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BACKGROUND AND OBJECTIVES: Research suggests mindfulness-based treatments may enhance efficacy of CBT for Generalized Anxiety Disorder (GAD). One hypothesized mechanism of mindfulness is cognitive flexibility; however, research findings to date are mixed as to a) whether cognitive inflexibility represents a characteristic of GAD, and b) whether mindfulness impacts cognitive flexibility. It is proposed that limitations in study methodology may partially account for these mixed findings. The present study investigated cognitive flexibility as a potential mechanism of mindfulness in a sample with elevated GAD symptoms using a modified emotional Stroop switching task while attempting to control for limitations of previous research. The purpose of the study was: 1) to explore cognitive inflexibility as a potential characteristic of GAD, and 2) to examine whether a brief mindfulness induction has measurable impact on cognitive flexibility.METHODS: A total of 66 participants (53 with elevated GAD symptoms, and 13 non-anxious) were randomized to a mindful-breathing, music-assisted relaxation, or thought wandering condition prior to completing an emotional Stroop and emotional Stroop switching task.
RESULTS: Results suggest that GAD may be characterized by an inflexible style of responding, and exposure to mindfulness and relaxation result in partial improvements in cognitive flexibility.
LIMITATIONS: Limitations of this study include small sample size, brief induction period, and use of an analog sample.
CONCLUSIONS: The present findings suggest that mindfulness may be associated with partial improvement in cognitive flexibility.
Accessible and practical, this book provides a unified framework for integrating acceptance and mindfulness into cognitive-behavioral practice. The authors interweave elements of acceptance and commitment therapy, mindfulness-based cognitive therapy, mindfulness-based relapse prevention, and dialectical behavior therapy. They demonstrate how to conduct an assessment, develop a case formulation, and derive a flexible treatment plan for each patient. Vivid case examples and transcripts illustrate the entire process of therapy, showing how treatment can be tailored for different presenting problems and concerns. More than two dozen reproducible handouts and forms are included.
Is there a connection between being healthy and being more consciously present? Do meditation practices that emphasize nonjudging awareness promote movement toward greater levels of health, including improvements in anxiety and related disorders? Can one successfully assume a larger degree of responsibility for one’s own health by adopting a personal meditation practice? Is it possible to establish an effective and broadly replicable training program in mindfulness meditation that appeals to individuals of diverse social, medical, and spiritual backgroundswhoshare a common motivation to improve their personal health outcomes? Mindfulness-based stress reduction (MBSR) was born of such questions.
Baer (2003; this issue) has provided a thoughtful conceptual and empirical review of mindfulness‐based clinical interventions, emphasizing the need for further research. In this commentary we elaborate on some of the areas needing further study. The promising initial data suggest a need for basic experimental and treatment outcome research in order to determine active ingredients and mechanisms of action in mindfulness‐based interventions. In addition, questions remain regarding the optimal mode of delivery of this treatment, as well as how to integrate the non‐striving aspect of mindfulness into clinical intervention.
The authors present a powerful new alternative that can help you break free of anxiety by fundamentally changing how you relate to it
Preventing and reducing depression in first-year college students are crucial areas in need of attention and resources. Programs that are cost-effective and time-efficient, that have replicable benefits across samples, are sorely needed. This study aims to examine whether a previously studied acceptance-based behavioral (ABBT) program, the Mindful Way Through the Semester (MWTS), is effective in comparison to a control condition at decreasing levels of depression and enhancing acceptance and academic values when integrated into a first-year undergraduate experience course. The current study also sought to examine the association between change in acceptance, mindfulness practice, and values practice on outcomes. Two hundred thirteen students were assigned to either the MWTS workshop condition or the control condition (in which the first-year experience curriculum as usual was received). Results revealed that the workshop condition produced larger decreases in depression over the course of the semester relative to the control condition, but only for participants endorsing higher levels of depression at baseline. Further, for participants in the workshop condition, changes in depression were negatively associated with changes in acceptance (i.e., larger increases in acceptance associated with larger decreases in depression), an association that was not statistically significant in the control group. Lastly, for participants in the workshop condition who endorsed higher levels of depression at baseline, mindfulness and values practice was associated with greater reductions in depression. Implications of these findings for future interventions are discussed.
First-year students in higher education deal with an increasing number of mental health issues. Cost-effective and time-efficient programs that ease transitions and reduce risk of depression are needed. To date, programs informed by both cognitive-behavioral and acceptance-based-behavioral therapy (ABBT) approaches have produced some positive outcomes, but methodological limitations limit their utility. The aim of the present study was to address some of these limitations, by developing and preliminary testing the efficacy of a one-session ABBT intervention with first-year undergraduates and first-year law students. Ninety-eight first-year students were randomly assigned to receive either a single-session 90-min ABBT workshop within their first month of school or to a waitlist control condition. Students who received the intervention reported significantly less depression and more acceptance. Moreover, increase in acceptance over the course of the semester was associated with reductions in depression. Implications of these findings for future interventions are discussed.
