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Gepubliceerd in: Mindfulness 2/2016

08-01-2016 | ORIGINAL PAPER

Effects of CBT Versus MBSR Treatment on Social Stress Reactions in Social Anxiety Disorder

Auteurs: Jacinthe Faucher, Diana Koszycki, Jacques Bradwejn, Zul Merali, Catherine Bielajew

Gepubliceerd in: Mindfulness | Uitgave 2/2016

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Abstract

Cognitive behavioral group therapy (CBGT) has been reported to be more effective than a mindfulness-based stress reduction program (MBSR) in reducing symptoms of social anxiety disorder (SAD). The present study determined whether CBGT and MBSR differentially affected subjective anxiety and physiological response to a stressful speaking task. The sample comprised 38 medication-free SAD patients who participated in a previously published trial comparing CBGT and MBSR; an additional 30 participants were healthy control (HC) volunteers. Patients performed a speech task before and after treatment while HC performed it only once. Subjective anxiety and core symptoms of SAD were assessed with visual analog scales (VAS), and physiological responses included salivary cortisol and heart rate variability. Prior to treatment, the speech task induced greater increases in anxiety and SAD symptoms in patients compared to HC. After treatment, VAS ratings during the task decreased in both treatment groups. The most significant improvement overall was observed with CBGT, with their responses being comparable to that of HC. No physiological differences were found as a function of treatment. Although CBGT produced the best results, MBSR was nonetheless associated with a significant decrease in subjective anxiety and symptoms of SAD during the speech task.
Literatuur
go back to reference American Psychiatric Association. (2000). Diagnostic and Statistical Manual of Mental Disorders (4th Ed.- Text Revision).Xxvii, 943 Pp. Arlington, VA, US: American Psychiatric Publishing, Inc.; US. American Psychiatric Association. (2000). Diagnostic and Statistical Manual of Mental Disorders (4th Ed.- Text Revision).Xxvii, 943 Pp. Arlington, VA, US: American Psychiatric Publishing, Inc.; US.
go back to reference Baer, R. A. (2003). Mindfulness training as a clinical intervention: a conceptual and empirical review. Clinical Psychology: Science and Practice, 10(2), 125–143. Baer, R. A. (2003). Mindfulness training as a clinical intervention: a conceptual and empirical review. Clinical Psychology: Science and Practice, 10(2), 125–143.
go back to reference Bogels, S. M., Sijbers, G. F. V. M., & Voncken, M. (2006). Mindfulness and task concentration training for social phobia: a pilot study. Journal of Cognitive Psychotherapy, 20(1), 33–44.CrossRef Bogels, S. M., Sijbers, G. F. V. M., & Voncken, M. (2006). Mindfulness and task concentration training for social phobia: a pilot study. Journal of Cognitive Psychotherapy, 20(1), 33–44.CrossRef
go back to reference Brewer, J. A., Sinha, R., Chen, J. A., Michalsen, R. N., Babuscio, T. A., Nich, C., . . . Rounsaville, B. J. (2009). Mindfulness training and stress reactivity in substance abuse: Results from a randomized, controlled stage I pilot study. Substance Abuse: Official Publication of the Association for Medical Education and Research in Substance Abuse, 30(4), 306–317. doi:10.1080/08897070903250241. Brewer, J. A., Sinha, R., Chen, J. A., Michalsen, R. N., Babuscio, T. A., Nich, C., . . . Rounsaville, B. J. (2009). Mindfulness training and stress reactivity in substance abuse: Results from a randomized, controlled stage I pilot study. Substance Abuse: Official Publication of the Association for Medical Education and Research in Substance Abuse, 30(4), 306–317. doi:10.​1080/​0889707090325024​1.
