Thorsten Barnhofer

Professor Thorsten Barnhofer

Professor of Clinical Psychology
+44 (0)1483 686485



Research interests

Research projects



Bernstein, A., Vago, D. R., & Barnhofer, T. (2019). Understanding mindfulness, one moment at a time: an introduction to the special issue. Current Opinion in Psychology

Lifshitz, M., Sacchet, M. D., Huntenburg, J. M., Thiery, T., Fan, Y., Gärtner, M., Grimm, S., Winnebeck, E., Fissler, M., Schroeder, T. A., Margulies, D. S., & Barnhofer, T. (2019). Mindfulness-based therapy regulates brain connectivity in Major Depression. Psychotherapy and Psychosomatics, 88(6), 375-377.

Sophie Dautricourt, Julie Gonneaud, Brigitte Landeau, Vince Calhoun, Robin de Flores, Géraldine Poisnel, Salma Bougacha, Valentin Ourry, Edelweiss Touron, Elizabeth Kuhn, Harriet Demintz-King, Natalie Marchant, Denis Vivien, Vincent de la Sayette, Antoine Lutz, Gaël Chételat, Thorsten Barnhofer (2022)Dynamic functional connectivity patterns associated with dementia risk, In: Alzheimer's research & therapy14(1)72pp. 72-72 BioMed Central

Background: This study assesses the relationships between dynamic functional network connectivity (DFNC) and dementia risk.Methods: DFNC of the default mode (DMN), salience (SN), and executive control networks was assessed in 127 cognitively unimpaired older adults. Stepwise regressions were performed with dementia risk and protective factors and biomarkers as predictors of DFNC.Results: Associations were found between times spent in (i) a "weakly connected" state and lower self-reported engagement in early- and mid-life cognitive activity and higher LDL cholesterol; (ii) a "SN-negatively connected" state and higher blood pressure, higher depression score, and lower body mass index (BMI); (iii) a "strongly connected" state and higher self-reported engagement in early-life cognitive activity, Preclinical Alzheimer's cognitive composite-5 score, and BMI; and (iv) a "DMN-negatively connected" state and higher self-reported engagement in early- and mid-life stimulating activities and lower LDL cholesterol and blood pressure. The lower number of state transitions was associated with lower brain perfusion.Conclusion: DFNC states are differentially associated with dementia risk and could underlie reserve.

Jenny Gu, Anke Karl, Ruth Baer, Clara Strauss, Thorsten Barnhofer, Catherine Crane (2020)Latent Profile Analysis of the Five Facet Mindfulness Questionnaire in a Sample With a History of Recurrent Depression, In: Assessment (Odessa, Fla.)27(1)pp. 149-163

Extending previous research, we applied latent profile analysis in a sample of adults with a history of recurrent depression to identify subgroups with distinct response profiles on the Five Facet Mindfulness Questionnaire and understand how these relate to psychological functioning. The sample was randomly divided into two subsamples to first examine the optimal number of latent profiles (test sample; = 343) and then validate the identified solution (validation sample; = 340). In both test and validation samples, a four-profile solution was revealed where two profiles mapped broadly onto those previously identified in nonclinical samples: "high mindfulness" and "nonjudgmentally aware." Two additional subgroups, "moderate mindfulness" and "very low mindfulness," were observed. "High mindfulness" was associated with the most adaptive psychological functioning and "very low mindfulness" with the least adaptive. In most people with recurrent depression, mindfulness skills are expressed evenly across different domains. However, in a small minority a meaningful and replicable uneven profile indicating nonjudgmental awareness is observable. Current findings require replication and future research should examine the extent to which profiles change from periods of wellness to illness in people with recurrent depression and how profiles are influenced by exposure to mindfulness-based intervention.

