Abstract
Anxiety disorders are highly prevalent and costly both to the individual and society. Established treatments are effective, but a number of patients fail to respond optimally. Mindfulness- and acceptance-based interventions (MABIs) constitute a family of treatments emphasising present-centred awareness, a stance of non-judgment, and value-oriented action. Anxiety disorders are instigated and maintained by a set of transdiagnostic processes within the domains of cognition, emotion, behaviour, and self-experience. A conceptual and empirical overview suggests that MABI may impact beneficially on these processes. Clinical trials and meta-analyses provide support for their effectiveness in anxiety disorders, although a pattern of divergent findings emerges. Clinical trials show strongest support for MABIs in the treatment of heterogeneous anxiety disorders and generalised anxiety disorder. Evidence for social anxiety disorder is mixed, and there is at present insufficient evidence to assess the impact of MABIs on panic disorder, PTSD, and OCD. Despite equivalent outcomes to cognitive behavioural therapy (CBT) in most head-to-head comparisons, MABIs have yet to perform as well as CBT at its best. While CBT is still the treatment of choice for most anxiety disorders, MABIs constitute a viable treatment option for CBT nonresponders and may also be preferred by some patients. Further tailoring of MABIs to discrete anxiety disorders may be needed. Clinical implementation is discussed, and recommendations for further research are presented.
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References
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders: DSM-IV (4th ed.). Washington, DC: APA.
Amstadter, A. (2008). Emotion regulation and anxiety disorders. Journal of Anxiety Disorders, 22, 211–221.
Antony, M. M. (2002). Enhancing current treatments for anxiety disorders. Clinical Psychology: Science and Practice, 9, 91–94.
Arch, J. J., Ayers, C. R., Baker, A., Almklov, E., Dean, D. J., & Craske, M. G. (2013). Randomized clinical trial of adapted mindfulness-based stress reduction versus group cognitive behavioral therapy for heterogeneous anxiety disorders. Behaviour Research and Therapy, 51, 185–196.
Arch, J. J., Eifert, G. H., Davies, C., Vilardaga, J. C. P., Rose, R. D., & Craske, M. G. (2012). Randomized clinical trial of cognitive behavioral therapy (CBT) versus acceptance and commitment therapy (ACT) for mixed anxiety disorders. Journal of Consulting and Clinical Psychology, 80, 750–765.
Austin, D. W., & Richards, J. C. (2001). The catastrophic misinterpretation model of panic disorder. Behaviour Research and Therapy, 39, 1277–1291.
Avdagic, E., Morrissey, S. A., & Boschen, M. J. (2014). A randomised controlled trial of acceptance and commitment therapy and cognitive-behaviour therapy for generalised anxiety disorder. Behaviour Change, 31, 110–130.
Baer, R. A. (2007). Mindfulness, assessment, and transdiagnostic processes. Psychological Inquiry, 18, 238–271.
Baer, R. A., Smith, G. T., Hopkins, J., Krietemeyer, J., & Toney, L. (2006). Using self-report assessment methods to explore facets of mindfulness. Assessment, 13, 27–45.
Bar-Haim, Y., Lamy, D., Pergamin, L., Bakermans-Kranenburg, M. J., & van Ijzendorn, M. H. (2007). Threat-related attentional bias in anxious and nonanxious individuals: A meta-analytic study. Psychological Bulletin, 133, 1–24.
Barlow, D. H. (2002). Anxiety and its disorders (2nd ed.). New York: The Guilford Press.
Baumeister, R. F., Heatherton, T. F., & Tice, D. M. (1994). Losing control: How and why people fail at self-regulation. San Diego: Academic.
Bishop, S. R., Lau, M., Shapiro, S., Carlson, L., Anderson, N. D., Carmody, J., et al. (2004). Mindfulness: A proposed operational definition. Clinical Psychology: Science and Practice, 11, 230–241.
Bluett, E. J., Homan, K. J., Morrison, K. L., Levin, M. E., & Twohig, M. P. (2014). Acceptance and commitment therapy for anxiety and OCD spectrum disorders: An empirical review. Journal of Anxiety Disorders, 28, 612–624.
Boettcher, J., Ă…ström, V., PĂ¥hlsson, D., Schenström, O., Andersson, G., & Carlbring, P. (2014). Internet-based mindfulness treatment for anxiety disorders: A randomized controlled trial. Behavior Therapy, 45, 241–253.
Bögels, S. M., Sijbers, G. F. V., & Voncken, M. (2006). Mindfulness and task concentration training for social phobia: A pilot study. Journal of Cognitive Psychotherapy, 20, 33–44.
Bohlmeijer, E. T., Fledderus, M., Rokx, T. A. J. J., & Pieterse, M. E. (2011). Efficacy of an early intervention based on acceptance and commitment therapy for adults with depressive symptomatology: Evaluation in a randomized controlled trial. Behaviour Research and Therapy, 49, 62–67.
Bolton J. M., Cox, B. J., Afifi, T. O., Enns, M. W., Bienvenu, O. J., & Sareen, J. (2008). Anxiety disorders and risk for suicide attempts: Findings from the Baltimore Epidemiologic Catchment area follow-up study. Depression and Anxiety, 25, 477–481.
Bondolfi, G., Jermann, F., der Linden, M. V., Gex-Fabry, M., Bizzini, L., Rouget, B. W., et al. (2010). Depression relapse prophylaxis with Mindfulness-Based Cognitive Therapy: Replication and extension in the Swiss health care system. Journal of Affective Disorders, 122, 224–231.
