Abstract
Randomized controlled trials have demonstrated that mindfulness-based cognitive therapy (MBCT) is efficacious in reducing residual depressive symptoms and preventing future depressive episodes (Kuyken et al., 2016). One potential treatment effect of MBCT may be improvement of positive affect (PA), due to improved awareness of daily positive events (Geschwind et al., 2011). Considering social anxiety disorder (SAD) is characterized by diminished PA (Brown et al., 1998; Kashdan, 2007), we sought to determine whether MBCT would reduce social anxiety symptoms, and whether this reduction would be associated with improvement of PA deficits. Adults (N = 22) who met criteria for varied anxiety disorders participated in a small, open-label trial of an 8-week manualized MBCT intervention. Most participants presented with either a diagnosis (primary, secondary, or tertiary) of generalized anxiety disorder (GAD) (N = 15) and/or SAD (N = 14) prior to treatment, with eight individuals meeting diagnostic criteria for both GAD and SAD. We hypothesized participants would demonstrate improvements in social anxiety symptoms, which would be predicted by improvements in PA, not reductions in negative affect (NA). Results of several hierarchical linear regression analyses (completed in both full and disorder-specific samples) indicated that improvements in PA but not reductions in NA predicted social anxiety improvement. This effect was not observed for symptoms of worry, which were instead predicted by decreased NA for individuals diagnosed with GAD and both decreased NA and increased PA in the entire sample. Results suggest that MBCT may be efficacious in mitigating social anxiety symptoms, and this therapeutic effect may be linked to improvements in PA. However, further work is necessary considering the small, heterogeneous sample, uncontrolled study design, and exploratory nature of the study.
Highlights
Social anxiety disorder (SAD) is a common and debilitating psychiatric disorder marked by fear of one or more social situations (American Psychiatric Association, 2013)
Given the lack of research pertaining to this topic, our study was exploratory in nature. From this limited literature base, we provide the following preliminary hypotheses: (1) participants treated with Mindfulness-based cognitive therapy (MBCT) would demonstrate social anxiety symptom improvement at post-treatment, as measured by reductions in self-reported social anxiety symptoms, (2) improvement in social anxiety symptoms, but not other anxiety symptoms would be uniquely related to positive affect (PA) change, and (3) improvements in mindful awareness would be related to improvements in PA change, as MBCT is believed to improve one’s ability to detect daily positive experiences (Geschwind et al, 2011)
The purpose of the current study was to evaluate the relationship between PA and social anxiety symptom change in the context of a pilot open-label trial of MBCT
Summary
Social anxiety disorder (SAD) is a common and debilitating psychiatric disorder marked by fear of one or more social situations (American Psychiatric Association, 2013). Current treatment approaches for SAD focus mainly on fear extinction and habituation processes as their primary mechanisms of action (Rodebaugh et al, 2004). Addressing Positive Affect in Social Anxiety been observed for SAD, with a considerable proportion of individuals still reporting clinically significant symptoms after completing treatment (Heimberg et al, 1998; Otto et al, 2000). Recent evidence suggests that unlike other anxiety disorders, SAD may be uniquely characterized by anhedonic symptoms and low positive affect (PA; Brown et al, 1998; Hughes et al, 2006; Kashdan, 2007). The current study utilized an 8-week manualized MBCT protocol in a sample of adults with anxiety disorders, to examine the role of PA change in social anxiety symptom reduction relative to reduction in other anxiety symptoms
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