week informal group is 3.58 and the
average score for 4-week is 3.16. Refer to Table 1.
Outcome Analysi s: The D if f e renc es a m o ng Three
Use one-way ANOVA to compare the pretest scores of the three
groups of subjects. The results show that, there is no obvious
difference among the depression degrees of the three groups (F
(2, 52) = 0.86, p > 0.01), there is no obvious difference in the
scores of mindfulness (F (2, 52) = 0.30, p > 0.01), and there is
obvious difference in the scores for five items of mindfulness.
Refer to Table 2 for the results.
Use one-way ANOVA to compare the posttest scores of the
three groups of subjects. Results indicate that, the three groups
show great difference in scores of the four items of depression
(F (2, 52) = 0.01, p < 0.05), total score of mindfulness (F (2,
Talk and pretest exclusion (n = 61)
36 (23.1%) do not meet
requirements 19 (12.2%)
cannot be contacted with
6 (3.8%) give up participation
Random assignment (n = 95)
8-week complete group (n = 32) 8-week informal group (n = 32)4-week group (n = 31)
Dropout of subjects (n = 12)
Causes: no time/hard to
Participate in the activity for
less than 4 times (n = 4)
Dropout of subjects (n = 8)
Causes: no time/ hard to
Participate in the activity for less
than 4 times (n = 5)
Dropout of subjects (n = 9)
Causes: no time/ hard to
Participate in the activity for less
than 2 times (n = 2)
Complete intervention (n = 16) Complete intervention (n = 19)Complete intervention (n = 20)
and dropout of
Assessed for eligibility (n = 156)
The situations of the subjects during research process.
Comparison of pretest scores among the three groups the result of one-way ANOVA.
Group 1 Group 2 Group 3 Group 1 Group 2 Group 3
M SD M SD M SD F Sig.M SD M SD M SD F Sig.
Depression 22.00 4.29 21.425.46 20.10 3.61 0.860.435.81 4.694.95 2.86 10.60 7.76 5.75*0.01
Mindfulness 89.31 10.38 91.639.85 91.65 10.070.30 0.74110.3117.08117.219.86 102.10 13.10 6.19*0.00
Observe 25.00 4.90 23.424.72 25.55 5.16 0.960.3927.945.2328.213.17 26.55 4.78 0.780.47
Describe 18.94 3.96 21.846.21 20.05 3.86 1.630.2123.064.1425.893.51 22.10 4.68 4.340.02
awareness 12.56 4.95 15.683.46 13.70 5.22 2.090.1318.81 5.4322.684.20 16.85 5.36 6.77*0.00
Nonjudge 13.25 4.09 11.424.13 12.20 3.64 0.940.4017.694.7617.895.57 16.30 2.83 0.720.49
Nonreact 19.56 3.35 19.264.47 20.15 3.33 0.280.7622.813.3922.533.96 20.30 3.56 2.670.08
Note: *The mean difference is significant at the 0.05 level. Group 1: 8-week complete group (n = 16); Group 2: 8-week informal group (n = 19); Group 3: 4-week group (n
Copyright © 2013 SciRes.
Q. WU ET AL.
52) = 0.00, p < 0.05), describe (F (2, 52) = 0.02, p < 0.05), act
with awareness (F (2, 52) = 0.00, p < 0.05).The depression
score of 4-week group is the highest among the three groups,
whole the total score of mindfulness of 4-week group is the
lowest among the three groups. Refer to Table 2 for results.
Use LSD post hoc suggestions to further compare posttest
score difference of the three groups on the above 4 items. For
the depression score, the score of 8-week formal group is obvi-
ously lower than that of 4-week group, p < 0.01; 8-week com-
plete group is obviously lower than 4-week group, p < 0.05. For
total score of mindfulness, the score of 8-week informal group
is obviously higher than that of 4-week group, p < 0.01. In the
describe item, the score of 8-week informal group is obviously
than that of 8-week formal group and 4-week group, p < 0.05.
