Testing the Efficacy of a Brief, Self-Guided Mindfulness Ecological Momentary Intervention on Emotion Regulation and Self-Compassion in Social Anxiety Disorder: Randomized Controlled Trial.
Study Goal
The researchers aimed to test whether a brief, mobile, self-guided mindfulness intervention (MEMI) could enhance emotion regulation and self-compassion in individuals with social anxiety disorder (SAD).
Results Summary
The MEMI was more effective than self-monitoring in improving specific self-compassion domains and reducing certain emotion regulation difficulties, but no significant mediation effects were found for SAD symptoms or other clinical outcomes.
Population
Individuals with social anxiety disorder (SAD), defined by a Social Phobia Inventory score ≥20.
Effective Dosage
14-day fully self-guided intervention (specific dosage not detailed).
Duration
14 days.
Interactions
None mentioned.
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
mindfulness ecological momentary interventions (MEMI) | decrease | ER goal-directed behavior difficulties | participants with SAD | between-group Cohen d=-0.24 | was more efficacious than the self-monitoring app in decreasing | #1 |
mindfulness ecological momentary interventions (MEMI) | decrease | lack of emotional clarity | participants with SAD | Cohen d=0.16 | was more efficacious than the self-monitoring app in decreasing | #2 |
mindfulness ecological momentary interventions (MEMI) | increase | self-compassion social connectedness | participants with SAD | Cohen d=0.19 | was more efficacious than the self-monitoring app in increasing | #3 |
mindfulness ecological momentary interventions (MEMI) | increase | nonidentification with emotions | participants with SAD | Cohen d=0.16 | was more efficacious than the self-monitoring app in increasing | #4 |
mindfulness ecological momentary interventions (MEMI) | increase | self-kindness | participants with SAD | Cohen d=0.19 | was more efficacious than the self-monitoring app in increasing | #5 |
mindfulness ecological momentary interventions (MEMI) | decrease | ER goal-directed behavior difficulties | participants with SAD | Cohen d=-0.73 vs -0.29 | within-group effect sizes from pretrial to midintervention were larger in the MEMI arm than in the self-monitoring app arm for | #6 |
mindfulness ecological momentary interventions (MEMI) | decrease | lack of emotional clarity | participants with SAD | Cohen d=-0.39 vs -0.21 | within-group effect sizes from pretrial to midintervention were larger in the MEMI arm than in the self-monitoring app arm for | #7 |
mindfulness ecological momentary interventions (MEMI) | increase | self-compassion domains of social connectedness | participants with SAD | Cohen d=0.45 vs 0.19 | within-group effect sizes from pretrial to midintervention were larger in the MEMI arm than in the self-monitoring app arm for | #8 |
mindfulness ecological momentary interventions (MEMI) | increase | nonidentification with emotions | participants with SAD | Cohen d=0.63 vs 0.48 | within-group effect sizes from pretrial to midintervention were larger in the MEMI arm than in the self-monitoring app arm for | #9 |
mindfulness ecological momentary interventions (MEMI) | increase | self-kindness | participants with SAD | Cohen d=0.36 vs 0.10 | within-group effect sizes from pretrial to midintervention were larger in the MEMI arm than in the self-monitoring app arm for | #10 |
self-monitoring app | decrease | ER emotional awareness issues | participants with SAD | between-group Cohen d=0.11 and within-group: Cohen d=-0.29 vs -0.13 | alleviated | #11 |
self-monitoring app | decrease | self-compassion acknowledging shared human struggles | participants with SAD | between-group Cohen d=0.26 and within-group: Cohen d=-0.23 vs 0.13 | reduced | #12 |
mindfulness ecological momentary interventions (MEMI) | no change | SAD symptoms | participants with SAD | P=.07-<.99 | No ER and self-compassion domains were mediators of the effect on | #13 |
mindfulness ecological momentary interventions (MEMI) | no change | generalized anxiety symptoms | participants with SAD | P=.16-.98 | No ER and self-compassion domains were mediators of the effect on | #14 |
