Mindfulness-based cognitive group therapy for treatment-refractory anxiety disorder: A pragmatic randomized controlled trial.
P. Spinhoven, E. Hoogerwerf, Anne E van Giezen, Anja Greeven
Journal of Anxiety Disorders June 1, 2022 DOI: 10.1016/j.janxdis.2022.102599 (opens in new tab) via Semantic Scholar
Summary
AI-generated from the abstractMindfulness-Based Cognitive Therapy (MBCT) led to larger reductions in anxiety, avoidance, emotion regulation difficulties, and worry, and larger increases in mindfulness skills, compared to Relapse Prevention-Cognitive Behavioral Therapy (CBT-RP) for outpatients with treatment-refractory anxiety disorders who had not responded sufficiently to first-line psychological treatment. At a 6-month follow-up, treatment gains were somewhat diminished. The effects of MBCT on anxiety at post-treatment were not mediated by mindfulness skills, emotion regulation, worry, or rumination at mid-treatment.
Study at a glance
| Characteristics | Randomized controlled trial Longitudinal Peer reviewed |
|---|---|
| Sample size | 136 |
| Population | Outpatients with treatment-refractory DSM-IV defined anxiety disorder who insufficiently responded to first-line psychological treatment |
| Interventions | Mindfulness-Based Cognitive Therapy Relapse Prevention-Cognitive Behavioral Therapy |
| Duration | 6-month follow-up |
| Keywords | Medicine Psychology |
| Key finding | MBCT produced larger improvements in anxiety, avoidance, emotion regulation, worry, and mindfulness than CBT-RP at post-treatment, but gains diminished by 6-month follow-up and were not mediated by the proposed mechanisms. |
Abstract
BACKGROUND This study aimed: (a) to examine the effectiveness of Mindfulness-Based Cognitive Therapy (MBCT) for patients with a treatment-refractory anxiety disorders compared to Relapse Prevention-Cognitive Behavioral Therapy (CBT-RP); and (b) to explore candidate mediating variables. METHODS We conducted a pragmatic randomized controlled trial comparing MBCT with CBT-RP in a group format for 136 outpatients with treatment-refractory DSM-IV defined anxiety disorder, who insufficiently responded to first-line psychological treatment. RESULTS At post-treatment, the MBCT group showed a significantly larger decrease in self-reported anxiety (Beck Anxiety Inventory), avoidance (Fear Questionnaire), difficulties in emotion regulation (Difficulties in Emotion Regulation Strategies), and worry (Penn State Worry Questionnaire), as well as a significantly larger increase in mindfulness skills (Five Facet Mindfulness Questionnaire). After a 6-month follow-up treatment gains were somewhat diminished. Effects of MBCT on anxiety at post-treatment did not prove to be mediated by mindfulness skills, difficulties in emotion regulation strategies, worry, or rumination (Rumination on Sadness Scales) at mid-treatment. CONCLUSIONS MBCT seems to be a promising intervention in routine clinical care for persons with an anxiety disorder who insufficiently responded to first-line psychological treatment. Future research in larger samples assessing long-term effects and using intensive longitudinal designs to identify possible working mechanisms is called for.