Randomized Controlled Trial of Mindfulness Meditation for Generalized Anxiety Disorder

Abstract

Objective Mindfulness meditation has met increasing interest as a therapeutic strategy for anxiety disorders, but prior studies have been limited by methodological concerns, including a lack of an active comparison group. This is the first randomized, controlled trial comparing the manualized Mindfulness-Based Stress Reduction (MBSR) program with an active control for Generalized Anxiety Disorder, a disorder characterized by chronic worry and physiological hyperarousal symptoms. Method Ninety-three individuals with DSM-IV-diagnosed GAD were randomized to an 8-week group intervention with MBSR or to an attention control, Stress Management Education (SME) between 2009 and 2011. Anxiety symptoms were measured with the Hamilton Anxiety Scale (HAM-A, primary outcome measure), the Clinical Global Impression of Severity and Improvement (CGI-S and CGI-I), and the Beck Anxiety Inventory (BAI). Stress reactivity was assessed by comparing anxiety and distress during pre- and post-treatment Trier Social Stress Tests (TSST). Results A modified intent-to-treat analysis including participants who completed at least one session of MBSR (N=48) or SME (N=41) showed that both interventions led to significant reductions in HAM-A scores at endpoint, but did not significantly differ. MBSR, however, was associated with a significantly greater reduction in anxiety as measured by the CGI-S, the CGI-I, and the BAI (all Ps<0.05). MBSR was also associated with greater reductions than SME in anxiety and distress ratings in response to the TSST stress challenge (P<0.05), and a greater increase in positive self-statements (P=0.004). Conclusions These results suggest that MBSR may have a beneficial effect on anxiety symptoms in GAD, and may also improve stress reactivity and coping as measured in a laboratory stress challenge.

Acceptance lowers stress reactivity: Dismantling mindfulness training in a randomized controlled trial

“…For example, eight-week mindfulness interventions have been shown to reduce physiological and subjective reactivity to acute stress challenge tasks (Britton et al, 2012;Hoge et al, 2013;Nyklíček et al, 2013). Still, little is known about the active mechanisms of mindfulness interventions that drive these stress reduction effects.…”

Mindfulness in mood and anxiety disorders: a review of the literature

“…14,15 The studies selected for the review also reported that mindfulness meditation training reduced anxiety symptoms in patients with GAD and improved coping during a laboratory stress paradigm due through greater resilience to stressful psychological questions. 13 MBCT was another method that used mindfulness and aimed to reduce rates of relapse and recurrence of major depression and treatment-resistant depression causing emotional reactivity in mindfulness meditation training. These studies have substantial implications for depression.…”

“…3,24 Mindfulness meditation allows thoughts to pass shown to predict increased depression symptoms over the following year. 13 Anxiety disorders are centered on excessive worrying about future events and negative thoughts, and the practice of mindfulness helps individuals focus on the present moment, helping to decrease worry, negative thoughts and feelings, and to ameliorate cognitive dysfunction in older adults. [14][15][16]19 The practice of mindfulness develops a state of acceptance, emphasizing emotional regulation strategies and increasing QoL and thereby decreasing invasive thoughts, anxiety, and depression.…”

“…13 One exception was a study by Lenze et al, in patients with general anxiety disorder (GAD). The study also showed that mindfulness meditation led to enhanced coping during a laboratory stress paradigm, due to resilience during stressful psychological…”

“…13 One study noted that the effects of MBSR on veterans included improved symptoms of anxiety and depression and a reduction in suicidal ideation. 15 Another study of veterans conducted a randomized clinical trial comparing adapted MBSR with CBT in treatment groups for anxiety disorders, and both groups revealed similar outcomes across most results, with several exceptions.…”