For the act with awareness, the score of 8-week informal group
is obviously higher than that of 8-week complete group, p <
0.05; the score of 8-week informal group is obviously higher
than that of 4-week group, p < 0.01.
Outcome Analysis: The Effect of the In t ervention
Use paired sample T test to respectively compare the differ-
ences of pretest and posttest scores of the three groups, and
refer to Ta b l e 3 for results. Results show that, the average de-
pression score of the three groups have obviously decreased (t
(15) = 14.05, p < 0.01; t (18) = 12.09, p < 0.01; t (19) = 5.96, p
< 0.01). It can been seen from Figure 3, the depression score of
8-week complete group has dropped to 5.81 points in posttest
score from 22 points in pretest score, with score decreasing rate
of 73.6%; the depression score of 8-week informal group has
dropped to 4.95 points in posttest score from 22.42 points in
pretest score, with score decreasing rate of 76.9%; the depres-
sion score of 4-week group has dropped to 10.60 points in
posttest score from 20.10 points in pretest score, with score
decreasing rate of 47.3%. Refer to Figure 3 for results.
The total scores of mindfulness of the three groups have been
obviously increased (t (15) = −4.68, p < 0.01; t (18) = −8.26, p
< 0.01; t (19) = −3.33, p < 0.01). From the column chart of total
score of mindfulness, the score of 8-week complete group has
increased to 110.31 points in posttest from 89.31 points in pre-
test, with an score increasing rate of 19.03%; the score of
8-week informal group has increased to 117.21 points in the
posttest from 91.63 points in the pretest, with score increasing
rate of 21.82%; the score of 4-week group has increased to
102.10 points in posttest from 91.65 points in pretest, with
score increasing rate of 10.23%. Refer to Figure 4 for results.
However, the differences of the three groups in different
items of the mindfulness are inconsistent. Among which, 8-
week complete group has obvious improvements after interven-
tion in scores of all the five items of observe (t (15) = −2.46, p
< 0.01), describe (t (15) = −3.39, p < 0.01), act with awareness
(t (15)= −6.19, p < 0.01), nonjudge (t (15) = −2.88, p < 0.05)
and nonreact (t (15) = −3.18, p < 0.05). 8-week informal group
also has obvious improvement in the scores of the five items,
Change of depression scores of the three groups before and after inter-
Change of total scores of mindfulness of the three groups before and
T test results of pretest and posttest scores in different items.
8-week complete group 8-week informal group 4-week group
Pretest Posttest Pretest Posttest Pretest Posttest
M SD M SD t. M SD M SDt. M SD M SDt
Depresson 22 4.29 5.81 4.69 14.05** 21.425.46 4.95 2.86 12.09** 20.1 3.61 10.6 7.765.96**
Mindfulness 89.31 10.38110.31 17.08 −4.68**91.63 9.85 117.2 9.86−8.26** 91.65 10.07 102.1 13.1−3.33**
Observe 25 4.9 27.94 5.23 −2.46**23.42 4.72 28.21 3.17−4.85** 25.55 5.16 26.55 4.78−0.87**
Describe 18.94 3.96 23.06 4.14 −3.39** 21.84 6.21 25.89 3.51−3.22** 20.05 3.86 22.1 4.68−2.26**
Act with awareness 12.56 4.95 18.81 5.43 −6.19**15.683.4622.684.2 −7.74** 13.7 5.22 16.85 5.36−4.01**
Nonjudge 13.25 4.09 17.69 4.76 −2.88* 11.424.1317.895.57−5.51** 12.2 3.64 16.3 2.83−4.05**
Nonreact 19.56 3.35 22.81 3.39 −3.17* 19.264.4722.533.96−3.70**20.15 3.33 20.3 3.56−0.19**
Note: *The mean difference is significant at the 0.05 level. **The mean difference is significant at the 0.01 level.
