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Studies of mood provocation in remitted patients with depression have enabled the description of specific brain changes relevant to depression relapse vulnerability. Because patients in these studies were also receiving maintenance pharmacotherapy, the ability to subtract out the drug effect from the changes observed is reduced. Our study addresses this concern. Changes in regional cerebral blood flow (rCBF) among 11 medication-free, remitted patients with unipolar depression relative to baseline state were assessed with [(15)O]H(2)O positron emission tomography (PET) following provocation of sadness. Participants showed decreased activation in prefrontal cortex similar to those reported for remitted, medicated patients undergoing mood challenge, as well as for acutely depressed patients who were medication free. Previously reported mediofrontal changes in remitted patients are unlikely to be a consequence of maintenance medication and more likely are evidence of relapse vulnerability. [ABSTRACT FROM AUTHOR]

The development of the Mindfulness-Based Cognitive Therapy Adherence Scale (MBCT-AS) is described. This 17-item scale measures therapist adherence to the treatment protocol for Mindfulness-Based Cognitive Therapy (MBCT), a treatment for the prevention of recurrence in Major Depressive Disorder. The MBCT-AS assesses therapist behaviours specific to (MBCT) as well as therapy practices that MBCT shares with Cognitive Behaviour Therapy (CBT). To determine the utility of this scale, we compared delivery of group MBCT against group CBT, with independent ratings of taped sessions provided to measure adherence to MBCT and CBT for therapists in both groups. The results showed that: (a) raters can reliably use the MBCT-AS; (b) MBCT therapists demonstrated adherence to the treatment protocol, as measured by the MBCT-AS; and (c) MBCT is distinguishable from CBT on both the MBCT-AS and a scale measuring adherence to CBT (CBT-AS). These findings indicate that the MBCT-AS may be a useful tool for ensuring the proper delivery of MBCT in future research, and may be helpful in determining the elements of MBCT that are unique to that treatment. Copyright © 2002 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]