Borkovec, T. D., Alcaine, O., & Behar, E. (2004). Avoidance theory of worry and generalized anxiety disorder. In R. G. Heimberg, C. L. Turk, & D. Mennin (Eds.), Generalized anxiety disorder: Advances in research and practice (pp. 77–108). New York: Guilford Press.
Bränström, R., Duncan, L. G., & Moskowitz, J. T. (2011). The association between dispositional mindfulness, psychological well-being, and perceived health in a Swedish population-based sample. British Journal of Health Psychology, 16, 300–316.
Brown, K. W., & Ryan, R. M. (2003). The benefits of being present: Mindfulness and its role in psychological well-being. Journal of Personality and Social Psychology, 84, 822–848.
Bruce, S. E., Yonkers, K. A., Otto, M. W., Eisen, J. L., Weisberg, R. B., Pagano, M., et al. (2005). Influence of psychiatric comorbidity on recovery and recurrence in generalized anxiety disorder, social phobia, and panic disorder: A 12-year prospective study. American Journal of Psychiatry, 162, 1179–1187.
Campbell-Sills, L., & Barlow, D. H. (2007). Incorporating emotion regulation into conceptualizations and treatments of anxiety and mood disorders. In J. J. Gross (Ed.), Handbook of emotion regulation (pp. 542–559). New York: Guilford.
Campbell-Sills, L., Barlow, D. H., Brown, T. A., & Hofmann, S. G. (2006a). Acceptability and suppression of negative emotion in anxiety and mood disorders. Emotion, 6, 587–595.
Campbell-Sills, L., Barlow, D. H., Brown, T. A., & Hofmann, S. G. (2006b). Effects of suppression and acceptance of emotional responses of individuals with anxiety and mood disorders. Behavior Research and Therapy, 44, 1251–1263.
Carmody, J. (2009). Evolving concepts of mindfulness in clinical settings. Journal of Cognitive Psychotherapy, 23, 270–280.
Cash, M., & Whittingham, K. (2010). What facets of mindfulness contribute to psychological well-being and depressive, anxious, and stress-related symptomatology? Mindfulness, 1, 177–182.
Chan, D., & Woollacott, M. (2007). Effects of level of meditation experience on attentional focus: Is the efficiency of executive or orientation networks improved? The Journal of Alternative and Complementary Medicine, 13, 651–658.
Chiesa, A., & Malinowski, P. (2011). Mindfulness-based approaches: Are they all the same? Journal of Clinical Psychology, 67, 1–21.
Chiesa, A., & Serretti, A. (2009). Mindfulness-based stress reduction for stress management in healthy people: A review and meta-analysis. Journal of Alternative and Complementary Medicine, 15, 593–600.
Clark, D. M. (1999). Anxiety disorders. Why they persist and how to treat them. Behaviour Research and Therapy, 37, 5–27.
Craigie, M. A., Rees, C. S., Marsh, A., & Nathan, P. (2008). Mindfulness-based cognitive therapy for generalized anxiety disorder: A preliminary evaluation. Behavioral and Cognitive Psychotherapy, 36, 553–568.
Craske, M. G., Rauch, S. L., Ursano, R., Prenoveau, J., Pine, D. S., & Zinbarg, R. E. (2009). What is an anxiety disorder? Depression and Anxiety, 26, 1066–1085.
Creswell, J. D., Way, B. M., Eisenberger, N. I., & Lieberman, M. D. (2007). Neural correlates of dispositional mindfulness during affect labeling. Psychosomatic Medicine, 69, 560–565.
Dalrymple, K. L., & Herbert, J. D. (2007). Acceptance and commitment therapy for generalized social anxiety disorder – a pilot study. Behavior Modification, 31, 543–568.
Dalrymple, K. L., Morgan, T. A., Lipschitz, J. M., Martinez, J. H., Tepe, E., & Zimmerman, M. (2014). An integrated, acceptance-based behavioral approach for depression with social anxiety - Preliminary results. Behavior Modification, 38, 516–548.
de Vibe, M., Bjørndal, A., Tipton, E., Hammerstrøm, K. T., & Kowalski, K. (2012). Mindfulness based stress reduction (MBSR) for improving health, quality of life, and social functioning in adults. Campbell Systematic Reviews, 8.
Deacon, B., Lickel, J., & Abramowitz, J. S. (2008). Medical utilization across the anxiety disorders. Journal of Anxiety Disorders, 22, 344–350.
Dehlin, J. P., Morrison, K. L., & Twohig, M. P. (2013). Acceptance and commitment therapy as a treatment for scrupulosity in obsessive compulsive disorder. Behavior Modification, 37, 409–430.
Desrosiers, A., Klemanski, D. H., & Nolen-Hoeksema, S. (2013). Mapping mindfulness facets onto dimensions of anxiety and depression. Behavior Therapy, 44, 373–384.
Deyo, M., Wilson, K. A., Ong, J., & Koopman, C. (2009). Mindfulness and rumination: Does mindfulness training lead to reductions in the ruminative thinking associated with depression? Patient Education and Counseling, 5, 265–271.
Dugas, M. J., Buhr, K., & Ladouceur, R. (2004). The role of intolerance of uncertainty in etiology and maintenance. In R. G. Heimberg, C. L. Turk, & D. S. Mennin (Eds.), Generalized anxiety disorder: Advances in research and practice (pp. 77–108). New York: Guilford Press.
