Randomized Controlled Trial of Mindfulness Meditation for Generalized Anxiety Disorder

作者：Elizabeth A. Hoge, Éric Bui, Luana M. Marques, Christina A. Metcalf, Laura K. Morris, Donald J. Robinaugh, John J. Worthington, Mark H. Pollack, Naomi M. Simon · 发表于：The Journal of Clinical Psychiatry · 年份：2013 · DOI：10.4088/jcp.12m08083 · 被引用次数：519 · 研究领域：Mindfulness and Compassion Interventions、Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes、Acupuncture Treatment Research Studies

Article 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 ...