go back to reference Burg, J. M., Wolf, O. T., & Michalak, J. (2012). Mindfulness as self-regulated attention: associations with heart rate variability. Swiss Journal of Psychology/Schweizerische Zeitschrift Fur Psychologie/Revue Suisse De Psychologie, 71(3), 135–139.CrossRef Burg, J. M., Wolf, O. T., & Michalak, J. (2012). Mindfulness as self-regulated attention: associations with heart rate variability. Swiss Journal of Psychology/Schweizerische Zeitschrift Fur Psychologie/Revue Suisse De Psychologie, 71(3), 135–139.CrossRef
go back to reference Buske-Kirschbaum, A., Geiben, A., Hollig, H., Morschhauser, E., & Hellhammer, D. (2002). Altered responsiveness of the hypothalamus-pituitary-adrenal axis and the sympathetic adrenomedullary system to stress in patients with atopic dermatitis. The Journal of Clinical Endocrinology and Metabolism, 87(9), 4245–4251.CrossRefPubMed Buske-Kirschbaum, A., Geiben, A., Hollig, H., Morschhauser, E., & Hellhammer, D. (2002). Altered responsiveness of the hypothalamus-pituitary-adrenal axis and the sympathetic adrenomedullary system to stress in patients with atopic dermatitis. The Journal of Clinical Endocrinology and Metabolism, 87(9), 4245–4251.CrossRefPubMed
go back to reference Clark, D. M., & McManus, F. (2002). Information processing in social phobia. Biological Psychiatry, 51(1), 92–100.CrossRefPubMed Clark, D. M., & McManus, F. (2002). Information processing in social phobia. Biological Psychiatry, 51(1), 92–100.CrossRefPubMed
go back to reference Craske, M. G., Niles, A., Burklund, L., Wolitzky-Taylor, K., Vilardaga, J., Arch, J., … Lieberman, M. (2014). Randomized control trial of cognitive behavioral therapy and acceptance and commitment therapy for social phobia: Outcomes and moderators. Journal of Counsulting and Clinical Psychology, 82(6), 1034–1048. Craske, M. G., Niles, A., Burklund, L., Wolitzky-Taylor, K., Vilardaga, J., Arch, J., … Lieberman, M. (2014). Randomized control trial of cognitive behavioral therapy and acceptance and commitment therapy for social phobia: Outcomes and moderators. Journal of Counsulting and Clinical Psychology, 82(6), 1034–1048.
go back to reference Fiocco, J. F., Joober, R., & Lupien, S. J. (2007). Education modulates cortisol reactivity to the Trier Social Stress Test in middle-aged adults. Psychoneuroendocinology, 32(8–10), 1158–1163.CrossRef Fiocco, J. F., Joober, R., & Lupien, S. J. (2007). Education modulates cortisol reactivity to the Trier Social Stress Test in middle-aged adults. Psychoneuroendocinology, 32(8–10), 1158–1163.CrossRef
go back to reference Gerlach, A. L., Wilhelm, F. H., & Roth, W. T. (2003). Embarrassment and social phobia: the role of parasympathetic activation. Journal of Anxiety Disorders, 17(2), 197–210.CrossRefPubMed Gerlach, A. L., Wilhelm, F. H., & Roth, W. T. (2003). Embarrassment and social phobia: the role of parasympathetic activation. Journal of Anxiety Disorders, 17(2), 197–210.CrossRefPubMed
go back to reference Gerra, G., Zaimovic, A., Mascetti, G. G., Gardini, S., Zambelli, U., Timpano, M., … Brambilla, F. (2001). Neuroendocrine responses to experimentally-induced psychological stress in healthy humans. Psychoneuroendocrinology, 26(1), 91–107. Gerra, G., Zaimovic, A., Mascetti, G. G., Gardini, S., Zambelli, U., Timpano, M., … Brambilla, F. (2001). Neuroendocrine responses to experimentally-induced psychological stress in healthy humans. Psychoneuroendocrinology, 26(1), 91–107.
go back to reference Grossman, P., Wilhelm, F. H., Kawachi, I., & Sparrow, D. (2001). Gender differences in psychophysiological responses to speech stress among older social phobics: Congruence and incongruence between self-evaluative and cardiovascular reactions. Psychosomatic Medicine, 63(5), 765–777.CrossRefPubMed Grossman, P., Wilhelm, F. H., Kawachi, I., & Sparrow, D. (2001). Gender differences in psychophysiological responses to speech stress among older social phobics: Congruence and incongruence between self-evaluative and cardiovascular reactions. Psychosomatic Medicine, 63(5), 765–777.CrossRefPubMed
go back to reference Heimberg, R. G., & Becker, R. E. (2002). Cognitive–behavioral group therapy for social phobia: basic mechanisms and clinical strategies. New York: The Guildford Press. Heimberg, R. G., & Becker, R. E. (2002). Cognitive–behavioral group therapy for social phobia: basic mechanisms and clinical strategies. New York: The Guildford Press.