mindfulness ecological momentary interventions (MEMI) | no change | depression severity | participants with SAD | P=.20-.94 | No ER and self-compassion domains were mediators of the effect on | #15 |
mindfulness ecological momentary interventions (MEMI) | no change | repetitive negative thinking | participants with SAD | P=.12-.96 | No ER and self-compassion domains were mediators of the effect on | #16 |
mindfulness ecological momentary interventions (MEMI) | no change | trait mindfulness | participants with SAD | P=.18-.99 | No ER and self-compassion domains were mediators of the effect on | #17 |
BACKGROUND: Theories propose that brief, mobile, self-guided mindfulness ecological momentary interventions (MEMIs) could enhance emotion regulation (ER) and self-compassion. Such changes are posited to be mechanisms of change. However, rigorous tests of these theories have not been conducted. OBJECTIVE: In this assessor-blinded, parallel-group randomized controlled trial, we aimed to test these theories in social anxiety disorder (SAD). METHODS: Participants with SAD (defined as having a prerandomization cut-off score ≥20 on the Social Phobia Inventory self-report) were randomized to a 14-day fully self-guided MEMI (96/191, 50.3%) or self-monitoring app (95/191, 49.7%) arm. They completed web-based self-reports of 6 clinical outcome measures at prerandomization, 15-day postintervention (administered the day after the intervention ended), and 1-month follow-up time points. ER and self-compassion were assessed at preintervention and 7-day midintervention time points. Multilevel modeling determined the efficacy of MEMI on ER and self-compassion domains from pretrial to midintervention time points. Bootstrapped parallel multilevel mediation analysis examined the mediating role of pretrial to midintervention ER and self-compassion domains on the efficacy of MEMI on 6 clinical outcomes. RESULTS: Participants demonstrated strong compliance, with 78% (149/191) engaging in at least 80% of the MEMI and self-monitoring prompts. MEMI was more efficacious than the self-monitoring app in decreasing ER goal-directed behavior difficulties (between-group Cohen d=-0.24) and lack of emotional clarity (Cohen d=0.16) and increasing self-compassion social connectedness (Cohen d=0.19), nonidentification with emotions (Cohen d=0.16), and self-kindness (Cohen d=0.19) from pretrial to midintervention time points. The within-group effect sizes from pretrial to midintervention were larger in the MEMI arm than in the self-monitoring app arm (ER goal-directed behavior difficulties: Cohen d=-0.73 vs -0.29, lack of emotional clarity: Cohen d=-0.39 vs -0.21, self-compassion domains of social connectedness: Cohen d=0.45 vs 0.19, nonidentification with emotions: Cohen d=0.63 vs 0.48, and self-kindness: Cohen d=0.36 vs 0.10). Self-monitoring, but not MEMI, alleviated ER emotional awareness issues (between-group Cohen d=0.11 and within-group: Cohen d=-0.29 vs -0.13) and reduced self-compassion acknowledging shared human struggles (between-group Cohen d=0.26 and within-group: Cohen d=-0.23 vs 0.13). No ER and self-compassion domains were mediators of the effect of MEMI on SAD symptoms (P=.07-<.99), generalized anxiety symptoms (P=.16-.98), depression severity (P=.20-.94), repetitive negative thinking (P=.12-.96), and trait mindfulness (P=.18-.99) from pretrial to postintervention time points. Similar nonsignificant mediation effects emerged for all of these clinical outcomes from pretrial to 1-month follow-up time points (P=.11-.98). CONCLUSIONS: Brief, fully self-guided, mobile MEMIs efficaciously increased specific self-compassion domains and decreased ER difficulties associated with goal pursuit and clarity of emotions from pretrial to midintervention time points. Higher-intensity MEMIs may be required to pinpoint the specific change mechanisms in ER and self-compassion domains of SAD. TRIAL REGISTRATION: Open Science Framework (OSF) Registries; osf.io/m3kxz https://osf.io/m3kxz.