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Health anxiety involves persistent worry about one's physical health, despite medical reassurance. Cognitive-behavioral therapy (CBT) is currently the most widely used, evidence-based treatment for health anxiety. Mindfulness-based cognitive therapy (MBCT) is an evidence-based cognitive-behavioral treatment approach that may be useful for health anxiety due to its focus on nonjudgmental awareness and acceptance of physical and emotional events. MBCT has largely been evaluated in a group format; however, the majority of outpatient CBT providers rely also on individual treatments. No research to date has examined the utility of MBCT delivered as an individual therapy for patients with health anxiety. The purpose of the current case study is to describe the delivery, acceptability, and effects of an individually delivered mindfulness-based cognitive-behavioral intervention on health anxiety symptoms for a young woman with severe health anxiety referred to outpatient behavioral medicine by her primary care provider. The treatment was a 16-session, patient-centered intervention largely delivered using MBCT techniques, supplemented by traditional cognitive-behavioral techniques. The patient completed a validated self-report measure of health anxiety symptoms (SHAI) at the beginning of each session. The treatment was found to be acceptable, as evidenced by high treatment attendance and patient feedback. The patient reported significant cognitive, affective, and behavioral improvements, including a 67% reduction in medial visits. Health anxiety scores on the SHAI showed a 52% decrease from the first to last session, reliable change index score of 12.11, and fell below the clinical cutoff at the final session, demonstrating clinical significance. These results suggest that it is feasible to adapt MBCT for the individual treatment of health anxiety, and that controlled trials of individual MBCT are warranted.
We examined specific mindfulness skills (observing, describing, acting with awareness, accepting without judgment, as measured by the Kentucky Inventory of Mindfulness Skills, in terms of anxiety-related cognitive processes among adult daily smokers (n = 90; 43 females; Mage = 26.6 years, SD = 11.8). Partially consistent with hypotheses, describing and accepting without judgment were each shown to significantly predict perceived control over anxiety-related events. The observed significant effects were evident above and beyond the variance accounted for by gender, smoking rate, and negative affectivity. Although observing also was shown to significantly predict agoraphobic cognition, it was in the opposite direction as was theoretically expected. No evidence of incremental validity for mindfulness skills was evident for anxiety sensitivity. These data highlight the potential explanatory relevance of only specific mindfulness skills in terms of only certain anxiety-based cognitive processes among adult daily smokers.