Randomized clinical trial of adapted mindfulness-based stress reduction versus group cognitive behavioral therapy for heterogeneous anxiety disorders.
Study Goal
The researchers aimed to compare the effectiveness of mindfulness-based stress reduction (MBSR) and cognitive behavioral therapy (CBT) in treating anxiety disorders among veterans.
Results Summary
Both MBSR and CBT showed large and equivalent improvements in principal disorder severity. CBT was more effective at reducing anxious arousal, while MBSR was more effective at reducing worry and comorbid emotional disorders.
Population
105 veterans (83% male, mean age 46 years, 30% minority) with DSM-IV anxiety disorders.
Effective Dosage
Not specified
Duration
Not specified (follow-up at 3 months)
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
adapted mindfulness-based stress reduction (MBSR) | decrease | principal disorder severity | veterans with one or more DSM-IV anxiety disorders | d=-4.08 | showed large and equivalent improvements | #1 |
cognitive behavioral therapy (CBT) | decrease | principal disorder severity | veterans with one or more DSM-IV anxiety disorders | d=-3.52 | showed large and equivalent improvements | #2 |
cognitive behavioral therapy (CBT) | decrease | anxious arousal outcomes | veterans with one or more DSM-IV anxiety disorders | d=.49 | outperformed adapted MBSR | #3 |
adapted mindfulness-based stress reduction (MBSR) | decrease | worry | veterans with one or more DSM-IV anxiety disorders | d=.64 | reduced worry at a greater rate | #4 |
adapted mindfulness-based stress reduction (MBSR) | decrease | comorbid emotional disorders | veterans with one or more DSM-IV anxiety disorders | d=.49 | resulted in greater reduction | #5 |
adapted mindfulness-based stress reduction (MBSR) | neutral | mood disorders and worry | veterans with one or more DSM-IV anxiety disorders | - | evidenced greater | #6 |
cognitive behavioral therapy (CBT) | decrease | principal diagnosis severity | complex sample | - | were both effective at reducing | #7 |
adapted mindfulness-based stress reduction (MBSR) | decrease | principal diagnosis severity | complex sample | - | were both effective at reducing | #8 |
cognitive behavioral therapy (CBT) | decrease | self-reported anxiety symptoms | complex sample | - | somewhat effective at reducing | #9 |
adapted mindfulness-based stress reduction (MBSR) | decrease | self-reported anxiety symptoms | complex sample | - | somewhat effective at reducing | #10 |
cognitive behavioral therapy (CBT) | decrease | anxious arousal | complex sample | - | more effective at reducing | #11 |
adapted mindfulness-based stress reduction (MBSR) | decrease | worry and comorbid disorders | complex sample | - | may be more effective at reducing | #12 |
OBJECTIVE: To compare a mindfulness-based intervention with cognitive behavioral therapy (CBT) for the group treatment of anxiety disorders. METHOD: One hundred five veterans (83% male, mean age=46 years, 30% minority) with one or more DSM-IV anxiety disorders began group treatment following randomization to adapted mindfulness-based stress reduction (MBSR) or CBT. RESULTS: Both groups showed large and equivalent improvements on principal disorder severity thru 3-month follow up (ps<.001, d=-4.08 for adapted MBSR; d=-3.52 for CBT). CBT outperformed adapted MBSR on anxious arousal outcomes at follow up (p<.01, d=.49) whereas adapted MBSR reduced worry at a greater rate than CBT (p<.05, d=.64) and resulted in greater reduction of comorbid emotional disorders (p<.05, d=.49). The adapted MBSR group evidenced greater mood disorders and worry at Pre, however. Groups showed equivalent treatment credibility, therapist adherence and competency, and reliable improvement. CONCLUSIONS: CBT and adapted MBSR were both effective at reducing principal diagnosis severity and somewhat effective at reducing self-reported anxiety symptoms within a complex sample. CBT was more effective at reducing anxious arousal, whereas adapted MBSR may be more effective at reducing worry and comorbid disorders.