go back to reference Hofmann, S. G., & Bogels, S. M. (2006). Recent advances in the treatment of social phobia: introduction to the special issue. Journal of Cognitive Psychotherapy, 20(1), 3–5.CrossRef Hofmann, S. G., & Bogels, S. M. (2006). Recent advances in the treatment of social phobia: introduction to the special issue. Journal of Cognitive Psychotherapy, 20(1), 3–5.CrossRef
go back to reference Hofmann, S. G., & Smits, J. A. (2008). Cognitive-behavioral therapy for adult anxiety disorders: a meta-analysis of randomized placebo-controlled trials. The Journal of Clinical Psychiatry, 69(4), 621–632.CrossRefPubMedPubMedCentral Hofmann, S. G., & Smits, J. A. (2008). Cognitive-behavioral therapy for adult anxiety disorders: a meta-analysis of randomized placebo-controlled trials. The Journal of Clinical Psychiatry, 69(4), 621–632.CrossRefPubMedPubMedCentral
go back to reference Kabat-Zinn, J. (1990). Full catastrophe living: using the wisdom of the body and the mind to fase stress, pain and illness. New York: Dell. Kabat-Zinn, J. (1990). Full catastrophe living: using the wisdom of the body and the mind to fase stress, pain and illness. New York: Dell.
go back to reference Kabat-Zinn, J. (2003). Mindfulness-based interventions in context: past, present, and future. Clinical Psychology: Science and Practice, 10(2), 144–156. Kabat-Zinn, J. (2003). Mindfulness-based interventions in context: past, present, and future. Clinical Psychology: Science and Practice, 10(2), 144–156.
go back to reference Kabat-Zinn, J., & Santorelli, S. (1993). Mindfulness-based stress reduction professional training resource manual. Kabat-Zinn, J., & Santorelli, S. (1993). Mindfulness-based stress reduction professional training resource manual.
go back to reference Kaviani, H., Javaheri, F., & Hatami, N. (2011). Mindfulness-based cognitive therapy (MBCT) reduces depression and anxiety induced by real stressful setting in non-clinical population. International Journal of Psychology & Psychological Therapy, 11(2), 285–296. Kaviani, H., Javaheri, F., & Hatami, N. (2011). Mindfulness-based cognitive therapy (MBCT) reduces depression and anxiety induced by real stressful setting in non-clinical population. International Journal of Psychology & Psychological Therapy, 11(2), 285–296.
go back to reference Kirschbaum, C., & Hellhammer, D. H. (1994). Salivary cortisol in psychoneuroendocrine research: recent developments and applications. Psychoneuroendocrinology, 19(4), 313–333.CrossRefPubMed Kirschbaum, C., & Hellhammer, D. H. (1994). Salivary cortisol in psychoneuroendocrine research: recent developments and applications. Psychoneuroendocrinology, 19(4), 313–333.CrossRefPubMed
go back to reference Kirschbaum, C., Prussner, J. C., Stone, A. A., Federenko, I., Gaab, J., Lintz, D., & Hellhammer, D. H. (1995). Persistent high cortisol responses to repeated psychological stress in a subpopulation of healthy men. Psychosomatic Medicine, 57(5), 468–474.CrossRefPubMed Kirschbaum, C., Prussner, J. C., Stone, A. A., Federenko, I., Gaab, J., Lintz, D., & Hellhammer, D. H. (1995). Persistent high cortisol responses to repeated psychological stress in a subpopulation of healthy men. Psychosomatic Medicine, 57(5), 468–474.CrossRefPubMed
