Background Mindfulness-based interventions are increasingly being implemented worldwide for problems with depression and anxiety, and they have shown evidence of efficacy. However, few studies have examined the effects of a mindfulness-based group therapy based on standard programs for depression and anxiety until follow-up in Japan. This study addresses that gap. Furthermore, this study explored the mechanisms of action, focusing on mindfulness, mind wandering, self-compassion, and the behavioral inhibition and behavioral activation systems (BIS/BAS) as possible mediators. Methods We examined 16 people who suffered from depression and/or anxiety in an 8-week mindfulness group therapy. Measurements were conducted using questionnaires on depression and trait-anxiety (outcome variables), mindfulness, mind wandering, self-compassion, and the BIS/BAS (process variables) at pre- and post-intervention and 2-month follow-up. Changes in the outcome and process variables were tested, and the correlations among the changes in those variables were explored. Results Depression and anxiety decreased significantly, with moderate to large effect sizes, from pre- to post-intervention and follow-up. In process variables, the observing and nonreactivity facets of mindfulness significantly increased from pre- to post-intervention and follow-up. The nonjudging facet of mindfulness and self-compassion significantly increased from pre-intervention to follow-up. Other facets of mindfulness, mind wandering, and the BIS/BAS did not significantly change. Improvements in some facets of mindfulness and self-compassion and reductions in BIS were significantly correlated with decreases in depression and anxiety. Conclusions An 8-week mindfulness group therapy program may be effective for people suffering from depression and anxiety in Japan. Mindfulness and self-compassion may be important mediators of the effects of the mindfulness group therapy. Future studies should confirm these findings by using a control group. Trial registration University Hospital Medical Information Network (UMIN CTR) UMIN000022966. Registered July 1, 2016, https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000026425

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The mechanisms of efficacy in mindfulness-based interventions for depression and anxiety are not fully understood. To clarify these mechanisms, we tested the hypotheses that mind-wandering, daydreaming, cognitive fusion, and experiential avoidance will decrease through mindfulness group therapy, and this decrease will correlate with improvements in depression and anxiety. Participants self-reported depression and/or anxiety (N = 28) took part in an 8-week mindfulness group therapy program. They were assessed using self-report scales at pre- and post-intervention, and at 2-month follow-up. Results indicated that depression and trait-anxiety decreased between pre- and post-intervention with moderate effect sizes, which were maintained at follow-up. Mind-wandering and cognitive fusion also decreased between pre- and post-intervention with small to moderate effect sizes, and maintained at follow-up. The decreases in mind-wandering and cognitive fusion moderately correlated with improvements in depression and anxiety, suggesting that decreases in mind-wandering and cognitive fusion might underlie efficacious mechanisms of mindfulness group therapy.

Self-compassion is regarded as a mediating or moderating variable in mindfulness-based interventions (MBI). However, few studies have investigated the role of self-compassion on MBI. Therefore, we conducted a randomized controlled trial to examine whether (1) MBI decreases depression and trait anxiety, while increasing trait mindfulness, trait self-compassion, self-compassionate behaviors (SC behaviors), and behaviors, along with improving mood; and (2) SC behaviors moderate the effect of mindful behaviors on mood in daily life. Participants were patients with depression and/or anxiety ( N=19) in Japan. Of the 27 participants recruited, 19 participated in the study. Using stratified randomization, we allocated 10 participants to the intervention group, with an 8-week standard MBI, and nine to the waitlist control group. Depression, trait anxiety, trait mindfulness, and trait self-compassion were assessed using questionnaires, while SC behaviors, mindful behaviors, and mood were measured using an ecological momentary assessment—a method used to repeatedly record events and behaviors in daily life. The results revealed that depression, trait anxiety, trait mindfulness, and trait self-compassion did not significantly change. However, SC behaviors, mindful behaviors, and mood significantly improved with MBI. Moreover, the interaction between SC behaviors and mindful behaviors was significantly shown in the pre-intervention, suggesting that SC behaviors moderate the effect of mindful behaviors on mood in daily life.

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