Low-intensity mindfulness and cognitive-behavioral therapy for social anxiety: a pilot randomized controlled trial.
Study Goal
The researchers aimed to examine the effectiveness of a four-session mindfulness and CBT (M-CBT) program in reducing negative cognition, fear of negative evaluation, and improving mindfulness, depressive symptoms, and subjective happiness in individuals with high social anxiety.
Results Summary
The M-CBT program showed significant improvements in negative cognition, fear of negative evaluation, dispositional mindfulness, depressive symptoms, and subjective happiness with moderate to high effect sizes, but no significant changes in social anxiety symptoms or self-focused attention.
Population
50 Japanese undergraduate students (37 women, 13 men) with high social anxiety.
Effective Dosage
Four-session M-CBT program (specific dosage not detailed).
Duration
Four sessions (duration per session not specified).
Interactions
None mentioned.
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
mindfulness and CBT (M-CBT) | decrease | negative cognition generated when paying attention to others in probability bias | Japanese undergraduate students with high social anxiety | moderate to high effect sizes (ds = .51-1.55) | produced significant pre-post improvements | #1 |
mindfulness and CBT (M-CBT) | decrease | fear of negative evaluation by others | Japanese undergraduate students with high social anxiety | moderate to high effect sizes (ds = .51-1.55) | produced significant pre-post improvements | #2 |
mindfulness and CBT (M-CBT) | increase | dispositional mindfulness | Japanese undergraduate students with high social anxiety | moderate to high effect sizes (ds = .51-1.55) | produced significant pre-post improvements | #3 |
mindfulness and CBT (M-CBT) | decrease | depressive symptoms | Japanese undergraduate students with high social anxiety | moderate to high effect sizes (ds = .51-1.55) | produced significant pre-post improvements | #4 |
mindfulness and CBT (M-CBT) | increase | subjective happiness | Japanese undergraduate students with high social anxiety | moderate to high effect sizes (ds = .51-1.55) | produced significant pre-post improvements | #5 |
mindfulness and CBT (M-CBT) | no change | social anxiety symptoms | Japanese undergraduate students with high social anxiety | - | no interactions | #6 |
mindfulness and CBT (M-CBT) | no change | self-focused attention | Japanese undergraduate students with high social anxiety | - | no interactions | #7 |
BACKGROUND: Cognitive-behavioral therapy (CBT) effectively improves the clinical symptoms of social anxiety disorder. However, there are non-responders who cannot decrease their cost/probability bias significantly; hence, their social anxiety symptoms remain unaddressed. Mindfulness training and cognitive-behavioral approaches promote a reduction in cost/probability bias and social anxiety symptoms. This study examines the effectiveness of a four-session program of mindfulness and CBT (M-CBT) in a non-clinical sample of individuals with high social anxiety. METHODS: Participants were 50 Japanese undergraduate students (37 women and 13 men) randomly allocated to an intervention group (n = 27) and a control group (n = 23). The intervention group underwent a four-session M-CBT program, while the control group did not receive any treatment. RESULTS: A group × time analysis of covariances showed significant interactions in the negative cognition generated when paying attention to others in probability bias, fear of negative evaluation by others, dispositional mindfulness, depressive symptoms, and subjective happiness. M-CBT also produced significant pre-post improvements in the above outcomes with moderate to high effect sizes (ds = .51-1.55). Conversely, there were no interactions in social anxiety symptoms and self-focused attention. CONCLUSIONS: These results indicate that M-CBT was effective for the negative cognition generated when paying attention to others in probability bias, fear of negative evaluation by others, dispositional mindfulness, depressive symptoms, and subjective happiness. The combination of mindfulness training with cognitive restructuring is proposed as potentially helpful for individuals with probability bias, leading to negative cognition from paying attention to others. TRIAL REGISTRATION: University Hospital Medical Information Network (UMIN CTR) UMIN000036763. Registered May 16, 2019.