Mindfulness-based stress reduction for patients with anxiety disorders: Evaluation in a randomized controlled trial

doi:10.1016/j.brat.2011.01.007

Behaviour Research and Therapy

Volume 49, Issue 4, April 2011, Pages 281-288

https://doi.org/10.1016/j.brat.2011.01.007 Get rights and content

Abstract

The aim of this study was to investigate the effect of mindfulness-based stress reduction (MBSR) for patients with heterogeneous anxiety disorders. Seventy-six self-referred patients were randomized to MBSR or a waiting-list control condition. Eight participants did not complete the eight-week MBSR intervention. Treatment completers improved significantly on all outcome measures compared to controls. The completer sample showed medium to large effect sizes on measures of anxiety (Cohen’s d = 0.55–0.97), and a large effect size for symptoms of depression (Cohen’s d = 0.97). Intention-to-treat analyses yielded effect sizes in the small to moderate range (Cohen’s d = 0.32–0.76). Gains were maintained at six months follow-up. The percentage of participants reaching recovered status was highest for symptom measures of depression and anxiety, and lower for worry and trait anxiety. Mediation analyses indicated that mindfulness fully mediated changes in acute anxiety symptoms, and partially mediated changes in worry and trait anxiety. However, the present study did not find evidence of temporal precedence for the proposed mediator. In the absence of true mediation and an active control condition, it cannot be ruled out that results are due to non-specific aspects of treatment. Despite these and other limitations, we conclude that MBSR is an effective treatment for anxiety disorders and related symptomatology.

Section snippets

Participants

Patients were recruited through a newspaper advertisement soliciting for individuals with anxiety symptoms that were willing to take part in a clinical trial of a novel treatment for anxiety disorders. Inclusion criteria were that patients 1) be between 18 and 65 years, and 2) fulfill diagnostic criteria for either PD/AG, SAD, or GAD. Exclusion criteria were: 1) suicidality, 2) substance abuse and/or dependence, 3) severe mental disorder (psychosis or bipolar disorder), 4) other Axis I

Baseline characteristics

Patient characteristics and diagnostic information are presented in Table 1, Table 2. Thirty-eight participants (50%) in the sample had a primary diagnosis of PD/AG, 25 (32.9%) a primary diagnosis of SAD, and 13 (17.1%) a primary diagnosis of GAD. Thirty participants (39.5%) had a comorbid mood disorder, while 20 (26.3%) had at least one comorbid anxiety disorder. Independent samples t-tests and chi-square tests were used to compare the groups on demographic variables and outcome variables at

Discussion

The present study examined the effects of MBSR for patients with heterogeneous anxiety disorders. For the completer sample, effect sizes were in the moderate to large range (0.53–0.97). Gains were maintained at follow-up for all outcome measures. These findings indicate that mindfulness training has sustained beneficial effects on anxiety disorders and related symptomatology compared to a waiting-list control condition. In a more conservative estimate, ITT analyses showed significant

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Shorter communicationMindfulness-based stress reduction for patients with anxiety disorders: Evaluation in a randomized controlled trial

Abstract

Section snippets

Participants

Baseline characteristics

Discussion

Patient Education and Counseling

Behaviour Research and Therapy

Journal of Psychosomatic Research

Behaviour Research and Therapy

Behavior Therapy

Behavior Research and Therapy

Mindfulness, assessment, and transdiagnostic processes

Psychological Inquiry

Using self-report assessment methods to explore facets of mindfulness

Assessment

The moderator-mediator variable distinction in social psychological research: conceptual, strategic, and statistical considerations

Journal of Personality and Social Psychology

Beck anxiety inventory manual

Manual for the Beck depresion inventory-II

Incorporating emotion regulation into conceptualizations and treatments of anxiety and mood disorders

What is an anxiety disorder?

Depression and Anxiety

SCL-90-R: Administration, scoring, & procedures manual II for the R(evised) version and other instruments of the psychopathology rating scale series

Repetetive negative thinking as a transdiagnostic process

International Journal of Cognitive Therapy

The efficacy of psychological treatments for generalized anxiety disorder

Recovery rates in generalized anxiety disorder following psychological therapy: an analysis of clinically significant change in STAI-T across outcome studies since 1990

Psychological Medicine

The effect of mindfulness-based therapy on anxiety and depression: a meta-analytic review

Journal of Consulting and Clinical Psychology

Shorter communication
Mindfulness-based stress reduction for patients with anxiety disorders: Evaluation in a randomized controlled trial