Earley, M. D., Chesney, M. A., Frye, J., Greene, P. A., Berman, B., & Kimbrough, E. (2014). Mindfulness intervention for child abuse survivors: A 2.5-year follow-up. Journal of Clinical Psychology, 70, 933–941.
Ehring, T., & Watkins, E. R. (2009). Repetitive negative thinking as a transdiagnostic process. International Journal of Cognitive Therapy, 1, 192–205.
Eifert, G. H., & Forsyth, J. P. (2005). Acceptance and commitment therapy for anxiety disorders: A practitioner’s treatment guide to using mindfulness, acceptance, and value-based behavior change strategies. Oakland, CA: New Harbinger Publications.
Eifert, G. H., & Heffner, M. (2003). The effects of acceptance versus control contexts on avoidance of panic-related symptoms. Journal of Behavior Therapy and Experimental Psychiatry, 34, 293–312.
Evans, S., Ferrando, S., Findler, M., Stowell, C., Smart, C., & Haglin, D. (2008). Mindfulness-based cognitive therapy for generalized anxiety disorder. Journal of Anxiety Disorders, 22, 716–721.
Farb, N. A., Anderson, A. K., & Segal, Z. V. (2012). The mindful brain and emotion regulation in mood disorders. Canadian Journal of Psychiatry, 57, 70–77.
Farb, N. A. S., Segal, Z. V., Mayberg, H., Bean, J., McKeon, D., Fatima, Z., et al. (2007). Attending to the present: Mindfulness meditation reveals distinct neural modes of self-reference. Social Cognitive and Affective Neuroscience, 2, 259–263.
Farb, N. A., Segal, Z. V., & Anderson, A. K. (2012). Mindfulness meditation training alters cortical representations of interoceptive attention. Social Cognitive and Affective Neuroscience, 8, 15–26.
Finucane, A., & Mercer, S. W. (2006). An exploratory mixed methods study of the acceptability and effectiveness of mindfulness-based cognitive therapy for patients with active depression and anxiety in primary care. BMC Psychiatry, 6, 14.
Frewen, P. A., Evans, E. M., Maraj, N., Dozois, D. J., & Partridge, K. (2008). Letting go: Mindfulness and negative automatic thinking. Cognitive Therapy and Research, 32, 758–774.
Gloster, A. T., Sonntag, R., Hoyer, J., Meyer, A. H., Heinze, S., Ströhle, A., et al. (2015). Treating treatment-resistant patients with panic disorder and agoraphobia using psychotherapy: A randomized controlled switching trial. Psychotherapy and Psychosomatics, 84, 100–109.
Godfrin, K. A., & van Heeringen, C. (2010). The effects of mindfulness-based cognitive therapy on recurrence of depressive episodes, mental health and quality of life: A randomized controlled study. Behaviour Research and Therapy, 48, 738–746.
Goldin, P. R., Ramel, W., & Gross, J. J. (2009). Mindfulness meditation training and self-referential processing in social anxiety disorders: Behavioral and neural effects. Journal of Cognitive Psychotherapy, 23, 242–257.
Goyal, M., Singh, S., Sibinga, E. M., Gould, N. F., Rowland-Seymour, A., Sharma, R., et al. (2014). Meditation programs for psychological stress and well-being: A systematic review and meta-analysis. JAMA Internal Medicine, 174, 357–368.
Greenberg, P. E., Sisitsky, T., Kessler, R. C., Finkelstein, S. N., Berndt, E. R., Davidson, J. R. T., et al. (1999). The economic burden of anxiety disorders in the 1990s. Journal of Clinical Psychiatry, 60, 427–435.
Gross, J. J. (2002). Emotion regulation: Affective, cognitive, and social consequences. Psychophysiology, 39, 281–291.
Hargus, E., Crane, C., Barnhofer, T., & Williams, J. M. G. (2010). Effects of mindfulness on meta-awareness and specificity of describing prodromal symptoms in suicidal depression. Emotion, 10, 34–42.
Hayes, S. C. (2004). Acceptance and commitment therapy, relational frame theory, and the third wave of behavioral and cognitive therapies. Behavior Therapy, 35, 639–665.
Hayes, A. M., & Feldman, G. (2004). Clarifying the construct of mindfulness in the context of emotion regulation and the process of change in therapy. Clinical Psychology: Research and Practice, 11, 255–262.
Hayes, S. C., Luoma, J. B., Bond, F. W., Masuda, A., & Lillis, J. (2006). Acceptance and Commitment Therapy: Model, processes, and outcomes. Behaviour Research and Therapy, 44, 1–25.
Hayes, S. A., Orsillo, S. M., & Roemer, L. (2010). Changes in proposed mechanisms of action during an acceptance-based behavior therapy for generalized anxiety disorder. Behaviour Research and Therapy, 48, 238–245.
Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (1999). Acceptance and commitment therapy. An experiential approach to behavior change. New York: The Guilford Press.
Hayes-Skelton, S. A., Roemer, L., & Orsillo, S. M. (2013). A randomized clinical trial comparing an acceptance-based behavior therapy to applied relaxation for generalized anxiety disorder. Journal of Consulting and Clinical Psychology, 81, 761–773.
Heimberg, R. G. (2002). Cognitive-behavioral therapy for social anxiety disorder: Current status and future directions. Biological Psychiatry, 51, 101–108.
Hofmann, S. G., & Asmundson, G. J. G. (2008). Acceptance- and mindfulness-based therapy: New wave or old hat? Clinical Psychology Review, 28, 1–16.
