A systematic review and meta-analysis of acceptance- and mindfulness-based interventions for DSM-5 anxiety disorders.
Study Goal
The researchers aimed to evaluate the effectiveness of standardized acceptance-/mindfulness-based interventions (ACT, MBCT, MBSR) in treating DSM-5 anxiety disorders compared to treatment as usual (TAU) and Cognitive Behavioral Therapy (CBT).
Results Summary
The study found that ACT, MBCT, and MBSR had short-term anxiolytic effects when added to TAU, with ACT and MBCT showing comparable effects to CBT, while MBSR was less effective. Long-term effects (up to 12 months) showed no significant differences compared to TAU or CBT.
Population
1815 adults with various DSM-5 anxiety disorders.
Effective Dosage
Not specified
Duration
Short-term effects noted; follow-up analyses up to 12 months.
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
Acceptance and Commitment Therapy (ACT), Mindfulness-Based Cognitive Therapy (MBCT), and Mindfulness-Based Stress Reduction (MBSR) | decrease | clinician- and patient-rated anxiety | adults with different DSM-5 anxiety disorders | - | led to short-term effects on | #1 |
Acceptance and Commitment Therapy (ACT) and Mindfulness-Based Cognitive Therapy (MBCT) | no change | anxiety outcomes | adults with different DSM-5 anxiety disorders | - | showed comparable effects on | #2 |
Mindfulness-Based Stress Reduction (MBSR) | decrease | anxiety outcomes | adults with different DSM-5 anxiety disorders | - | showed significantly lower effects on | #3 |
Acceptance and Commitment Therapy (ACT), Mindfulness-Based Cognitive Therapy (MBCT), and Mindfulness-Based Stress Reduction (MBSR) | no change | anxiety outcomes | adults with different DSM-5 anxiety disorders | - | did not reveal significant differences on | #4 |
Acceptance and Commitment Therapy (ACT), Mindfulness-Based Cognitive Therapy (MBCT), and Mindfulness-Based Stress Reduction (MBSR) | decrease | depression | adults with different DSM-5 anxiety disorders | - | showed similar trends on | #5 |
Acceptance and Commitment Therapy (ACT), Mindfulness-Based Cognitive Therapy (MBCT), and Mindfulness-Based Stress Reduction (MBSR) | increase | quality of life | adults with different DSM-5 anxiety disorders | - | showed similar trends on | #6 |
This meta-analysis systematically reviewed the evidence on standardized acceptance-/mindfulness-based interventions in DSM-5 anxiety disorders. Randomized controlled trials examining Acceptance and Commitment Therapy (ACT), Mindfulness-Based Cognitive Therapy (MBCT), and Mindfulness-Based Stress Reduction (MBSR) were searched via PubMed, Central, PsycInfo, and Scopus until June 2021. Standardized mean differences (SMD) and 95% confidence intervals (CI) were calculated for primary outcomes (anxiety) and secondary ones (depression and quality of life). Risk of bias was assessed using the Cochrane tool. We found 23 studies, mostly of unclear risk of bias, including 1815 adults with different DSM-5 anxiety disorders. ACT, MBCT and MBSR led to short-term effects on clinician- and patient-rated anxiety in addition to treatment as usual (TAU) versus TAU alone. In comparison to Cognitive Behavioral Therapy (CBT), ACT and MBCT showed comparable effects on both anxiety outcomes, while MBSR showed significantly lower effects. Analyses up to 6 and 12 months did not reveal significant differences compared to TAU or CBT. Effects on depression and quality of life showed similar trends. Statistical heterogeneity was moderate to considerable. Adverse events were reported insufficiently. The evidence suggests short-term anxiolytic effects of acceptance- and mindfulness-based interventions. Specific treatment effects exceeding those of placebo mechanisms remain unclear. Protocol registry: Registered at Prospero on November 3rd, 2017 (CRD42017076810).