This exploratory study examined factors that contribute to psychological distress within racial majority and minority undergraduate students. Using a dataset obtained from a larger study (Danitz, Suvak, & Orsillo, 2016), we explored the relationship between acceptance, academic values, and psychological distress across these two groups. Participants included 186 undergraduate students (71.5% self-identified as White) enrolled in a private urban university located in the northeastern U.S. Results revealed no significant differences in psychological distress or acceptance across majority/minority groups. Racial majority students who endorsed higher acceptance and educational values reported psychological well-being, although this relationship was less robust in minority students. The implications of these findings for future research are discussed.
OBJECTIVE:To examine whether an empirically and theoretically derived treatment combining mindfulness- and acceptance-based strategies with behavioral approaches would improve outcomes in generalized anxiety disorder (GAD) over an empirically supported treatment.
METHOD:
This trial randomized 81 individuals (65.4% female, 80.2% identified as White, average age 32.92) diagnosed with GAD to receive 16 sessions of either an acceptance-based behavior therapy (ABBT) or applied relaxation (AR). Assessments at pretreatment, posttreatment, and 6-month follow-up included the following primary outcome measures: GAD clinician severity rating, Structured Interview Guide for the Hamilton Anxiety Rating Scale, Penn State Worry Questionnaire, Depression Anxiety Stress Scale, and the State-Trait Anxiety Inventory. Secondary outcomes included the Beck Depression Inventory-II, Quality of Life Inventory, and number of comorbid diagnoses.
RESULTS:
Mixed effect regression models showed significant, large effects for time for all primary outcome measures (ds = 1.27 to 1.61) but nonsignificant, small effects for condition and Condition × Time (ds = 0.002 to 0.20), indicating that clients in the 2 treatments improved comparably over treatment. For secondary outcomes, time was significant (ds = 0.74 to 1.38), but condition and Condition × Time effects were not (ds = 0.004 to 0.31). No significant differences emerged over follow-up (ds = 0.03 to 0.39), indicating maintenance of gains. Between 63.3 and 80.0% of clients in ABBT and 60.6 and 78.8% of clients in AR experienced clinically significant change across 5 calculations of change at posttreatment and follow-up.
CONCLUSION:
ABBT is a viable alternative for treating GAD. (PsycINFO Database Record (c) 2013 APA, all rights reserved).
A growing body of research suggests that mindfulness- and acceptance-based principles can increase efforts aimed at reducing human suffering and increasing quality of life. A critical step in the development and evaluation of these new approaches to treatment is to determine the acceptability and efficacy of these treatments for clients from nondominant cultural and/or marginalized backgrounds. This special series brings together the wisdom of clinicians and researchers who are currently engaged in clinical practice and treatment research with populations who are historically underrepresented in the treatment literature. As an introduction to the series, this paper presents a theoretical background and research context for the papers in the series, highlights the elements of mindfulness- and acceptance-based treatments that may be congruent with culturally responsive treatment, and briefly outlines the general principles of cultural competence and responsive treatment. Additionally, the results of a meta-analysis of mindfulness- and acceptance-based treatments with clients from nondominant cultural and/or marginalized backgrounds are presented. Our search yielded 32 studies totaling 2,198 clients. Results suggest small (Hedges' g = .38, 95% CI = .11 – .64) to large (Hedges' g = 1.32, 95% CI = .61 – 2.02) effect sizes for mindfulness- and acceptance-based treatments, which varied by study design.
A growing body of research suggests that mindfulness- and acceptance-based principles can increase efforts aimed at reducing human suffering and increasing quality of life. A critical step in the development and evaluation of these new approaches to treatment is to determine the acceptability and efficacy of these treatments for clients from nondominant cultural and/or marginalized backgrounds. This special series brings together the wisdom of clinicians and researchers who are currently engaged in clinical practice and treatment research with populations who are historically underrepresented in the treatment literature. As an introduction to the series, this paper presents a theoretical background and research context for the papers in the series, highlights the elements of mindfulness- and acceptance-based treatments that may be congruent with culturally responsive treatment, and briefly outlines the general principles of cultural competence and responsive treatment. Additionally, the results of a meta-analysis of mindfulness- and acceptance-based treatments with clients from nondominant cultural and/or marginalized backgrounds are presented. Our search yielded 32 studies totaling 2,198 clients. Results suggest small (Hedges' g = .38, 95% CI = .11 – .64) to large (Hedges' g = 1.32, 95% CI = .61 – 2.02) effect sizes for mindfulness- and acceptance-based treatments, which varied by study design.