Copyright © 2013 SciRes. 13
Q. WU ET AL.
with (t (18) = −4.85, p < 0.01; t (18) = −3.22, p < 0.01; t (18) =
−7.74, p < 0.01; t (18) = −5.51, p < 0.01; t (18) = −3.70, p <
0.01). While 4-week group only has obvious improvement in
the scores of the three items of describe (t (19) = −2.26, p <
0.05), act with awareness (t (19) = −4.01, p < 0.01) and non-
judge (t (19) = −4.05, p < 0.01), but the 4-week group has no
obvious improvement in score of the two items of observe (t
(19) = −0.87, p > 0.05) and nonreact ( t (19) = −0.19, p > 0.05).
The Intervention Effects on Depression
Though the time and contents arrangement of the three mind-
fulness trainings in the research are different, they have obvi-
ously reduce the depression degrees of the subjects, which can
be seen from data in Table 3 and Figure 3. The decrease of de-
pression scores verifies the effectiveness of mindfulness train-
ing in the research on one hand, and it also verifies the research
conclusions of using mindfulness cognitive therapy to intervene
depressed patients before on the other hand.
To specifically compare the differences among the three
groups, the score decrease rate of the 4-week group on depres-
sion score (47.3%) is the least in comparison with 8-week com-
plete group (73.6%) and 8-week informal group (76.9%) (Fig-
ure 3), and although 4-week group also has obvious interven-
tion effects, it still lacks behind 8-week complete group and
8-week informal group (p < 0.05). In the mindfulness cognitive
therapy, mindfulness training helps the subjects to know the
relationship between their own thoughts and emotions, and
helps subjects to objectively observe and regard their own
thoughts from another point of view. The practice time for both
8-week complete group and 8-week informal group is 8 weeks
while the practice time for 4-week group is 4 weeks, which
indicates that the practice time plays an important role in mind-
fulness cognitive therapy. Although short-time mindfulness train-
ing can reduce the depression level, but its effect is not so ob-
vious as long-time mindfulness training. In mindfulness train-
ing, the subjects need to learn to observe themselves from an-
other perspective without falling into automatic thoughts. Such
transformation of thinking habit needs a certain period of prac-
ticing time as foundation indeed.
Meanwhile, the difference between 8-week complete group
and 8-week informal group is not obvious (p > 0.05), which
reminds researchers that for the intervention of mindfulness
training on depression, body scanning may not be necessary.
The body scanning practice focuses on training the awareness
on body parts, but the depressed individuals generally are very
sensitive to the awareness of their own state. In 8-week infor-
mal group, the subjects do not practice body scanning, but they
practice using mindfulness in daily life, such as mindfulness
walking, mindfulness working and so on, and the depression
degree of subjects in 8-week informal group has also been ob-
viously reduced, so it can been seen that informal mindfulness
practice may replace body scanning practice in 8-week formal
mindfulness practice. This provides a very good training mode
for individuals who do not have time or have no ability to prac-
tice formal mindfulness training, which will enable them to
know mindfulness thought in daily life and use it in their life,
so that they can effectively adjust their emotional state.
In the variance of scores in mindfulness scale (see Ta b le 3 ),
the results show that, the subjects in the three groups all have
obvious improvement only in the posttest score of nonjudge
item, and there is no difference among the three groups (see
Table 2), while the three groups have some difference in the
other 4 items in some aspects. The results show that, the key for
mindfulness cognitive therapy to treat depression symptoms is
to train and cultivate “nonjudge” thinking mode of the subjects,
while other training modes such as the training of body scan-
ning on awareness might only assist in treating depression. Of
course, the difference may also be caused by the difference
among the subjects of the groups, and more research is needed
to come into definite conclusions.
