Objective To examine whether an empirically and theoretically derived treatment combining mindfulness- and acceptance-based strategies with behavioral approaches would improve outcomes in GAD over an empirically-supported treatment. Method This trial randomized 81 individuals (65.4% female, 80.2% identified as White, average age 32.92) diagnosed with GAD to receive 16 sessions of either an Acceptance Based Behavior Therapy (ABBT) or Applied Relaxation (AR). Assessments at pre-treatment, post-treatment, and 6-month follow-up included the following primary outcome measures: GAD Clinician Severity Rating, Structured Interview Guide for the Hamilton Anxiety Rating Scale, Penn State Worry Questionnaire, Depression Anxiety Stress Scale, and the State Trait Anxiety Inventory. Secondary outcomes included the Beck Depression Inventory-II, Quality of Life Inventory, and number of comorbid diagnoses. Results Mixed Effect Regression Models showed significant large effects for Time for all primary outcome measures (d’s 1.36 to 1.61) but non-significant, small effects for Condition and Condition X Time (d’s 0.002 to 0.24), indicating clients in both treatments improved comparably over treatment. For secondary outcomes, Time was significant (d’s 0.74 to 1.38) but Condition and Condition X Time effects were not (d’s 0.11 to 0.31). No significant differences emerged over follow-up (d’s 0.02 to 0.16) indicating maintenance of gains. Between 63.3 and 80.0% of clients in ABBT and 60.6 and 78.8% of clients in AR experienced clinically significant change across 5 calculations of change at post-treatment and follow-up. Conclusions ABBT is a viable alternative for treating GAD.

Background The tendency to employ both cognitive reappraisal and mindfulness are associated with reduced trait social anxiety; however, it is unclear whether reappraisal and mindfulness are associated with social anxiety through the same mechanisms. It has been proposed that decentering, or the process of seeing thoughts or feelings as objective events in the mind rather than personally identifying with them, may be a key mechanism underlying both cognitive reappraisal and mindfulness. Aims To examine the relationships between reappraisal, mindfulness, decentering, and social anxiety. Methods This study utilized structural equation modeling to examine the relationships among cognitive reappraisal, mindfulness, decentering, and social anxiety in a large cross-sectional study. Results Results indicate that the relationship between mindfulness and social anxiety is partially accounted for by decentering, whereas the relationship between cognitive reappraisal and social anxiety is more fully accounted for by decentering. Conclusions These results imply that decentering may be a common mechanism underlying both cognitive reappraisal and mindfulness, although mindfulness may also affect social anxiety through additional mechanisms. However, given the cross-sectional nature of these findings, results should be considered preliminary with future research being needed to further elucidate these relationships.

Internalized heterosexism refers to the development of a negative view of one’s own and others’ sexual minority identities as a product of living within a heterosexist society. Various negative mental health outcomes have been associated with internalized heterosexism (IH), such as anxiety, depression, and suicidality. However, little is known about the actual processes through which these outcomes take place. The current study examined the role of self-criticism (a psychological process) and lack of connectedness with other sexual minorities (a social process) in explaining the relation between IH and psychological distress. Data were collected via an online survey (N = 436) and analyzed using structural equation modeling. Results supported previous research, showing a significant direct positive relationship between IH and psychological distress. In addition, higher self-criticism (β = .28, p < .001; 95% CI: .22, .36) and lower connectedness with sexual minorities (β = .10, p < .01; 95% CI: .04, .16) partially explained the shared variance between IH and psychological distress. The final model, which included both mediators of the relation between IH and psychological distress, accounted for a significant amount of the variance in psychological distress (64.3%) and fit the data well. Both self-criticism and connectedness to a sexual minority community are mechanisms that could be targeted within therapy when working to improve the mental health of clients with high IH and specific therapeutic suggestions are presented.

The present findings as well as the rich descriptive data and flexibility offered by computer administration suggest that the CAMI is a promising instrument for the comprehensive assessment of maltreatment history from adults.