Tim Whitfield, Harriet Demnitz-King, Marco Schlosser, Thorsten Barnhofer, Eric Frison, Nina Coll-Padros, Sophie Dautricourt, Florence Requier, Marion Delarue, Julie Gonneaud, Olga M. Klimecki, Antoine Lutz, Leo Paly, Eric Salmon, Ann-Katrin Schild, Zuzana Walker, Frank Jessen, Gael Chetelat, Fabienne Collette, Miranka Wirth, Natalie L. Marchant (2022)Effects of a mindfulness-based versus a health self-management intervention on objective cognitive performance in older adults with subjective cognitive decline (SCD): a secondary analysis of the SCD-Well randomized controlled trial, In: Alzheimer's research & therapy14(1)125pp. 125-125 Springer Nature

Background Older individuals with subjective cognitive decline (SCD) perceive that their cognition has declined but do not show objective impairment on neuropsychological tests. Individuals with SCD are at elevated risk of objective cognitive decline and incident dementia. Non-pharmacological interventions (including mindfulness-based and health self-management approaches) are a potential strategy to maintain or improve cognition in SCD, which may ultimately reduce dementia risk. Methods This study utilized data from the SCD-Well randomized controlled trial. One hundred forty-seven older adults with SCD (M-Age = 72.7 years; 64% female) were recruited from memory clinics in four European countries and randomized to one of two group-based, 8-week interventions: a Caring Mindfulness-based Approach for Seniors (CMBAS) or a health self-management program (HSMP). Participants were assessed at baseline, post-intervention (week 8), and at 6-month follow-up (week 24) using a range of cognitive tests. From these tests, three composites were derived-an "abridged" Preclinical Alzheimer's Cognitive Composite 5 (PACC5(Abridged)), an attention composite, and an executive function composite. Both per-protocol and intention-to-treat analyses were performed. Linear mixed models evaluated the change in outcomes between and within arms and adjusted for covariates and cognitive retest effects. Sensitivity models repeated the per-protocol analyses for participants who attended >= 4 intervention sessions. Results Across all cognitive composites, there were no significant time-by-trial arm interactions and no measurable cognitive retest effects; sensitivity analyses supported these results. Improvements, however, were observed within both trial arms on the PACC5(Abridged) from baseline to follow-up (Delta [95% confidence interval]: CMBAS = 0.34 [0.19, 0.48]; HSMP = 0.30 [0.15, 0.44]). There was weaker evidence of an improvement in attention but no effects on executive function. Conclusions Two non-pharmacological interventions conferred small, non-differing improvements to a global cognitive composite sensitive to amyloid-beta-related decline. There was weaker evidence of an effect on attention, and no evidence of an effect on executive function. Importantly, observed improvements were maintained beyond the end of the interventions. Improving cognition is an important step toward dementia prevention, and future research is needed to delineate the mechanisms of action of these interventions and to utilize clinical endpoints (i.e., progression to mild cognitive impairment or dementia).

Natalie L. Marchant, Thorsten Barnhofer, Roxane Coueron, Miranka Wirth, Antoine Lutz, Eider M. Arenaza-Urquijo, Fabienne Collette, Geraldine Poisnel, Harriet Demnitz-King, Ann-Katrin Schild, Nina Coll-Padros, Floriane Delphin-Combe, Tim Whitfield, Marco Schlosser, Julie Gonneaud, Julien Asselineau, Zuzana Walker, Pierre Krolak-Salmon, Jose Luis Molinuevo, Eric Frison, Gael Chetelat, Frank Jessen, Olga M. Klimecki (2021)Effects of a Mindfulness-Based Intervention versus Health Self-Management on Subclinical Anxiety in Older Adults with Subjective Cognitive Decline: The SCD-Well Randomized Superiority Trial, In: Psychotherapy and psychosomatics90(5)pp. 341-350 Karger

INTRODUCTION: Older adults experiencing subjective cognitive decline (SCD) have a heightened risk of developing dementia and frequently experience subclinical anxiety, which is itself associated with dementia risk. OBJECTIVE: To understand whether subclinical anxiety symptoms in SCD can be reduced through behavioral interventions.METHODS: SCD-Well is a randomized controlled trial designed to determine whether an 8-week mindfulness-based intervention (caring mindfulness-based approach for seniors; CMBAS) is superior to a structurally matched health self-management program (HSMP) in reducing subclinical anxiety. Participants were recruited from memory clinics at 4 European sites. The primary outcome was change in anxiety symptoms (trait subscale of the State-Trait Anxiety Inventory; trait-STAI) from pre- to postintervention. Secondary outcomes included a change in state anxiety and depression symptoms postintervention and 6 months postrandomization (follow-up).RESULTS: One hundred forty-seven participants (mean [SD] age: 72.7 [6.9] years; 64.6% women; CMBAS, n = 73; HSMP, n = 74) were included in the intention-to-treat analysis. There was no difference in trait-STAI between groups postintervention (adjusted change difference: -1.25 points; 95% CI -4.76 to 2.25) or at follow-up (adjusted change difference: -0.43 points; 95% CI -2.92 to 2.07). Trait-STAI decreased postintervention in both groups (CMBAS: -3.43 points; 95% CI -5.27 to -1.59; HSMP: -2.29 points; 95% CI -4.14 to -0.44) and reductions were maintained at follow-up. No between-group differences were observed for change in state anxiety or depression symptoms.CONCLUSIONS: A time-limited mindfulness intervention is not superior to health self-management in reducing subclinical anxiety symptoms in SCD. The sustained reduction observed across both groups suggests that subclinical anxiety symptoms in SCD are modifiable. identifier: NCT03005652.