The Effects of Training Time on Mindfulness Level
From the perspective of training time, the research can be di-
vided into two training modes, one of which is 8-week mind-
fulness training (8-week complete group and 8-week informal
group), and the other of which is 4-week mindfulness training
(4-week group). The difference between 8-week mindfulness
training and 4-week mindful training lies in that, in 8-week
group, subjects need to participate in group activity for 8 times
and need to complete 8-week homework, that is, the subjects'
learning time in the group and practice time after class of 8-
week group is twice of that of 4-week group. The research also
finds that, different training modes have different effects on five
items of mindfulness. After 8-week mindfulness training in
8-week complete group and 8-week informal group, the sub-
jects have obvious improvement on the scores of five items of
mindfulness (Table 3). After 4-week mindfulness training in the
4-week group, scores of 3 items out of the 5 items have been
obviously improved, while the scores of observe item (t (19) =
−0.87, p > 0.05) and nonreact item (t (19) = −0.19, p > 0.05)
improve to a certain extent after intervention, but they have no
obvious improvement (see Ta b l e 3 ). In some extent, the effect
of duration on the intervention can be explained by the two
First, the establishment of new thinking mode “being” needs
to conquer the original response mode “doing”, which is the
most difficult to conquer in all practices, and the main way to
solve it is by large quantity of practice. However, due to time
constraints, practice times were greatly reduced, and this is
adverse to establish a new thinking mode.
The 4-week group began to practice meditation in the third
week, which would be practiced once in the group and would
be practiced for two weeks after training with 14 practice times
in total. While the 8-week complete group and 8-week informal
group began to practice meditation in the fifth week, which
would be practiced once each for 15 minutes, 30 minutes and
40 minutes, and which would be practiced for 4 weeks after
training, with 28 practice times in total. So, the insufficiency of
practice times might be the main reason for the unobvious im-
provement on the two items of observe and non-react in 4-week
Second, as the hurried practice, subjects more easily took
mindfulness practice as coping strategies for dealing with bad
emotions, while they used less time and energy to explore the
deep meaning of mindfulness. This caused subjects usually
encountered more obstacles in the practice, and it might impair
the subjects’ enthusiasm for keeping practice. For example, in
the sharing stage of the third group activity, group member No.
307 came up with that, the activity progressed too fast, espe-
cially that the breathing space practice was difficult to com-
mand in one time; group member No. 319 pointed out that he
Copyright © 2013 SciRes.
Q. WU ET AL.
couldn’t distinguish the difference between body scanning and
meditation, both of which seemed to pay attention to body’s
feelings; Besides, many group members asked the significance
of the practice which focused on observation without response.
For subjects of 8-week complete group and 8-week informal
group, they only come into contact with one to two new activi-
ties each time with slower course rhythm and sufficient practice
time after class. Compared with 4-week group, these subjects
have mastered each practice better, have deeper understanding
of mindfulness, and in the latter half period of the course, most
group members are willing to share their understanding in the
mindfulness training instead of asking the purpose and signifi-
cance of the practice.
The Effects o f Traini ng Content s on Mindf u l ne s s
The three groups have different contents arrangement in
mindfulness training, both 8-week complete group and 4-week
group practice all mindfulness contents, while 8-week informal
group does not practice body scanning and it focuses on prac-
tice mindfulness in daily life; Besides, 4-week group only prac-
tices each item for once during the activity, while 8-week com-
plete group practices each item at least twice during the activity.
The mindfulness levels of the three groups are all improved
obviously, but the difference of training contents affects the
scores of mindfulness items in various degrees.