Hofmann, S. G., & Bögels, S. M. (2006). Recent advances in the treatment of social phobia: Introduction to the special issue. Journal of Cognitive Psychotherapy, 20, 3–5.
Hofmann, S. G., Sawyer, A. T., Witt, A. A., & Oh, D. (2010). The effect of mindfulness-based therapy on anxiety and depression: A meta-analytic review. Journal of Consulting and Clinical Psychology, 78, 169–183.
Hofmann, S. G., & Smits, J. A. (2008). Cognitive-behavioral therapy for adult anxiety disorders: A meta-analysis of randomized placebo-controlled trials. Journal of Clinical Psychiatry, 69, 621–632.
Hoge, E. A., Bui, E., Marques, L., Metcalf, C. A., Morris, L. K., Robinaugh, D. J., et al. (2013). Randomized controlled trial of mindfulness meditation for generalized anxiety disorder: Effects on anxiety and stress reactivity. The Journal of Clinical Psychiatry, 74, 786–792.
Hollon, S. D., & Beck, A. T. (2004). Cognitive and cognitive-behavioral therapies. In A. E. Bergin & S. L. Garfield (Eds.), Handbook of psychotherapy and behavior change (4th ed., pp. 428–466). Oxford: John Wiley & Sons.
Hölzel, B. K., Carmody, J., Evans, K. C., Hoge, E. A., Dusek, J. A., Morgan, L., et al. (2009). Stress reduction correlates with structural changes in the amygdala. Social Cognitive and Affective Neuroscience, 5, 11–17.
Hölzel, B. K., Carmody, J., Vangel, M., Congleton, C., Yerramsetti, S. M., Gard, K., et al. (2010). Mindfulness practice leads to increases in regional gray matter density. Psychiatry Research: Neuroimaging, 1, 36–43.
Hölzel, B. K., Hoge, E. A., Greve, D. N., Gard, T., Creswell, J. D., Brown, K. W., et al. (2013). Neural mechanisms of symptom improvements in generalized anxiety disorder following mindfulness training. NeuroImage: Clinical, 2, 448–458.
Hölzel, B. K., Lazar, S. W., Gard, T., Schuman-Olivier, Z., Vago, D. R., & Ott, U. (2011). How does mindfulness meditation work? Proposing mechanisms of action from a conceptual and neural perspective. Perspectives on Psychological Science, 6, 537–559.
Hölzel, B. K., Ott, U., Gard, T., Hempel, H., Weygandt, M., Morgen, K., et al. (2008). Investigation of mindfulness meditation practitioners with voxel-based morphometry. Social Cognitive and Affective Neuroscience, 3, 55–61.
Ingram, R. E. (1990). Self-focused attention in clinical disorders: Review and a conceptual model. Psychological Bulletin, 107, 156–176.
Ivanovski, B., & Malhi, G. S. (2007). The psychological and neuropsychological concomitants of mindfulness forms of meditation. Acta Neuropsychiatrica, 19, 76–91.
Jain, S., Shapiro, S. L., Swanwick, S., Roesch, P. J., Mills, P. J., Bell, I., et al. (2007). A randomized controlled trial of mindfulness meditation versus relaxation training: Effects on distress, positive states of mind, and distraction. Annals of Behavioral Medicine, 33, 11–21.
Jazaieri, H., Goldin, P. R., Werner, K., Ziv, M., & Gross, J. J. (2012). A randomized trial of MBSR versus aerobic exercise for social anxiety disorder. Journal of Clinical Psychology, 68, 715–731.
Jha, A. P., Krompinger, J., & Baime, M. J. (2007). Mindfulness training modifies subsystems of attention. Cognitive Affective and Behavioral Neuroscience, 7, 109–119.
Kabat-Zinn, J. (1990). Full catastrophe living. Using the wisdom of your body and mind to face stress, pain, and illness. New York: Bantam.
Kabat-Zinn, J. (2003). Mindfulness-based interventions in context: Past, present, and future. Clinical Psychology: Research and Practice, 10, 144–156.
Kabat-Zinn, J., Massion, A. O., Kristeller, J., Peterson, L., Fletcher, K. E., Pbert, L., et al. (1992). Effectiveness of a meditation-based stress reduction program in the treatment of anxiety disorders. American Journal of Psychiatry, 149, 936–943.
Kang, H. K., Bullman, T. A., Smolenski, D. J., Skopp, N. A., Gahm, G. A., & Reger, M. A. (2015). Suicide risk among 1.3 million veterans who were on active duty during the Iraq and Afghanistan wars. Annals of Epidemiology, 25, 96–100.
Kearney, D. J., McDermott, K., Malte, C., Martinez, M., & Simpson, T. L. (2012). Association of participation in a mindfulness program with measures of PTSD, depression and quality of life in a veteran sample. Journal of Clinical Psychology, 68, 101–116.
Kearney, D. J., McDermott, K., Malte, C., Martinez, M., & Simpson, T. L. (2013). Effects of participation in a mindfulness program for veterans with posttraumatic stress disorder: A randomized controlled pilot study. Journal of Clinical Psychology, 69, 14–27.
Kessler, R. C., Chiu, W. T., Demler, O., & Walters, E. E. (2005). Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey replication. Archives of General Psychiatry, 62, 617–627.
Kessler, R. C., Ruscio, A. M., Shear, K., & Wittchen, H.-U. (2010). Epidemiology of anxiety disorders. Current Topics in Behavioral Neurosciences, 2, 21–35.
Khoury, B., Lecomte, T., Fortin, G., Masse, M., Therien, P., Bouchard, V., et al. (2013). Mindfulness-based therapy: A comprehensive meta-analysis. Clinical Psychology Review, 33, 763–771.