go back to reference Kirschbaum, C., Kudielka, B. M., Gaab, J., Schommer, N. C., & Hellhammer, D. H. (1999). Impact of gender, menstrual cycle phase, and oral contraceptives on the activity of the hypothalamus-pituitary-adrenal axis. Psychosomatic Medicine, 61, 154–162.CrossRefPubMed Kirschbaum, C., Kudielka, B. M., Gaab, J., Schommer, N. C., & Hellhammer, D. H. (1999). Impact of gender, menstrual cycle phase, and oral contraceptives on the activity of the hypothalamus-pituitary-adrenal axis. Psychosomatic Medicine, 61, 154–162.CrossRefPubMed
go back to reference Klatt, M. D., Buckworth, J., & Malarkey, W. B. (2009). Effects of low-dose mindfulness-based stress reduction (MBSR-ld) on working adults. Health Education & Behavior: The Official Publication of the Society for Public Health Education, 36(3), 601–614. doi:10.1177/1090198108317627.CrossRef Klatt, M. D., Buckworth, J., & Malarkey, W. B. (2009). Effects of low-dose mindfulness-based stress reduction (MBSR-ld) on working adults. Health Education & Behavior: The Official Publication of the Society for Public Health Education, 36(3), 601–614. doi:10.​1177/​1090198108317627​.CrossRef
go back to reference 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(3), 276–289.CrossRef 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(3), 276–289.CrossRef
go back to reference 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.CrossRefPubMed 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.CrossRefPubMed
go back to reference 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. Behaviour Research and Therapy, 45(10), 2518–2526. doi:10.1016/j.brat.2007.04.011.CrossRefPubMed 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. Behaviour Research and Therapy, 45(10), 2518–2526. doi:10.​1016/​j.​brat.​2007.​04.​011.CrossRefPubMed
go back to reference Kudielka, B. N., Gierens, A., Hellhammer, D. H., Wüst, S., & Schlotz, W. (2012). Salivary cortisol in ambulatory assessment—some dos and don’ts and some open questions. Psychosomatic Medicine, 74, 418–431.CrossRefPubMed Kudielka, B. N., Gierens, A., Hellhammer, D. H., Wüst, S., & Schlotz, W. (2012). Salivary cortisol in ambulatory assessment—some dos and don’ts and some open questions. Psychosomatic Medicine, 74, 418–431.CrossRefPubMed
go back to reference Leahy, R. L., & Holland, S. J. (2000). Treatment plans and interventions for depression and anxiety disorders. New York: Guilford Press. Leahy, R. L., & Holland, S. J. (2000). Treatment plans and interventions for depression and anxiety disorders. New York: Guilford Press.
go back to reference Manzaneque, J. M., Vera, F. M., Ramos, N. S., Godoy, Y. A., Rodriguez, F. … Enguix, A. (2011). Psychobiological modulation in anxious and depressed patients after a mindfulness meditation programme: a pilot study. Stress and Health: Journal of the International Society for the Investigation of Stress, 27(3), 216–222. Manzaneque, J. M., Vera, F. M., Ramos, N. S., Godoy, Y. A., Rodriguez, F. … Enguix, A. (2011). Psychobiological modulation in anxious and depressed patients after a mindfulness meditation programme: a pilot study. Stress and Health: Journal of the International Society for the Investigation of Stress, 27(3), 216–222.