For the item of act with awareness, there is no obvious dif-
ference among the pretest scores of the three groups, but there
is obvious difference among the posttest scores of the three
groups (F (2, 52) = 6.77, p < 0.01 see Ta b l e 2 ). 8-week infor-
mal group improves the most in posttest scores, and the differ-
ence among posttest scores of 8-week informal group, 8-week
complete group and 4-week group is obvious. Therefore, we
pay attention to particular characteristics of the training in 8-
week informal group. As informal training group, 8-week in-
formal group lay stress on practicing mindfulness in daily life
by informal training mode, such as brushing teeth with aware-
ness, having meals with awareness, walking with awareness
and washing clothes with awareness, so as to cultivate aware-
ness towards life. When the subjects of 8-week complete group
and 4-week group finish their homework of body scanning in
the first two weeks, 8-week informal group has begun to try
using mindfulness in life, which is exactly the training directed
towards act with awareness. Researchers consider that, the uni-
queness in training contents is the main factor that causes the
obvious difference between 8-week informal group and 8-week
complete group as well as 4-week group in the item of act with
In addition, 8-week informal group does not practice body
scanning that is formal practice and takes longer time, which
also brings one corresponding advantage that subjects of 8-
week informal group has more sufficient time in other activities
in the group and the discussion and sharing between members
are more sufficient. The effects that the difference brings are
reflected in that, there is obvious difference between the de-
scribe item of 8-week informal group and that of 8-week com-
plete group and 4-week group, and the score of describe item of
8-week informal group with sufficient group discussion time is
obviously higher than that of 4-week group with compact con-
tents arrangement and less discussion time (p < 0.05). The de-
scribe item lies in whether the group members are able to
clearly express their thoughts and feelings, the improvement of
which is inseparable from mindfulness training on the subjects’
awareness and perception as well as group sharing and discus-
sion. Especially for depressed individuals, this is particularly
The main form of mindfulness training is group activity,
which is similar to group counseling, so the group dynamics
will have effects on subjects in no doubt. The mindfulness
group in the research is composed of depressed university stu-
dents. The depressed individuals generally have very fixed
thinking model, and their description is monotonous and ap-
praisive, and they will frequently associate with their drawback
and shortcomings and thus have the thought of helplessness and
desperation (such as Bjarehed, Sarkohi, & Andersson, 2010).
Negative thinking mode will repeat again and again and will
seriously affect the emotions and life of de-pressed patients.
However, in group sharing, these university students with strong
learning ability and introspection ability will hear different
opinions and different experience from others and learn other
information that is different from their own. For example, in the
sharing period after walking meditation, under the encourage-
ment and guidance of the instructor, different subjects share
their different experience: some feel swaying of their legs,
some have the feelings that are close to cramps, some find that
they are luckier than the disabled, and some think of their hur-
ried walking appearance in normal times. Group discussion will
change their original fixed and rigid thinking mode, and after
subjects receive and reflect upon these differences, their think-
ing will thus be more broad and flexible, which is the effects of
mindfulness training or a key factor of treating the depressed
patients. What is more important, these changes are perceived
by the subjects from other subjects and are not from the stereo-
type indoctrination of the instructor, which is good for the
maintenance of the changes.
In Grou p Activity Design, th e Rela tion
between Subjects Dropout Rate, Subjects
Attendance Rate, Homework Completion
Status and Intervention Effects
The research also makes statistics of subjects’ attendance of
group activity and assignment completion situation each week.
The results show that, the average attendance rates of the three
groups are 6.50 times, 6.58 times and 3.80 times respectively
(see Tab le 1 ). The subjects in 4-week group almost attend all
the four group activities with the highest attendance rate among
the three groups. However, the statistical analysis excludes 4
subjects with lower attendance times in the groups, so the re-
sults may not be very accurate. However, combined with the
subjects dropout rate in the three groups (50%, 40.6% and
37.5%) and the subjective perception of the instructor, the
4-week group activity design is better for the subjects to attend
group activities, better for the subjects to properly learn all
contents of mindfulness training in group activity, and better for
ensuring the completeness of the group dynamics.
When the activity is designed to be 8 weeks, because the
overall training time is too long, the subjects are easily to get
weary and may fail to attend the activities due to temporary
emergency in the medium term. For example, some subject left
the group because he needed to go out for a period of time in
8-week informal group, and in 8-week complete group, some
subject failed to attend the group activity twice in succession.