Kim, Y. W., Lee, S., Choi, T. K., Young, S. Y., Kim, B., Kim, C. M., et al. (2009). Effectiveness of mindfulness-based cognitive therapy as an adjuvant to pharmacotherapy in patients with panic disorder or generalized anxiety disorder. Depression and Anxiety, 26, 601–606.
Kim, B., Lee, S., Kim, Y. W., Choi, T. K., Yook, K., Suh, S. Y., et al. (2010). Effectiveness of a mindfulness-based cognitive therapy program as an adjunct to pharmacotherapy in patients with panic disorder. Journal of Anxiety Disorders, 24, 590–595.
Kimbrough, E., Magyari, T., Langenberg, P., Chesney, M., & Berman, B. (2010). Mindfulness intervention for child abuse survivors. Journal of Clinical Psychology, 66, 17–33.
King, A. P., Erickson, T. M., Giardino, N. D., Favorite, T., Rauch, S. A., Robinson, E., et al. (2013). A pilot study of group Mindfulness-Based Cognitive Therapy (MBCT) for combat veterans with posttraumatic stress disorder (PTSD). Depression and Anxiety, 30, 638–645.
Kocovski, N. L., Fleming, J. E., Hawley, L. L., Huta, V., & Antony, M. M. (2013). Mindfulness and acceptance-based group therapy versus traditional cognitive behavioral group therapy for social anxiety disorder: A randomized controlled trial. Behaviour Research and Therapy, 51, 889–898.
Kocovski, N. L., Fleming, J. E., & Rector, N. A. (2009). Mindfulness and acceptance-based group therapy for social anxiety disorder: An open trial. Cognitive and Behavioral Practice, 16, 276–289.
Koszycki, D., Benger, M., Shlik, J., & Bradwejn, J. (2007). Randomized trial of a meditation-based stress reduction program and cognitive behavior therapy in generalized social anxiety disorder. Behavior Research and Therapy, 45, 2518–2526.
Kozasa, E. H., Sato, J. R., Lacerda, S. S., Barreiros, M. A., Radvany, J., Russell, T. A., et al. (2012). Meditation training increases brain efficiency in an attention task. NeuroImage, 59, 745–749.
Kubzansky, L. D., Davidson, K. W., & Rozanski, A. (2005). The clinical impact of negative psychological states: Expanding the spectrum of risk for coronary heart disease. Psychosomatic Medicine, 67, 10–14.
Kumar, S., Feldman, G., & Hayes, A. (2008). Changes in mindfulness and emotion regulation in an exposure-based cognitive therapy for depression. Cognitive Therapy and Research, 32, 734–744.
Kuyken, W., Byford, S., Taylor, R. S., Watkins, E., Holden, E., White, K., et al. (2008). Mindfulness-based cognitive therapy to prevent relapse in recurrent depression. Journal of Consulting and Clinical Psychology, 76, 966–978.
Kuyken, W., Watkins, E., Holden, E., White, K., Taylor, R. S., Byford, S., et al. (2010). How does mindfulness-based cognitive therapy work? Behaviour Research and Therapy, 48, 1105–1112.
Lee, S. H., Ahn, S. C., Lee, Y. J., Choi, T. K., Yook, K. H., & Suh, S. Y. (2007). Effectiveness of a meditation-based stress management program as an adjunct to pharmacotherapy in patients with anxiety disorder. Journal of Psychosomatic Research, 62, 189–195.
Lépine, J. P. (2002). The epidemiology of anxiety disorders: Prevalence and social costs. Journal of Clinical Psychiatry, 63, 4–8.
Levitt, J. T., Brown, T. A., Orsillo, S. M., & Barlow, D. H. (2004). The effects of acceptance versus suppression of emotion on subjective and psychophysiological response to carbon dioxide challenge in patients with panic disorder. Behavior Therapy, 35, 747–766.
Lovas, D. A., & Barsky, A. J. (2010). Mindfulness-based cognitive therapy for hypochondriasis, or severe health anxiety: A pilot study. Journal of Anxiety Disorders, 24, 931–935.
Lutz, J., Herwig, U., Opialla, S., Hittmeyer, A., Jäncke, L., Rufer, M., et al. (2014). Mindfulness and emotion regulation—An fMRI study. Social Cognitive and Affective Neuroscience, 9, 776–785.
Lutz, A., Slagter, H. A., Dunne, J. D., & Davidson, R. J. (2008). Attention regulation and monitoring in meditation. Trends in Cognitive Science, 12, 163–169.
Ma, S., & Teasdale, J. (2004). Mindfulness-based cognitive therapy for depression: Replication and exploration of differential relapse prevention effects. Journal of Consulting and Clinical Psychology, 72, 31–40.
Mansell, W., Harvey, A., Watkins, E., & Shafran, R. (2009). Conceptual foundations of the transdiagnostic approach to CBT. Journal of Cognitive Psychotherapy, 23, 6–19.
Marchand, W. R. (2014). Neural mechanisms of mindfulness and meditation: Evidence from neuroimaging studies. World Journal of Radiology, 6, 471.
Marciniak, M., Lage, M. J., Landbloom, R. P., Dunayevich, E., & Bowman, L. (2004). Medical and productivity costs of anxiety disorders: Case control study. Depression and Anxiety, 19, 112–120.
Mathews, A., & MacLeod, C. (2005). Cognitive vulnerability to emotional disorders. Annual Review of Clinical Psychology, 1, 167–195.