go back to reference Marcus, M. T., Fine, M., Moeller, F. G., Khan, M. M., Pitts, K., Swank, P. R., & Liehr, P. (2003). Change in stress levels following mindfulness-based stress reduction in a therapeutic community. Addictive Disorders & Their Treatment, 2(3), 63–68.CrossRef Marcus, M. T., Fine, M., Moeller, F. G., Khan, M. M., Pitts, K., Swank, P. R., & Liehr, P. (2003). Change in stress levels following mindfulness-based stress reduction in a therapeutic community. Addictive Disorders & Their Treatment, 2(3), 63–68.CrossRef
go back to reference Martinez, J. M., Garakani, A., Kaufmann, H., Aaronson, C. J., & Gorman, J. M. (2010). Heart rate and blood pressure changes during autonomic nervous system challenge in panic disorder patients. Psychosomatic Medicine, 72(5), 442–449. doi:10.1097/PSY.0b013e3181d972c2.CrossRefPubMed Martinez, J. M., Garakani, A., Kaufmann, H., Aaronson, C. J., & Gorman, J. M. (2010). Heart rate and blood pressure changes during autonomic nervous system challenge in panic disorder patients. Psychosomatic Medicine, 72(5), 442–449. doi:10.​1097/​PSY.​0b013e3181d972c2​.CrossRefPubMed
go back to reference Mauss, I. B., Wilhelm, F. H., & Gross, J. J. (2003). Autonomic recovery and habituation in social anxiety. Psychophysiology, 40(4), 648–653.CrossRefPubMed Mauss, I. B., Wilhelm, F. H., & Gross, J. J. (2003). Autonomic recovery and habituation in social anxiety. Psychophysiology, 40(4), 648–653.CrossRefPubMed
go back to reference Mauss, I. B., Wilhelm, F. H., & Gross, J. J. (2004). Is there less to social anxiety than meets the eye? emotion experience, expression, and bodily responding. Cognition and Emotion, 18(5), 631–662. doi:10.1080/02699930341000112.CrossRef Mauss, I. B., Wilhelm, F. H., & Gross, J. J. (2004). Is there less to social anxiety than meets the eye? emotion experience, expression, and bodily responding. Cognition and Emotion, 18(5), 631–662. doi:10.​1080/​0269993034100011​2.CrossRef
go back to reference Payne, L. A., Hibel, L. C., Granger, D. A., Tsao, J. C., & Zelter, L. K. (2014). Relationship of salivary alpha amylase and cortisol to social anxiety in healthy children undergoing laboratory pain tasks. Journal of Child and Adolescent Behaviour, 2, 1–12. doi:10.4172/jcalb.1000129.CrossRef Payne, L. A., Hibel, L. C., Granger, D. A., Tsao, J. C., & Zelter, L. K. (2014). Relationship of salivary alpha amylase and cortisol to social anxiety in healthy children undergoing laboratory pain tasks. Journal of Child and Adolescent Behaviour, 2, 1–12. doi:10.​4172/​jcalb.​1000129.CrossRef
go back to reference 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. doi:10.1111/j.1467-9450.2009.00801.x.PubMed 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. doi:10.​1111/​j.​1467-9450.​2009.​00801.​x.PubMed
go back to reference Porges, S. W., Doussard-Roosevelt, J. A., & Maiti, A. J. (1994). Vagal tone and the physiological regulation of emotion. In N. A. Fox (Ed.), The development of emotion regulation. Chicago: University of Chicago Press. Porges, S. W., Doussard-Roosevelt, J. A., & Maiti, A. J. (1994). Vagal tone and the physiological regulation of emotion. In N. A. Fox (Ed.), The development of emotion regulation. Chicago: University of Chicago Press.
go back to reference Pruessner, J. C., Kirschbaum, C., Meinlschmid, G., & Hellhammer, D. H. (2003). Two formulas for computation of the area under the curve represent measures of total concentration versus time-dependent change. Psychoneuroendocrinology, 28(7), 916–931.CrossRefPubMed Pruessner, J. C., Kirschbaum, C., Meinlschmid, G., & Hellhammer, D. H. (2003). Two formulas for computation of the area under the curve represent measures of total concentration versus time-dependent change. Psychoneuroendocrinology, 28(7), 916–931.CrossRefPubMed
go back to reference Roelofs, K., van Peer, J., Berretty, E., Jong, P., Spinhoven, P., & Elzinga, B. M. (2009). Hypothalamus-pituitary-adrenal axis hyperresponsiveness is associated with increased social avoidance behavior in social phobia. Biological Psychiatry, 65(4), 336–343. doi:10.1016/j.biopsych.2008.08.022.CrossRefPubMed Roelofs, K., van Peer, J., Berretty, E., Jong, P., Spinhoven, P., & Elzinga, B. M. (2009). Hypothalamus-pituitary-adrenal axis hyperresponsiveness is associated with increased social avoidance behavior in social phobia. Biological Psychiatry, 65(4), 336–343. doi:10.​1016/​j.​biopsych.​2008.​08.​022.CrossRefPubMed
go back to reference Roemer, L., & Orsillo, S. M. (2003). Mindfulness: a promising intervention strategy in need of further study. Clinical Psychology: Science and Practice, 10(2), 172–178. Roemer, L., & Orsillo, S. M. (2003). Mindfulness: a promising intervention strategy in need of further study. Clinical Psychology: Science and Practice, 10(2), 172–178.
