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Which treatment worked better for whom? Moderators of group cognitive behavioral therapy versus adapted mindfulness based stress reduction for anxiety disorders.

Behaviour research and therapy
August 1, 2013
Joanna J Arch et al. (2 authors)
Journal ArticleRandomized Controlled TrialResearch Support, Non-U.S. Gov'tHuman StudyClinical
Study Details

Study Goal

The researchers aimed to identify treatment moderators (baseline depression symptoms, anxiety sensitivity, and diagnostic severity) to determine for whom mindfulness-based stress reduction (MBSR) or cognitive behavioral therapy (CBT) is more effective for anxiety disorders.

Results Summary

CBT was more effective than adapted MBSR for individuals with no to mild depressive symptoms and, at post-treatment only, for those with very high anxiety sensitivity. At follow-up, adapted MBSR outperformed CBT for those with moderate to severe depressive symptoms and average anxiety sensitivity.

Population

71 patients with DSM-IV anxiety disorders.

Effective Dosage

Not specified

Duration

Assessed at baseline, post-treatment, and 3-month follow-up (exact intervention duration not specified).

Interactions

None mentioned

Extracted Claims (6)
InterventionDirectionEndpointPopulationDosageImpactClaim #
group CBT
decrease
principal anxiety disorder severity outcomes
patients with a DSM-IV anxiety disorder with no to mild depressive symptoms
-
outperformed
#1
group CBT
decrease
principal anxiety disorder severity outcomes
patients with a DSM-IV anxiety disorder with very high anxiety sensitivity
-
outperformed
#2
adapted mindfulness based stress reduction (MBSR)
decrease
principal anxiety disorder severity outcomes
patients with a DSM-IV anxiety disorder with moderate to severe depressive symptoms
-
outperformed
#3
adapted mindfulness based stress reduction (MBSR)
decrease
principal anxiety disorder severity outcomes
patients with a DSM-IV anxiety disorder with average anxiety sensitivity
-
outperformed
#4
group CBT
neutral
post-treatment outcomes
patients with a DSM-IV anxiety disorder
-
affected
#5
adapted mindfulness based stress reduction (MBSR)
neutral
post-treatment outcomes
patients with a DSM-IV anxiety disorder
-
affected
#6
Abstract

OBJECTIVE: Identifying treatment moderators facilitates treatment matching and personalized medicine. No previous studies have investigated treatment moderators for a mindfulness-based versus traditional cognitive behavioral therapy (CBT) for anxiety disorders to determine for whom each is most effective. The current study examined three putative moderators of principal anxiety disorder severity outcomes for adapted mindfulness based stress reduction (MBSR) and group CBT - baseline depression symptoms, anxiety sensitivity, and diagnostic severity. METHOD: Seventy-one patients with a DSM-IV anxiety disorder were randomized to adapted MBSR or group CBT and assessed at baseline, post-treatment, and 3-month follow up. RESULTS: CBT outperformed adapted MBSR among those with no to mild depressive symptoms and, at post-treatment only, among those with very high anxiety sensitivity. At follow up, adapted MBSR outperformed CBT among those with moderate to severe depressive symptoms and among those with average anxiety sensitivity (for this sample). Baseline severity affected post-treatment outcomes differently in CBT than in adapted MBSR. CONCLUSION: Baseline levels of depression, anxiety sensitivity, and to some extent diagnostic severity, differentially moderated outcomes in CBT and adapted MBSR for anxiety disorders. Recommendations and clinical implications are discussed.

Medical Subject Headings (MeSH)
AdolescentAdultAgedAnxiety DisordersClinical CompetenceCognitive Behavioral TherapyDepressionFemaleHumansMaleMiddle AgedMindfulnessPsychotherapy, GroupSeverity of Illness IndexTreatment Outcome
Study Links
Quality Scores
SafetyNot Assessed
Efficacy70/10
Quality85/10
Citation Metrics
Total Citations43
Citations/Year3.6
Relative Citation Ratio1.95
NIH Percentile73.8%
Research Impact Scores
APT Score0.75
Weight Score1.67
Normalized Score0.65
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