McKee, L., Zvolensky, M. J., Solomon, S. E., Bernstein, A., & Leen-Feldner, E. (2007). Emotional vulnerability and mindfulness: A preliminary test of associations among negative affectivity, anxiety sensitivity, and mindfulness skills. Cognitive Behaviour Therapy, 36, 91–101.
McManus, F., Grey, N., & Shafran, R. (2008). Cognitive therapy for anxiety disorders: Current status and future challenges. Behavioural and Cognitive Psychotherapy, 36, 695–704.
McManus, F., Surawy, C., Muse, K., Vazquez-Montes, M., & Williams, J. M. G. (2012). A randomized clinical trial of mindfulness-based cognitive therapy versus unrestricted services for health anxiety (hypochondriasis). Journal of Consulting and Clinical Psychology, 80, 817–828.
Mendlowicz, M. V., & Stein, M. B. (2000). Quality of life in individuals with anxiety disorders. American Journal of Psychiatry, 157, 669–682.
Mennin, D. S., Ellard, K. K., Fresco, D. M., & Gross, J. J. (2013). United we stand: Emphasizing commonalities across cognitive-behavioral therapies. Behavior Therapy, 44, 234–248.
Meuret, A. E., Twohig, M. P., Rosenfield, D., Hayes, S. C., & Craske, M. G. (2012). Brief acceptance and commitment therapy and exposure for panic disorder: A pilot study. Cognitive and Behavioral Practice, 19, 606–618.
Miller, J. J., Fletcher, K., & Kabat-Zinn, J. (1995). Three-year follow-up and clinical implications of a mindfulness-based stress reduction intervention in the treatment of anxiety disorders. General Hospital Psychiatry, 17, 192–200.
Mor, N., & Winquist, J. (2002). Self-focused attention and negative affect: A meta-analysis. Psychological Bulletin, 128, 638–662.
National Institute for Health and Care Excellence. (2013). Social anxiety disorder: Recognition, assessment and treatment of social anxiety disorder (Clinical guideline 159.) http://guidance.nice.org.uk/CG159
Neff, K. D. (2003). Self-compassion: An alternative conceptualization of a healthy attitude toward oneself. Self and Identity, 2, 85–102.
Niles, B. L., Klunk-Gillis, J., Ryngala, D. J., Silberbogen, A. K., Paysnick, A., & Wolf, E. J. (2012). Comparing mindfulness and psychoeducation treatments for combat-related PTSD using a telehealth approach. Psychological Trauma: Theory, Research, Practice, and Policy, 4, 538–547.
Ninan, P. T. (2001). Dissolving the burden of generalized anxiety disorder. Journal of Clinical Psychiatry, 62, 5–10.
Nolen-Hoeksema, S. (2000). The role of rumination in depressive disorder and mixed anxiety/depressive symptoms. Journal of Abnormal Psychology, 109, 504–511.
Norton, A. R., Abbott, M. J., Norberg, M. M., & Hunt, C. (2014). A systematic review of mindfulness and acceptance-based treatments for social anxiety disorder. Journal of Clinical Psychology. doi:10.1002/jclp.22144.
Norton, P. J., & Philipp, L. M. (2008). Transdiagnostic approaches to the treatment of anxiety disorders: A quantitative review. Psychotherapy: Theory, Research, Practice, Training, 45, 214–226.
Norton, P. J., & Price, E. M. (2007). A meta-analytic review of adult cognitive-behavioral treatment outcome across the anxiety disorders. The Journal of Nervous and Mental Disease, 195, 521–531.
Olatunji, B. O., Cisler, J. M., & Tolin, D. F. (2007). Quality of life in the anxiety disorders: A meta-analytic review. Clinical Psychology Review, 27, 572–581.
Ossman, W. A., Wilson, K. G., Storaasli, R. D., & McNeill, J. W. (2006). A preliminary investigation of the use of Acceptance and Commitment Therapy in group treatment for social phobia. International Journal of Psychology and Psychological Therapy, 6, 397–416.
Panos, P. T., Jackson, J. W., Hasan, O., & Panos, A. (2013). Meta-analysis and systematic review assessing the efficacy of dialectical behavior therapy (DBT). Research on Social Work Practice, Retrieved from: http://rsw.sagepub.com/content/early/2013/09/16/1049731513503047
Piet, J., Hougaard, E., Hecksher, M. S., & Rosenberg, N. K. (2010). A randomized pilot study of mindfulness-based cognitive therapy and group cognitive-behavioral therapy for young adults with social phobia. Scandinavian Journal of Psychology, 51. doi:10.1111/j.1467-9450.2009.00801.x/pdf
Powers, M. B., Zum Vörde Sive Vörding, M. B., & Emmelkamp, P. M. G. (2009). Acceptance and commitment therapy: A meta-analytic review. Psychotherapy and Psychosomatics, 78, 73–80.
Ramel, W., Goldin, P. R., Carmona, P. E., & McQuaid, J. R. (2004). The effects of mindfulness meditation on cognitive processes and affect in patients with past depression. Cognitive Therapy and Research, 28, 433–455.
Ramsawh, H. J., Raffa, S. D., Edelen, M. O., Rende, R., & Keller, M. B. (2009). Anxiety in middle adulthood: Effects of age and time on the 14-year course of panic disorder, social phobia and generalized anxiety disorder. Psychological Medicine, 39, 615–624.
Ree, M. J., & Craigie, M. A. (2007). Outcomes following mindfulness-based cognitive therapy in a heterogeneous sample of adult outpatients. Behavior Change, 24, 70–86.