Copyright © 2013 SciRes. 15
Q. WU ET AL.
Absence from group activities, especially absence from the ac-
tivities twice in succession, will seriously affect consistency of
practice. When subjects participate in the activities again, it is
difficult for them to make up the missing parts, it will hinder
learning and understanding the subsequent learning contents,
and will further affect the overall intervention effects of mind-
Besides attending group activity, subjects’ homework com-
pletion status also has important effects on intervention results.
Compared with the homework completion status, the results
show that homework completion status in 4-week group is the
worst (M = 3.16, SD = 1.62), and homework completion status
in 8-week informal group is the best among the three groups (M
= 3.58, SD = 0.87). The difference of homework completion
status is also reflected in the difference of contents arrangement
and homework arrangement: 4-week group has more course
contents arranged and has more homework, and large amount
of homework and insufficient course practice affects the home-
work completion status of subjects. For homework of 8-week
informal group, there is no practice for body scanning and there
is more informal practice which is easier to be operated, so the
homework completion quality of 8-week informal group is gua-
ranteed. This is one of the reasons for different intervention ef-
fects of the three groups.
Conclusions and Prospects
All the three different mindfulness training modes in the re-
search have obvious intervention effects on depression, and the
intervention effects of 8-week training are better than those of
4-week training. Different mindfulness training modes will
have significant impact on the improvement of mindfulness
level, for instance, informal training mode is good for enhanc-
ing the item of “act with awareness”, compared with short-term
training mode, long-term training mode is better in improving
the two items “observe” and “nonreact”, and sufficient discus-
sion and practice within the group is good for improving the
“describe” item of the subjects. Meanwhile, different group ac-
tivity design is relevant to subject dropout rate, attendance rate,
homework completion status and intervention effects.
This study is beneficial for seeking the optimized mindful-
ness training mode (which is time saving, easy and effective).
And it may perfect the operation standard of mindfulness train-
ing, especially for the non-clinical groups. At present, many
reports in this field are still about completing mindfulness train-
ing modes, so it needs further research on the comparison be-
tween the formal training and informal training. This study also
helps to distinguish the mechanism of the specific training con-
tent, thus it will help the mentor guide more accurately and
specifically. For example, “body scan” may be guided with the
purpose of “observation” and “nonreact”. Future research can
be combined with cognitive neuroscience method to determine
the mechanism, and measure the effect with some fixed inter-
Subject dropout is one of the limitations in this study. As we
think, here may be two following reasons: firstly, the subjects
are university students whose depressed symptoms are not as
serious as the clinical patients, secondly, this intervention didn’t
submit any money or give credits to these subjects. So their
motivation might be lower than the clinical groups, which
might give rise to the number of subject dropout. The high
dropout rate might suggest the mindfulness training was not as
valid as the study argued. In future studies, psychotherapists
should consider some better ways to solve this problem. In
addition, the depression was only measured in a single way.
Beck Depression Inventory-II is a self-report inventory, like all
questionnaires, the scores can be easily exaggerated or mini-
mized by the subjects. And it cannot be used in clinical diagno-
sis. If the study could use the modes with other measurement
tools and analysis combining multiple scale data, such as
HAMD and SDS, the results would be more persuasive.
Alberts, H. J. E. M., & Thewissen, R. (2011). The effect of a brief
mindfulness intervention on memory for positively and negatively
valenced stimuli. Mindfulness, 2, 73-77.
Anna, M. T., Yvonne, M. C., & Catherine, R. (2004). Mindfulness-
based stress reduction in women with breast cancer. Families, Sys-
tems & Health, 22, 193-203. doi:10.1037/1091-75126.96.36.199
Baer, R. A. (2006). Mindfulness training as a clinical intervention: A
conceptual and empirical review. Clinical Psychology: Science and
Practice, 10, 125-143. doi:10.1093/clipsy.bpg015
Biegel, G. M., Brown, K. W., Shapiro, S. L., & Schubert, C. M. (2009).
