Estudio con grupo control-Mindfulness y ansiedad
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Randomized Controlled Trial of Mindfulness Meditation for Generalized Anxiety Disorder: Effects on Anxiety and Stress Reactivity. J Clin Psychiatry. 2013 Aug; 74(8): 786–792.
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, a disorder characterized by chronic
worry and physiological hyperarousal symptoms.
Method
Ninety-three
individuals with DSM-IV-diagnosed GAD were randomized 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 Scale (HAM-A, primary outcome
measure), the Clinical Global Impression of Severity and Improvement
(CGI-S and CGI-I), and the Beck Anxiety Inventory (BAI). Stress
reactivity was assessed by comparing anxiety and distress during pre-
and post-treatment Trier Social Stress Tests (TSST).
Results
A
modified intent-to-treat analysis including participants who completed
at least one session of MBSR (N=48) or SME (N=41) showed that both
interventions led to significant reductions in HAM-A 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 Ps<0.05). MBSR was also associated
with greater reductions than SME in anxiety and distress ratings in
response to the TSST stress challenge (P<0.05), and a greater increase in positive self-statements (P=0.004).
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.
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