There are limitations of the literature regarding the effectiveness of mindfulness.
For example, some authors have pointed out (Chiesa & Malinowski, 2011 ; Chiesa
& Serretti 2010a ) that some studies have substantial methodological limitations. Of these, perhaps the most signifi cant criticism concerns the lack of high- quality, ran-domized controlled studies (Chiesa & Malinowski, 2011 ). Other limitations include absence of follow-up measures as well as small sample size, reliance on self-report instruments, and a variety of differences across interventions (Chiesa & Malinowski, 2011 ; Fjorback, Arendt, Ornbol, Fink, & Walach, 2011 ).
In regard to the two most studied interventions, MBSR and MBCT, there is con-siderable evidence of benefi t for depression and other psychiatric conditions. As reviewed elsewhere (Marchand, 2012 ), studies indicate effectiveness of MBSR for depressive and anxiety symptoms. For MBCT, the strongest evidence is for relapse prevention in unipolar illness (Bondolfi et al., 2010 ; Chiesa & Serretti, 2010a ; Godfrin & van Heeringen, 2010a , 2010b ; Kuyken et al., 2008 ; Manicavasgar, Parker, & Perich, 2010 ; Mathew, Whitford, Kenny, & Denson, 2010 ; Piet &
Hougaard, 2011 ; Segal et al., 2010 ) particularly among those with three or more prior episodes. Furthermore, MBCT offers protection against relapse equal to that of maintenance antidepressant pharmacotherapy (Marchand, 2012 ; Segal et al., 2010 ). Evidence also suggests effi cacy for those experiencing a current episode as well as for those in remission (Finucane & Mercer, 2006 ; van Aalderen et al., 2011 ), and one study indicates that MBCT is as effective as CBT in the treatment of current depression (Manicavasgar, Parker, & Perich, 2011 ).
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Conclusions
Mindfulness is practiced with the objective of maintaining attention in the present moment rather than allowing thought patterns and emotional responses to be carried away by automatic thought processes (autopilot/SIT). Mindfulness is based upon Buddhist practices aimed at the reduction of suffering. Secular mindfulness inter-ventions attempt to relieve suffering associated with psychiatric conditions, stress, and physical illness. The foundation of a mindfulness practice is meditation. By practicing mindfulness meditation, one may develop the skill of decreasing autopi-lot/SIT thought patterns, which contribute to depressive symptoms.
The main psychological mechanism of mindfulness is known as reperceiving, which is a perspective shift such that one sees thoughts and emotions as passing and frequently insignifi cant phenomena rather than as representing fact. This shift causes thought patterns associated with depressive symptoms to lose power. Thus, one is able to break the repetitive autopilot/SIT cycle of pessimistic thoughts lead-ing to dysphoria, leadlead-ing to more negative thoughts, resultlead-ing in more negative affect and so on.
Neuroimaging studies indicate that mindfulness induces neuroplasticity such that the brain is more likely to engage in moment-by-moment awareness than DMN- mediated autopilot/SIT.
Finally, compelling evidence indicates that two secular mindfulness-based inter-ventions, MBSR and MBCT, have antidepressant benefi ts. Very strong evidence sup-ports the use of MBCT as an adjunctive intervention for depressive spectrum illness.
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