Mindfulness-based stress reduction for the treatment of adolescent
psychiatric outpatients: A randomized clinical trial. Journal of Con-
sulting and Clinical Psychology, 77, 855-866. doi:10.1037/a0016241
Bjarehed, J., Sarkohi, A., & Andersson, G. (2010). Less positive or
more negative? Future-directed thinking in mild to moderate depress-
sion. Cognitive Behaviour Therapy, 39, 37-45.
Brotto, L. A., Seal, B. N., & Rellini, A. (2012). Pilot study of a brief
cognitive behavioral versus mindful-ness-based intervention for
women with sexual distress and a history of childhood sexual abuse.
Journal of Sex & Marital Therapy, 38, 1-27.
Byrne, B. M., Stewart, S. M., & Lee, P. W. H.(2004).Validating the
beck depression inventory-II for Hong Kong Community Adoles-
cents. International Journal of Testing, 4, 199-216.
Chambers, R., Lo, B. C., Yee, & Allen, N. B. (2008). The impact of
intensive mindfulness training on attentional control, cognitive style,
and affect. Cognitive Therapy and Research, 32, 303-322.
Daubenmier, J., Kristeller, J., Hecht, F. M., Maninger, N., Kuwata, M.,
Jhaveri, K. et al. (2011). Mindfulness intervention for stress eating to
reduce cortisol and abdominal fat among overweight and obese wo-
men: An exploratory randomized controlled study. Journal of Obe-
sity, 6, 19-36.
Deng, Y. Q. (2009). Effects of mindfulness on the mental health level in
the university students. Thesis, Beijing: Capital Normal University.
Deng, Y. Q., Liu, X. H., Rodriguez, M. A., & Xia, C.-Y. (2011). The
five facet mindfulness questionnaire: Psychometric properties of the
Chinese version. Mindfulness, 2, 123-128.
Hoelzel, B. K., Carmody, J., Evans, K. C., Hoge, E. A., Dusek, J. A.,
Morgan, L. et al. (2010). Stress reduction correlates with structural
changes in the amygdala. Social Cognitive and Affective Neurosci-
ence, 5, 11-17. doi:10.1093/scan/nsp034
Joanne, C. K., Susan, D., Wiley, T. C., Debra, M. B., & Shauna, S.
(2004). The effects of mindfulness-based stress reduction on nurse
stress and burnout—A quantitative and qualitative study. Holistic
Nursing Practice, 18, 302-308.
Joanne, C. K., Susan, D., Wiley, T. C., Debra, M. B., & Shauna, S.
(2005a). The effects of mindfulness-based stress reduction on nurse
stress and burnout—A quantitative and qualitative study, part II. Ho-
listic Nursing Practice, 19, 26-35.
Joanne, C. K., Susan, D., Wiley, T. C., Debra, M. B., & Shauna, S.
(2005b). The effects of mindfulness-based stress reduction on nurse
Copyright © 2013 SciRes.
Q. WU ET AL.
Copyright © 2013 SciRes. 17
stress and burnout—A quantitative and qualitative study, part III.
Holistic Nursing Practice, 19, 78-86.
Kabat-Zinn, J. (1994). Wherever you go, there you are: Mindfulness
meditation in everyday life. New York: Hyperion
Lutz, A., Slagter, H. A., Dunne, J. D., & Davidson, R. J. (2008). Atten-
tion regulation and monitoring in meditation. Trends in Cognitive
Sciences, 12, 163-169. doi:10.1016/j.tics.2008.01.005
Marchand, W. R. (2012). Self-referential thinking, suicide, and function
of the cortical midline structures and striatum in mood disorders:
Possible implications for treatment studies of mindfulness-based in-
terventions for bipolar depression. Depression Research and Treat-
ment, 2, 1-16. doi:10.1155/2012/246725
Ma, S. H., & Teasdale, J. D. (2004). Mindfulness-based cognitive ther-
apy for depression: Replication and exploration of differential re-
lapse prevention effects. Journal of Consulting and Clinical Psy-
chology, 72, 31-40. doi:10.1037/0022-006X.72.1.31
Ortner, C. N. M., Kilner, S. J., & Zelazo, P. D. (2007). Mindfulness
meditation and reduced emotional interference on a cognitive task.