Rodebaugh, T. L., Holaway, R. M., & Heimberg, R. G. (2004). The treatment of social anxiety disorder. Clinical Psychology Review, 24, 883–908.
Roemer, L., Erisman, S. M., & Orsillo, S. M. (2008). Mindfulness and acceptance-based treatments for anxiety disorders. In M. M. Antony & M. B. Stein (Eds.), Oxford handbook of anxiety and related disorders (pp. 476–487). Oxford: Oxford University Press.
Roemer, L., Lee, J. K., Salters-Pedneault, K., Erisman, S. M., Orsillo, S. M., & Mennin, D. S. (2009). Mindfulness and emotion regulation difficulties in generalized anxiety disorder: Preliminary evidence for independent and overlapping contributions. Behavior Therapy, 40, 142–154.
Roemer, L., & Orsillo, S. M. (2007). An open trial of an acceptance-based behavior therapy for generalized anxiety disorder. Behavior Therapy, 38, 72–85.
Roemer, L., Orsillo, S. M., & Salters-Pedneault, K. (2008). Efficacy of an acceptance-based behavior therapy for generalized anxiety disorder: Evaluation in a randomized controlled trial. Journal of Consulting and Clinical Psychology, 76, 1083–1089.
Roness, A., Mykletun, A., & Dahl, A. A. (2005). Help-seeking behaviour in patients with anxiety disorder and depression. Acta Psychiatrica Scandinavia, 111, 51–58.
Roy-Byrne, P. P., Craske, M. G., & Stein, M. B. (2006). Panic disorder. Lancet, 368, 1023–1032.
Rubia, K. (2009). The neurobiology of meditation and its clinical effectiveness in psychiatric disorders. Biological Psychology, 82, 1–11.
Salkovskis, P. M. (1991). The importance of behaviour in the maintenance of anxiety and panic. Behavioural and Cognitive Psychotherapy, 19, 6–19.
Santorelli, S. (1999). Heal thy self: Lessons on mindfulness in medicine. New York: Bell Tower.
Segal, Z. V., Bieling, P., Young, T., MacQueen, G., Cooke, R., Martin, L., et al. (2010). Antidepressant monotherapy vs sequential pharmacotherapy and Mindfulness-Based Cognitive Therapy, or placebo, for relapse prophylaxis in recurrent depression. Archives of General Psychiatry, 67, 1256–1264.
Segal, Z. V., Williams, J. M. G., & Teasdale, J. D. (2012). Mindfulness-based cognitive therapy for depression. New York: Guilford Press.
Serpa, J. G., Taylor, S. L., & Tillisch, K. (2014). Mindfulness-based stress reduction (MBSR) reduces anxiety, depression, and suicidal ideation in veterans. Medical Care, 52, 19–24.
Shapiro, S. L., Carlson, L. E., Astin, J. A., & Freedman, B. (2006). Mechanisms of mindfulness. Journal of Clinical Psychology, 62, 373–386.
Shear, M. K., Bjelland, I., Beesdo, K., Gloster, A. T., & Wittchen, H. (2007). Supplementary dimensional assessment in anxiety disorders. International Journal of Methods in Psychiatric Research, 16, 52–64.
Smith, B. W., Ortiz, J. A., Steffen, L. E., Tooley, E. M., Wiggins, K. T., Yeater, E. A., et al. (2011). Mindfulness is associated with fewer PTSD symptoms, depressive symptoms, physical symptoms, and alcohol problems in urban firefighters. Journal of Consulting and Clinical Psychology, 79, 613–617.
Stein, D. J. (2002). Obsessive-compulsive disorder. Lancet, 360, 397–405.
Stein, M. B., & Stein, D. J. (2008). Social anxiety disorder. Lancet, 371, 1115–1125.
Stopa, L., & Clark, D. M. (2000). Social phobia and interpretation of social events. Behaviour Research and Therapy, 38, 273–283.
Strauss, C., Cavanagh, K., Oliver, A., & Pettman, D. (2014). Mindfulness-based interventions for people diagnosed with a current episode of an anxiety or depressive disorder: A meta-analysis of randomised controlled trials. PLoS ONE, 9, e96110.
Swift, J. K., & Callahan, J. L. (2009). The impact of client treatment preferences on outcome: A meta-analysis. Journal of Clinical Psychology, 65, 368–381.
Taylor, S., Abramowitz, J. S., & McKay, D. (2012). Non-adherence and non-response in the treatment of anxiety disorders. Journal of Anxiety Disorders, 26, 583–589.
Teasdale, J. D., Moore, R. G., Hayhurst, H., Pope, M., Williams, S., & Segal, Z. V. (2002). Metacognitive awareness and prevention of relapse in depression: Empirical evidence. Journal of Consulting and Clinical Psychology, 70, 275–287.
Teasdale, J. D., Segal, Z. V., Williams, J. M. G., Ridgeway, V. A., Soulsby, J. M., & Lau, M. A. (2000). Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy. Journal of Consulting and Clinical Psychology, 68, 615–623.
Teasdale, J. D., Segal, Z. V., & Williams, J. M. G. (2003). Mindfulness training and problem formulation. Clinical Psychology: Science and Practice, 10, 157–160.
Thompson, B. L., & Waltz, J. (2010). Mindfulness and experiential avoidance as predictors of posttraumatic stress disorder avoidance symptom severity. Journal of Anxiety Disorders, 24, 409–415.
