Uncontrollable worry is a core feature of generalized anxiety disorder and other mental health conditions. Mindfulness-based strategies can help reduce worry, but it is unclear which specific techniques work best and how they affect the brain. In a study of 40 participants with clinically significant worry, functional magnetic resonance imaging was used while they engaged in real-time worry and then tried to disengage using two mindfulness strategies (focused attention, acceptance) and one comparison strategy (suppression). All disengagement strategies reduced activity in the default mode network and increased activity in frontoparietal and salience networks, indicating shared mechanisms.
A proof-of-concept study with 40 high-worry adults (80% with an anxiety disorder) tested whether features of worry predict which cognitive strategy works best to regulate it. Participants rated their worries on five dimensions and tried mindful acceptance, focused attention meditation, or thought suppression during brain scanning. The preregistered hypotheses were not supported, but exploratory analyses showed that mindfulness-based strategies were more effective than thought suppression for worries rated as more uncontrollable. The authors call for larger studies with more varied perseverative thoughts.
Uncontrollable worry, common in generalized anxiety disorder and other conditions, can be reduced by mindfulness strategies. In 40 participants with clinically significant worry, fMRI showed that three disengagement strategies—focused attention, acceptance, and suppression—all reduced activity in the default mode network and increased activity in frontoparietal and salience networks. Focused attention was most effective, decreasing activity in cognitive control and sensorimotor regions. Successful disengagement correlated with increased activity in the rostrolateral prefrontal cortex and stronger connectivity between the posterior cingulate and primary somatosensory cortex. These findings suggest both shared and distinct neural mechanisms, with focused attention being a particularly promising strategy for disengaging from worry.