Tim Whitfield, Thorsten Barnhofer, Rebecca Acabchuk, Avi Cohen, Michael Lee, Marco Schlosser, Eider M. Arenaza-Urquijo, Adriana Böttcher, Willoughby Britton, Nina Coll-Padros, Fabienne Collette, Gaël Chételat, Sophie Dautricourt, Harriet Demnitz-King, Travis Dumais, Olga Klimecki, Dix Meiberth, Inès Moulinet, Theresa Müller, Elizabeth Parsons, Lauren Sager, Lena Sannemann, Jodi Scharf, Ann-Katrin Schild, Edelweiss Touron, Miranka Wirth, Zuzana Walker, Ethan Moitra, Antoine Lutz, Sara W. Lazar, David Vago, Natalie L. Marchant (2022)The Effect of Mindfulness-based Programs on Cognitive Function in Adults: A Systematic Review and Meta-analysis, In: Neuropsychology review32(3)677pp. 677-702 Springer US

Mindfulness-based programs (MBPs) are increasingly utilized to improve mental health. Interest in the putative effects of MBPs on cognitive function is also growing. This is the first meta-analysis of objective cognitive outcomes across multiple domains from randomized MBP studies of adults. Seven databases were systematically searched to January 2020. Fifty-six unique studies ( n  = 2,931) were included, of which 45 ( n  = 2,238) were synthesized using robust variance estimation meta-analysis. Meta-regression and subgroup analyses evaluated moderators. Pooling data across cognitive domains, the summary effect size for all studies favored MBPs over comparators and was small in magnitude ( g  = 0.15; [0.05, 0.24]). Across subgroup analyses of individual cognitive domains/subdomains, MBPs outperformed comparators for executive function ( g  = 0.15; [0.02, 0.27]) and working memory outcomes ( g  = 0.23; [0.11, 0.36]) only. Subgroup analyses identified significant effects for studies of non-clinical samples, as well as for adults aged over 60. Across all studies, MBPs outperformed inactive, but not active comparators. Limitations include the primarily unclear within-study risk of bias (only a minority of studies were considered low risk), and that statistical constraints rendered some p -values unreliable. Together, results partially corroborate the hypothesized link between mindfulness practices and cognitive performance. This review was registered with PROSPERO [CRD42018100904].

Kate Williams, Rebecca Elliott, Thorsten Barnhofer, Roland Zahn, Ian M. Anderson (2021)Positive Shifts in Emotion Evaluation Following Mindfulness-Based Cognitive Therapy (MBCT) in Remitted Depressed Participants, In: Mindfulness12(3)623pp. 623-635 Springer Nature

Objectives A combination of negatively biased information processing and a reduced ability to experience positive emotions can persist into remission from major depression (rMDD). Studies have shown that mindfulness-based cognitive therapy (MBCT) can increase self-reported positive emotions in rMDD participants; similar changes using neuropsychological tasks have not been shown. In this study, we investigated neuropsychological change in emotional processing following MBCT in rMDD participants. Methods Seventy-three rMDD participants, 40 of whom received MBCT and 33 of whom continued with treatment as usual (TAU), and 42 never depressed participants took part; neither the TAU nor never depressed participants received MBCT. All were assessed at baseline and immediately following MBCT or after an 8-week gap for those without active intervention. Participants completed emotion evaluation and face emotion recognition tasks with self-report measures (mood, mindfulness) at each session. Results Results showed an MBCT-specific shift in ratings from less negative to more positive emotion evaluations, which correlated with mindfulness practice and self-report mindfulness change. Both the MBCT and TAU groups showed a small increase in overall face emotion recognition accuracy compared with no change in never depressed participants. Conclusions These findings support a specific role for MBCT in encouraging more positive evaluations of life situations in those with previous depression rather than influencing lower-level processing of emotions. Results should be interpreted cautiously given that this was a non-randomised, preference choice trial.

