Interpersonal Problems, Mindfulness, and Therapy Outcome in an Acceptance-Based Behavior Therapy for Generalized Anxiety Disorder

Abstract

Objective To better understand the role interpersonal problems play in response to two treatments for generalized anxiety disorder (GAD); an acceptance based behavior therapy (ABBT) and applied relaxation (AR), and to examine how the development of mindfulness may be related to change in interpersonal problems over treatment and at follow-up. Method Eighty-one individuals diagnosed with GAD (65.4% female, 80.2% identified as White, average age 32.92) were randomized to receive 16 sessions of either ABBT or AR. GAD severity, interpersonal problems, and mindfulness were measured at pre-treatment, post-treatment, 6-month follow-up, and 12-month follow-up. Results Mixed effect regression models did not reveal any significant effects of pre-treatment interpersonal problems on GAD severity over treatment. After controlling for post-treatment GAD severity, remaining post-treatment interpersonal problems predicted 6- but not 12- month GAD severity. Participants in both conditions experienced a large decrease in interpersonal problems over treatment. Increases in mindfulness over treatment and through follow-up were associated with decreases in interpersonal problems, even when accounting for reductions in overall GAD severity. Conclusions Interpersonal problems may be an important target of treatment in GAD, even if pre-treatment interpersonal problems are not predictive of outcome. Developing mindfulness in individuals with GAD may help ameliorate interpersonal difficulties among this population.

<p>Mindfulness-Based Intervention For Nurses In AIDS Care In China: A Pilot Study</p>

“…The findings of this study demonstrate that most participants accepted the MLWS intervention and believed that it helped them to improve communications with patients, colleagues, and families; increase acceptance of other people; regulate negative emotions; and cultivate better attention. Our findings are consistent with previous studies which show that mindfulness-based intervention can enhance interpersonal relationships with patients experiencing generalized anxiety disorders,30,31 cultivate the forgiveness of other people among social work students,32 improve emotional regulation in nurses working in senior cadre wards for aged patients20 and nurse leaders,33 and improve concentration ability of social work and healthcare students 32,34,35…”

The relationship between early maladaptive schemas and interpersonal problems: A meta‐analytic review

“…Building on this argument, Karremans, Schellekens, and Kappen (2017) contended that mindful acceptance can buffer against the effects of problematic behaviour patterns in intimate relationships by increasing understanding of why the person might be behaving in that way. In contrast, low trait mindfulness has also been found to be negatively associated with interpersonal relationship satisfaction, where a low sense of awareness is negatively associated communication, management of conflict, and general interpersonal satisfaction (Barnes, Brown, Krusemark, Campbell, & Rogge, 2007; Millstein, Orsillo, Hayes‐Skelton, & Roemer, 2015; Wachs & Cordova, 2007). Trait mindfulness has also been found to mediate the relationship between EMSs and interpersonal problems (Janovsky et al, 2019).…”

Trait mindfulness mediates the relationship between early maladaptive schema and interpersonal problems

“…Given the relationships between EMSs, trait mindfulness, and interpersonal problems and the possible mediation role of trait mindfulness on the relationship between EMSs and psychological symptoms (Martin et al, 2014;Oliver et al, 2012;Shorey et al, 2015;Thimm, 2017), it is possible that EMSs might predispose an individual to being low in trait mindfulness, which might increase interpersonal problems. It is also possible that trait mindfulness may be increased by mindfulness practice (Barnes, Brown, Krusemark, Campbell, & Rogge, 2007;Knowles et al, 2015;Millstein et al, 2015;Wachs & Cordova, 2007). As a result, it is also possible that increasing trait mindfulness might inhibit automatic and emotionally fuelled reactions encouraged by EMSs, thereby, indirectly reducing the impact of EMSs on interpersonal problems.…”

“…In contrast, Borders, Earleywine, and Jajodia () found that high trait mindfulness can decrease aggression and hostility indirectly by decreasing rumination. Furthermore, in a randomised control trial, Millstein, Orsillo, Hayes‐Skelton, and Roemer () found that increases in trait mindfulness over the course of 16 sessions of an acceptance‐based behaviour therapy resulted in reduced interpersonal problems. Together these studies provide support for a negative association between trait mindfulness and interpersonal problems.…”