Treanor, M. (2011). The potential impact of mindfulness on exposure and extinction learning in anxiety disorders. Clinical Psychology Review, 31, 617–625.
Twohig, M. P., Hayes, S. C., & Masuda, A. (2006). Increasing willingness to experience obsessions: Acceptance and commitment therapy as a treatment for obsessive-compulsive disorder. Behavior Therapy, 37, 3–13.
Twohig, M. P., Hayes, S. C., Plumb, J. C., Pruitt, L. D., Collins, A. B., Hazlett-Stevens, H., & Woidneck, M. R. (2010). A randomized clinical trial of acceptance and commitment therapy versus progressive relaxation training for obsessive-compulsive disorder. Journal of Consulting and Clinical Psychology, 78, 705–716.
Tyrer, P., & Baldwin, D. (2006). Generalised anxiety disorder. Lancet, 368, 2156–2166.
van den Hurk, P. A., Giommi, F., Gielen, S. C., Speckens, A. E., & Barendregt, H. P. (2010). Greater efficiency in attentional processing related to mindfulness meditation. The Quarterly Journal of Experimental Psychology, 63, 1168–1180.
Vassilopoulos, S. P. (2008). Social anxiety and ruminative self-focus. Journal of Anxiety Disorders, 22, 860–867.
Vassilopoulos, S. P., & Watkins, E. R. (2009). Adaptive and maladaptive self-focus: A pilot extension study with individuals high and low in fear of negative evaluation. Behavior Therapy, 40(2), 181–189.
Vøllestad, J., Nielsen, M. B., & Nielsen, G. H. (2012). Mindfulness- and acceptance-based interventions for anxiety disorders: A systematic review and meta-analysis. British Journal of Clinical Psychology, 51, 239–260.
Vøllestad, J., Sivertsen, B., & Nielsen, G. H. (2011). Mindfulness-based stress reduction for patients with anxiety disorders: Evaluation in a randomized controlled trial. Behaviour Research and Therapy, 49, 281–288.
Voncken, M. J., Bögels, S. M., & de Vries, K. (2003). Interpretation and judgmental biases in social phobia. Behaviour Research and Therapy, 41, 1481–1488.
Vujanovic, A. A., Youngwirth, N. E., Johnson, K. A., & Zvolensky, M. J. (2009). Mindfulness-based acceptance and posttraumatic stress symptoms among trauma-exposed adults without axis I psychopathology. Journal of Anxiety Disorders, 23, 297–303.
Vujanovic, A. A., Zvolensky, M. J., Bernstein, A., Feldner, M. T., & McLeish, A. C. (2007). A test of the interactive effects of anxiety sensitivity and mindfulness in the prediction of anxious arousal, agoraphobic cognitions, and body vigilance. Behaviour Research and Therapy, 45, 1393–1400.
Wadlinger, D. A., & Isaacowitz, D. M. (2010). Fixing our focus: Training attention to regulate emotion. Personality and Social Psychology Review, 20, 1–28.
Wang, P. S., Berglund, P., Olfson, M., Pincus, H. A., Wells, K. B., & Kessler, R. C. (2005). Failure and delay in initial treatment contact after first onset of mental disorders in the National Comorbidity Survey replication. Archives of General Psychiatry, 62, 603–613.
Watkins, E., Moberly, N. J., & Moulds, M. L. (2008). Processing mode causally influences emotional reactivity. Distinct effects of abstract versus concrete construal on emotional response. Emotion, 8, 364–378.
Watts, B. V., Schnurr, P. P., Mayo, L., Young-Xu, Y., Weeks, W. B., & Friedman, M. J. (2013). Meta-analysis of the efficacy of treatments for posttraumatic stress disorder. The Journal of Clinical Psychiatry, 74, 541–550.
Wegner, D. M., Broome, A., & Blumberg, S. J. (1997). Ironic effects of trying to relax under stress. Behaviour Research and Therapy, 35, 11–21.
Wegner, D. M., & Erber, R. (1992). The hyperaccessibility of suppressed thought. Journal of Personality and Social Psychology, 63, 903–912.
Williams, J. M. G. (2010). Mindfulness and psychological process. Emotion, 10, 1–7.
Wittchen, H.-U., Lieb, R., Pfister, H., & Schuster, P. (2000). The waxing and waning of mental disorders: Evaluating the stability of syndromes of mental disorders in the population. Comprehensive Psychiatry, 41, 122–132.
Wolitzky-Taylor, K. B., Arch, J. J., Rosenfield, D., & Craske, M. G. (2012). Moderators and non-specific predictors of treatment outcome for anxiety disorders: A comparison of cognitive behavioral therapy to acceptance and commitment therapy. Journal of Consulting and Clinical Psychology, 80, 786–799.
Yehuda, R. (2002). Post-traumatic stress disorder. New England Journal of Medicine, 346, 108–114.
Yook, K., Lee, S., Ryu, M., Kim, K., Choi, K. C., Suh, S. Y., et al. (2008). Usefulness of mindfulness-based cognitive therapy for treating insomnia in patients with anxiety disorders. The Journal of Nervous and Mental Disease, 196, 501–503.
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Vøllestad, J. (2016). Mindfulness- and Acceptance-Based Interventions in the Treatment of Anxiety Disorders. In: Shonin, E., Gordon, W., Griffiths, M. (eds) Mindfulness and Buddhist-Derived Approaches in Mental Health and Addiction. Advances in Mental Health and Addiction. Springer, Cham. https://doi.org/10.1007/978-3-319-22255-4_6
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