Motivation and Emotion, 31, 271-283.
Rood, L., Roelofs, J., Bogels, S. M., & Alloy, L. B. (2010). Dimensions
of negative thinking and the relations with symptoms of depression
and anxiety in children and adolescents. Cognitive Therapy and Re-
search, 34, 333-342. doi:10.1007/s10608-009-9261-y
Semple, R. J. (2010). Does mindfulness meditation enhance attention?
A randomized controlled trial. Mindfulness, 1, 121-130.
Shaw, S. (2006). Buddhist meditation: An anthology of texts from the
Pāli Canon. London and New York: Routledge, 17, 76.
Shi, Z. Y. (2011). Effects of mindfulness training on the anxiety in
university students. Science of Social Psychology, 26, 211-213.
Tang, Y. Y., Ma, Y. H., Wang, J. H., Fan, Y. X. et al. (2007). Short-
term meditation training improves attention and self-regulation. Pro-
ceedings of the National Academy of Sciences, 104, 17152-17156.
Teasdale, J. D., Segal, Z. V., Williams, J. M. G., Ridgeway, V. A.,
Soulsby, J. M., & Lau, M. A. (2000). Prevention of relapse/recur-
rence in major depression by mindfulness-based cognitive therapy.
Journal of Consulting and Clinical Psychology, 68, 615-623.
Tan, J. W., & Wu, H. M. (2009). Mindfulness training in psychological
counseling and psychotherapy. Journal of Mudanjiang College of
Wang, Z., Yuan, C. M., Huang, J., Li, Z. Z., Chen, J., Zhang, H. Y.,
Fang, Y. R., & Xiao, Z. P.(2011). Reliability and validity of the Chi-
nese version of Beck Depression Inventory-II among depression pa-
tients. Chinese Mental Health Journal, 25, 476-480.
Williams, J. M., Danielle S. D., Catherine C., Melanie J. V., & Fennell
(2006). Mindfulness-based cognitive therapy for prevention of re-
currence of suicidal behavior. Journal of Clinical Psychology, 62,
Williams, J. M. (2008). Mindfulness, depression and modes of mind.
Cognitive Therapy and Research, 32, 721-733.
Zangi, H. A., Mowinckel, P., Finset, A., Eriksson, L. R., Hoystad, T. O.,
Lunde, A. K. et al. (2012). A mindful-ness-based group intervention
to reduce psychological distress and fatigue in patients with inflam-
matory rheumatic joint diseases: A randomised controlled trial. An-
nals of the Rheumatic Diseases, 71, 911-917.
Zautra, A. J., Davis, M. C., Reich, J. W., Nicassario, P., Tennen, H.,
Finan, P. et al. (2008). Comparison of cogni-tive behavioral and
mindfulness meditation interventions on adaptation to rheumatoid
arthritis for patients with and without history of recurrent depression.
Journal of Consulting and Clinical Psychology, 76, 408-421.
Zeidan, F., Johnson, S. K., Diamond, B. J., David, Z., & Goolkasian, P.
(2010). Mindfulness meditation improves cognition: Evidence of
brief mental training. Consciousness and Cognition: An International
Journal, 19, 597-605. doi:10.1016/j.concog.2010.03.014
Zindel, V. S, Williams, J. M. G., & Teasdale, J. D. (2008). Mindful-
ness-based cognitive therapy for depression. New York: The Guil-
ford Publications, 120-125.