Randomized clinical trial of adapted mindfulness-based stress reduction versus group cognitive behavioral therapy for heterogeneous anxiety disorders

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• 作者：Joanna J. Arch^a ; ^{Joanna.Arch@Colorado.edu} ; Catherine R. Ayers^b ; ^{cayers@ucsd.edu} ; Aaron Baker^c ; ^{asbaker@ucla.edu} ; Erin Almklov^d ; ^{Erin.L.Almklov@dartmouth.edu} ; Derek J. Dean^a ; ^{Derek.Dean@colorado.edu} ; Michelle G. Craske^e ; ^{Craske@psych.ucla.edu}
• 关键词：Cognitive behavioral therapy (CBT) ; Mindfulness-based stress reduction (MBSR) ; Mindfulness training ; Veterans ; Anxiety disorders
• 刊名：Behaviour Research and Therapy
• 出版年：2013
• 出版时间：May, 2013
• 年：2013
• 卷：51
• 期：4-5
• 页码：185-196
• 全文大小：547 K

文摘

Objective

To compare a mindfulness-based intervention with cognitive behavioral therapy (CBT) for the group treatment of anxiety disorders.

Method

One hundred five veterans (83 % male, mean age?=?46 years, 30 % minority) with one or more DSM-IV anxiety disorders began group treatment following randomization to adapted mindfulness-based stress reduction (MBSR) or CBT.

Results

Both groups showed large and equivalent improvements on principal disorder severity thru 3-month follow up (ps?<?.001, d?=??4.08 for adapted MBSR; d?=??3.52 for CBT). CBT outperformed adapted MBSR on anxious arousal outcomes at follow up (p?<?.01, d?=?.49) whereas adapted MBSR reduced worry at a greater rate than CBT (p?<?.05, d?=?.64) and resulted in greater reduction of comorbid emotional disorders (p?<?.05, d?=?.49). The adapted MBSR group evidenced greater mood disorders and worry at Pre, however. Groups showed equivalent treatment credibility, therapist adherence and competency, and reliable improvement.

Conclusions

CBT and adapted MBSR were both effective at reducing principal diagnosis severity and somewhat effective at reducing self-reported anxiety symptoms within a complex sample. CBT was more effective at reducing anxious arousal, whereas adapted MBSR may be more effective at reducing worry and comorbid disorders.