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Is a brief mindfulness ecological momentary intervention more efficacious than a self-monitoring app for social anxiety disorder? A randomized controlled trial.

Journal of anxiety disorders
June 1, 2024
Nur Hani Zainal et al. (4 authors)
Journal ArticleRandomized Controlled TrialHuman StudyClinical
Study Details

Study Goal

The researchers aimed to evaluate the potential benefits of a 14-day mindfulness ecological momentary intervention (MEMI) for individuals with social anxiety disorder (SAD), comparing its effects to a self-monitoring app.

Results Summary

The MEMI showed statistically significant but small improvements in momentary depression, anxiety, and mindfulness compared to self-monitoring. While no significant between-group differences were found for SAD fear and avoidance, worry, or trait mindfulness, within-group effects were small-to-large, and MEMI specifically reduced depression severity more than self-monitoring.

Population

Individuals with self-reported social anxiety disorder (SAD).

Effective Dosage

Mindfulness exercises prompted five times daily.

Duration

14 days.

Interactions

None mentioned.

Extracted Claims (13)
InterventionDirectionEndpointPopulationDosageImpactClaim #
14-day mindfulness ecological momentary intervention (MEMI)
decrease
momentary depression
participants with self-reported social anxiety disorder (SAD)
Cohen's d = -0.10-0.11
yielded statistically significantly larger improvements
#1
14-day mindfulness ecological momentary intervention (MEMI)
decrease
momentary anxiety
participants with self-reported social anxiety disorder (SAD)
Cohen's d = -0.10-0.11
yielded statistically significantly larger improvements
#2
14-day mindfulness ecological momentary intervention (MEMI)
increase
momentary mindfulness
participants with self-reported social anxiety disorder (SAD)
Cohen's d = -0.10-0.11
yielded statistically significantly larger improvements
#3
14-day mindfulness ecological momentary intervention (MEMI)
no change
SAD fear and avoidance
participants with self-reported social anxiety disorder (SAD)
-0.13-0.15
no between-group effects emerged
#4
14-day mindfulness ecological momentary intervention (MEMI)
no change
excessive worry
participants with self-reported social anxiety disorder (SAD)
-0.13-0.15
no between-group effects emerged
#5
14-day mindfulness ecological momentary intervention (MEMI)
no change
depression severity
participants with self-reported social anxiety disorder (SAD)
-0.13-0.15
no between-group effects emerged
#6
14-day mindfulness ecological momentary intervention (MEMI)
no change
repetitive negative thinking
participants with self-reported social anxiety disorder (SAD)
-0.13-0.15
no between-group effects emerged
#7
14-day mindfulness ecological momentary intervention (MEMI)
no change
trait mindfulness
participants with self-reported social anxiety disorder (SAD)
-0.13-0.15
no between-group effects emerged
#8
14-day mindfulness ecological momentary intervention (MEMI)
decrease
SAD fear and avoidance, excessive worry, depression severity, repetitive negative thinking, and trait mindfulness
participants with self-reported social anxiety disorder (SAD)
-4.62-0.67
within-group effects were significantly small-to-large
#9
14-day mindfulness ecological momentary intervention (MEMI)
decrease
depression severity
participants with self-reported social anxiety disorder (SAD)
-0.63--0.60
significant reduction
#10
self-monitoring app (SM)
no change
depression severity
participants with self-reported social anxiety disorder (SAD)
-0.31--0.29
no significant reduction
#11
brief mindfulness ecological momentary intervention (MEMI)
no change
SAD, comorbid symptoms, and risk factors
participants with self-reported social anxiety disorder (SAD)
-
yielded nondifferent sustained effects
#12
self-monitoring app (SM)
no change
SAD, comorbid symptoms, and risk factors
participants with self-reported social anxiety disorder (SAD)
-
yielded nondifferent sustained effects
#13
Abstract

Despite their proliferation, limited knowledge exists regarding possible benefits of brief mindfulness ecological momentary interventions (MEMIs) for social anxiety disorder (SAD). Propositions that MEMIs could alleviate SAD symptoms and related clinical outcomes remain untested. This trial evaluated a 14-day MEMI for SAD. Participants with self-reported SAD were randomized to MEMI (n = 96) or self-monitoring app (SM; n = 95). Whereas MEMI instructed mindfulness exercises, SM prompted only self-monitoring five times daily for 14 days. Participants completed state-level self-reports of depression, anxiety, and mindfulness pre-post-mindfulness practice and SAD symptoms, worry, depression severity, repetitive negative thinking, and trait mindfulness at pre-randomization, post-intervention, and 1-month follow-up (1MFU). Hierarchical linear modeling was conducted. The MEMI yielded statistically significantly larger improvements in momentary depression, anxiety, and mindfulness (Cohen's d = -0.10-0.11). Although no between-group effects emerged in alleviating SAD fear and avoidance, excessive worry, depression severity, repetitive negative thinking, and trait mindfulness (-0.13-0.15), within-group effects were significantly small-to-large from pre-post and pre-1MFU (-4.62-0.67). A significant reduction in depression severity occurred in MEMI (-0.63--0.60) but not SM (-0.31--0.29). Brief MEMI and SM yielded nondifferent sustained effects on SAD, comorbid symptoms, and risk factors, highlighting its potential value within stepped-care delivery settings.

Medical Subject Headings (MeSH)
HumansMindfulnessFemaleMalePhobia, SocialAdultMobile ApplicationsEcological Momentary AssessmentYoung AdultTreatment OutcomeMiddle AgedDepression
Study Links
Quality Scores
SafetyNot Assessed
Efficacy65/10
Quality80/10
Citation Metrics
Total Citations5
Citations/Year5.0
Relative Citation Ratio2.46
Research Impact Scores
APT Score0.25
Weight Score2.87
Normalized Score0.62
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