Marc P Bennett, Rachel Knight, Shivam Patel, Tierney So, Darren Dunning, Thorsten Barnhofer, Patrick Smith, Willem Kuyken, Tamsin Ford, Tim Dalgleish (2021)Decentering as a core component in the psychological treatment and prevention of youth anxiety and depression: a narrative review and insight report, In: Translational psychiatry11(1)288pp. 288-288

Decentering is a ubiquitous therapeutic concept featuring in multiple schools of psychological intervention and science. It describes an ability to notice to day-to-day psychological stressors (negative thoughts, feelings, and memories) from an objective self-perspective and without perseverating on the themes they represent. Thus, decentering dampens the impact and distress associated with psychological stressors that can otherwise increase mental ill health in vulnerable individuals. Importantly, the strengthening of decentering-related abilities has been flagged as a core component of psychological interventions that treat and prevent anxiety and depression. We provide an in-depth review evidence of the salutary effects of decentering with a special focus on youth mental health. This is because adolescence is a critical window for the development of psychopathology but is often under-represented in this research line. A narrative synthesis is presented that integrates and summarizes findings on a range of decentering-related abilities. Section 1 reviews extant conceptualizations of decentering and data-driven approaches to characterize its characteristic. A novel definition is then offered to guide future empirical research. Section 2 overviews laboratory-based research into the development of decentering as well as its relationship with anxiety and depression. Section 3 examines the role decentering-related skills play in psychological interventions for anxiety and depression. Critically, we review evidence that treatment-related increases in decentering predict latter reductions in anxiety and depression severity. Each section highlights important areas for future research. The report concludes by addressing the vital questions of whether, how, why and when decentering alleviates youth anxiety and depression.

Thorsten Barnhofer, Tim J. Reess, Maria Fissler, Emilia Winnebeck, Simone Grimm, Matti Gaertner, Yan Fan, Julia M. Huntenburg, Titus A. Schroeter, Marie Gummersbach, Malek Bajbouj, Britta K. Hoelzel (2021)Effects of Mindfulness Training on Emotion Regulation in Patients With Depression: Reduced Dorsolateral Prefrontal Cortex Activation Indexes Early Beneficial Changes, In: Psychosomatic medicine83(6)579pp. 579-591 Lippincott Williams & Wilkins

Objective Mindfulness-based interventions (MBIs) have been found to be a promising approach for the treatment of recurrent courses of depression. However, little is known about their neural mechanisms. This functional magnetic resonance imaging study set out to investigate activation changes in corticolimbic regions during implicit emotion regulation. Methods Depressed patients with a recurrent lifetime history were randomized to receive a 2-week MBI (n = 16 completers) or psychoeducation and resting (PER; n = 22 completers). Before and after, patients underwent functional magnetic resonance imaging while labeling the affect of angry, happy, and neutral facial expressions and completed questionnaires assessing ruminative brooding, the ability to decenter from such thinking, and depressive symptoms. Results Activation decreased in the right dorsolateral prefrontal cortex (dlPFC) in response to angry faces after MBI (p < .01, voxel-wise family-wise error rate correction, T > 3.282; 56 mm(3); Montreal Neurological Institute peak coordinate: 32, 24, 40), but not after PER. This change was highly correlated with increased decentring (r = -0.52, p = .033), decreased brooding (r = 0.60, p = .010), and decreased symptoms (r = 0.82, p = .005). Amygdala activation in response to happy faces decreased after PER (p < .01, family-wise error rate corrected; 392 mm(3); Montreal Neurological Institute peak coordinate: 28, -4, -16), whereas the MBI group showed no significant change. Conclusions The dlPFC is involved in emotion regulation, namely, reappraisal or suppression of negative emotions. Decreased right dlPFC activation might indicate that, after the MBI, patients abstained from engaging in elaboration or suppression of negative affective stimuli; a putatively important mechanism for preventing the escalation of negative mood. Trial Registration: The study is registered at (NCT02801513; 16/06/2016).

Additional publications