Randomized controlled trial of mindfulness meditation for generalized anxiety disorder: effects on anxiety and stress reactivity.

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 (GAD), a disorder characterized by chronic worry and physiologic hyperarousal symptoms.

METHOD:

Ninety-three individuals with DSM-IV-diagnosed GAD were randomly assigned 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 Rating Scale (HAMA; primary outcome measure), the Clinical Global Impressions-Severity of Illness and -Improvement scales (CGI-S and CGI-I), and the Beck Anxiety Inventory (BAI). Stress reactivity was assessed by comparing anxiety and distress during pretreatment and posttreatment administration of the Trier Social Stress Test (TSST).

RESULTS:

A modified intent-to-treat analysis including participants who completed at least 1 session of MBSR (n = 48) or SME (n = 41) showed that both interventions led to significant (P < .0001) reductions in HAMA 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 P values < .05). MBSR was also associated with greater reductions than SME in anxiety and distress ratings in response to the TSST stress challenge (P < .05) and a greater increase in positive self-statements (P = .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.

TRIAL REGISTRATION:

ClinicalTrials.gov identifier: NCT01033851.

• Authors: Elizabeth A Hoge, Eric Bui, Luana Marques, Christina A Metcalf, Laura K Morris, Donald J Robinaugh, John J Worthington, Mark H Pollack, Naomi M Simon
• Journal: The Journal of clinical psychiatry (J Clin Psychiatry) Vol. 74 Issue 8 Pg. 786-92 (Aug 2013) ISSN: 1555-2101 [Electronic] United States
• PMID: 23541163 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, N.I.H., Extramural)
• Copyright: © Copyright 2013 Physicians Postgraduate Press, Inc.

Topics

• Adaptation, Psychological
• Adult
• Anxiety Disorders (diagnosis, psychology, therapy)
• Arousal
• Awareness
• Combined Modality Therapy
• Female
• Follow-Up Studies
• Humans
• Interview, Psychological
• Male
• Meditation (methods, psychology)
• Middle Aged
• Patient Education as Topic
• Problem Solving
• Self Concept
• Social Environment
• Speech
• Stress, Psychological (complications, psychology)
• Surveys and Questionnaires
• Yoga (psychology)