go back to reference Stein, M. B., & Asmundson, G. J. (1994). Autonomic function in panic disorder: cardiorespiratory and plasma catecholamine responsivity to multiple challenges of the autonomic nervous system. Biological Psychiatry, 36(8), 548–558.CrossRefPubMed Stein, M. B., & Asmundson, G. J. (1994). Autonomic function in panic disorder: cardiorespiratory and plasma catecholamine responsivity to multiple challenges of the autonomic nervous system. Biological Psychiatry, 36(8), 548–558.CrossRefPubMed
go back to reference Stratford, T., Meara, A., & Lal, S. (2014). Heart rate variability and the anxious client: cardiac autonomic and behavioral associations with therapeutic alliance. Journal of Nervous and Mental Disease, 202(8), 613–619.CrossRefPubMed Stratford, T., Meara, A., & Lal, S. (2014). Heart rate variability and the anxious client: cardiac autonomic and behavioral associations with therapeutic alliance. Journal of Nervous and Mental Disease, 202(8), 613–619.CrossRefPubMed
go back to reference Tabachnick, B. G., & Fidell, L. S. (2007). Experimental design using ANOVA. US: Duxbury. Tabachnick, B. G., & Fidell, L. S. (2007). Experimental design using ANOVA. US: Duxbury.
go back to reference Wewers, M. E., & Lowe, N. K. (1990). A critical review of visual analogue scales in the measurement of clinical phenomena. Research in Nursing & Health, 13(4), 227–236.CrossRef Wewers, M. E., & Lowe, N. K. (1990). A critical review of visual analogue scales in the measurement of clinical phenomena. Research in Nursing & Health, 13(4), 227–236.CrossRef
go back to reference Williams, V. S., Morlock, R. J., & Feltner, D. (2010). Psychometric evaluation of a visual analog scale for the assessment of anxiety. Health and Quality of Life Outcomes, 8, 57-7525-8-57. doi:10.1186/1477-7525-8-57.CrossRef Williams, V. S., Morlock, R. J., & Feltner, D. (2010). Psychometric evaluation of a visual analog scale for the assessment of anxiety. Health and Quality of Life Outcomes, 8, 57-7525-8-57. doi:10.​1186/​1477-7525-8-57.CrossRef
go back to reference Witek-Janusek, L., Albuquerque, K., Chroniak, K. R., Chroniak, C., Durazo-Arvizu, R., & Mathews, H. L. (2008). Effect of mindfulness based stress reduction on immune function, quality of life and coping in women newly diagnosed with early stage breast cancer. Brain, Behavior, and Immunity, 22(6), 969–981. doi:10.1016/j.bbi.2008.01.012.CrossRefPubMedPubMedCentral Witek-Janusek, L., Albuquerque, K., Chroniak, K. R., Chroniak, C., Durazo-Arvizu, R., & Mathews, H. L. (2008). Effect of mindfulness based stress reduction on immune function, quality of life and coping in women newly diagnosed with early stage breast cancer. Brain, Behavior, and Immunity, 22(6), 969–981. doi:10.​1016/​j.​bbi.​2008.​01.​012.CrossRefPubMedPubMedCentral
Metagegevens
Titel
Effects of CBT Versus MBSR Treatment on Social Stress Reactions in Social Anxiety Disorder
Auteurs
Jacinthe Faucher
Diana Koszycki
Jacques Bradwejn
Zul Merali
Catherine Bielajew
Publicatiedatum
08-01-2016
Uitgeverij
Springer US
Gepubliceerd in
Mindfulness / Uitgave 2/2016
Print ISSN: 1868-8527
Elektronisch ISSN: 1868-8535
DOI
https://doi.org/10.1007/s12671-015-0486-4

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