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Randomized Controlled Trial
. 2013 Aug;74(8):786-92.
doi: 10.4088/JCP.12m08083.

Randomized controlled trial of mindfulness meditation for generalized anxiety disorder: effects on anxiety and stress reactivity

Elizabeth A Hoge  1 , Eric Bui, Luana Marques, Christina A Metcalf, Laura K Morris, Donald J Robinaugh, John J Worthington, Mark H Pollack, Naomi M Simon
Affiliations
Randomized Controlled Trial

Randomized controlled trial of mindfulness meditation for generalized anxiety disorder: effects on anxiety and stress reactivity

Elizabeth A Hoge et al. J Clin Psychiatry. 2013 Aug.

Abstract

Objective: Mindfulness meditation has met increasing interest as a therapeutic strategy for anxiety disorders, but prior studies have been limited by methodological concerns, including a lack of an active comparison group. This is the first randomized, controlled trial comparing the manualized Mindfulness-Based Stress Reduction (MBSR) program with an active control for generalized anxiety disorder (GAD), a disorder characterized by chronic worry and physiologic hyperarousal symptoms.

Method: Ninety-three individuals with DSM-IV-diagnosed GAD were randomly assigned to an 8-week group intervention with MBSR or to an attention control, Stress Management Education (SME), between 2009 and 2011. Anxiety symptoms were measured with the Hamilton Anxiety Rating Scale (HAMA; primary outcome measure), the Clinical Global Impressions-Severity of Illness and -Improvement scales (CGI-S and CGI-I), and the Beck Anxiety Inventory (BAI). Stress reactivity was assessed by comparing anxiety and distress during pretreatment and posttreatment administration of the Trier Social Stress Test (TSST).

Results: A modified intent-to-treat analysis including participants who completed at least 1 session of MBSR (n = 48) or SME (n = 41) showed that both interventions led to significant (P < .0001) reductions in HAMA scores at endpoint, but did not significantly differ. MBSR, however, was associated with a significantly greater reduction in anxiety as measured by the CGI-S, the CGI-I, and the BAI (all P values < .05). MBSR was also associated with greater reductions than SME in anxiety and distress ratings in response to the TSST stress challenge (P < .05) and a greater increase in positive self-statements (P = .004).

Conclusions: These results suggest that MBSR may have a beneficial effect on anxiety symptoms in GAD and may also improve stress reactivity and coping as measured in a laboratory stress challenge.

Trial registration: ClinicalTrials.gov identifier: NCT01033851.

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Figures

Figure 1
Figure 1
CONSORT Chart
Figure 2
Figure 2
Anxiety Symptom Change Scores in modified ITT analyses of MBSR compared to SME
Figure 3
Figure 3
Treatment Responders (CGI-I of 1 or 2)
Figure 4
Figure 4
Stress Reactivity Task Score Changes
See this image and copyright information in PMC

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