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Mindfulness-based cognitive group therapy for treatment-refractory anxiety disorder: A pragmatic randomized controlled trial.

Philip 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)

Study at a glance

AI-extracted from the abstract
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
Topics Anxiety Meditation
Key findings 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.