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Mindfulness-Based Cognitive Therapy for Generalized Anxiety Disorder

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Mindfulness-Based Cognitive Therapy

Abstract

Generalized anxiety disorder (GAD) is a chronic condition characterized by intense and excessive worry and is associated with high rates of comorbidity. Cognitive behavioral therapy (CBT) has been found to be efficacious for GAD. Nonetheless, GAD is the least successfully treated of the anxiety disorders, and there are often residuals symptoms in patients who are successfully treated. Mindfulness-based therapies may provide an alternative and/or adjunctive approach to CBT. This chapter discusses CBT and mindfulness for GAD as well as the recent literature on the neurobiology of GAD. A conceptual framework for a mindfulness-based approach to GAD is developed. Specific case examples are provided to illustrate key concepts. The author proposes an 8-week protocol specific to GAD based on mindfulness-based cognitive therapy (MBCT) developed by Segal et al. (Mindfulness-based cognitive therapy for depression: a new approach to preventing relapse. Guilford, 2002). Challenges implementing MBCT are reviewed as well as recommendations for professionals considering training in MBCT.

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References

  1. Brown TA, Barlow DH. Comorbidity among anxiety disorders: implications for treatment and DSM-IV. J Consult Clin Psychol. 1992;60:835–44.

    Article  CAS  PubMed  Google Scholar 

  2. Kessler RC, Berglund P, Demler O, Jin R, Walters EE. Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry. 2005;62:593–602.

    Article  PubMed  Google Scholar 

  3. Maier W, Gansicke M, Freyberger HJ, Linz M, Huen R, Lecrubier Y. Generalized anxiety disorder (ICD-10) in primary care from a cross-cultural perspective: a valid diagnostic entity? Acta Psychiatr Scand. 2000;101:29–36.

    Article  CAS  PubMed  Google Scholar 

  4. American Psychiatric Association. Diagnostic and statistical manual of mental disorders fifth edition DSM-5. Washington, DC: American Psychiatric Publishing; 2013. p. 222–6.

    Google Scholar 

  5. Borkovec TD, Ruscio AM. Psychotherapy for generalized anxiety disorder. J Clin Psychiatry. 2001;62 Suppl 11:37–42.

    PubMed  Google Scholar 

  6. Borkovec TD, Newman MG, Lytle R, Pincus A. A component analysis of cognitive behavioral therapy for generalized anxiety disorder and the role of interpersonal problems. J Consult Clin Psychol. 2002;70:288–98.

    Article  CAS  PubMed  Google Scholar 

  7. Butler G, Fennell M, Robson P, Gelder M. Comparison of behavior therapy and cognitive behavior therapy in the treatment of generalized anxiety disorder. J Consult Clin Psychol. 1991;59:167–75.

    Article  CAS  PubMed  Google Scholar 

  8. Ladouceur R, Dugas MJ, Freeston MH, Leger E, Gagnon F, Thiboeau N. Efficacy of a new cognitive-behavioral treatment for generalized anxiety disorder: evaluation in a controlled clinical trial. J Consult Clin Psychol. 2000;68:957–64.

    Article  CAS  PubMed  Google Scholar 

  9. Brown TA, Barlow DH, Lebowitz MR. The empirical basis of generalized anxiety disorder. Am J Psychiatry. 1994;151:1272–80.

    Article  CAS  PubMed  Google Scholar 

  10. Ninan PT. General anxiety disorder: why are we failing our patients? J Clin Psychiatry. 2001;62 Suppl 19:3–4.

    Google Scholar 

  11. Barlow DH. Anxiety and its disorders: the nature and treatment of anxiety and panic. New York, NY: Guilford; 1988. p. 579.

    Google Scholar 

  12. Killingsworth MA, Gilbert DT. A wandering mind is an unhappy mind. Sci Mag. 2010;330:932.

    CAS  Google Scholar 

  13. Borkovec TD. The nature, functions, and origins of worry. In: Davey GCL, Tallis F, editors. Worrying: perspectives on theory, assessment, and treatment. New York, NY: Wiley; 1994.

    Google Scholar 

  14. Roemer L, Orsillo SM. Expanding our conceptualization of and treatment for generalized anxiety disorder: integrating mindfulness/acceptance-based approaches with existing cognitive-behavioral models. Clin Psychol Sci Pract. 2002;9(1):54–68.

    Article  Google Scholar 

  15. Mennin DS, Heimberg RG, Turk CL, Fresco DM. Applying an emotion regulation framework to integrative approaches to generalized anxiety disorder. Clin Psychol Sci Pract. 2002;9(1):85–90.

    Article  Google Scholar 

  16. Kim MJ, Loucks RA, Palmer AL, Brown AC, Solomon KM, Marchante AN, et al. The structural and functional connectivity of the amygdala: from normal emotion to pathological anxiety. Behav Brain Res. 2011;223(2):403–10.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Tromp DP, Grupe DW, Oathes DJ, McFarlin DR, Herandez PJ, Krai TR, et al. Reduced structural connectivity of a major frontolimbic pathway in generalized anxiety disorder. Arch Gen Psychiatry. 2012;69(9):925–34.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Mochcovitch MD, da Rocha FR, Ferreira R, Nardi GA. A systematic review of fMRI studies in generalized anxiety disorder: evaluation its neural and cognitive basis. J Affect Disord. 2014;167(10):336–42.

    Article  PubMed  Google Scholar 

  19. Holzel BK, Hoge EA, Greve DN, Gard T, Creswell JD, Brown KW, et al. Neural mechanisms of symptom improvements in generalized anxiety disorder following mindfulness training. Neuroimage Clin. 2013;2:448–58.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Kabat-Zinn J. Full catastrophe living: Using the wisdom of your body and mind to face stress, pain, and illness. New York, NY: Dell; 1990.

    Google Scholar 

  21. Astin JA. Stress reduction through mindfulness meditation. Effects on psychological symptomatology, sense of control and spiritual experiences. Psychother Psychosom. 1997;66:97–106.

    Article  CAS  PubMed  Google Scholar 

  22. Roemer L, Lee JK, Salters-Pedneault K, Erisman SM, Orsillo SM, Mennin DS. Mindfulness and emotion regulation difficulties in generalized anxiety disorder: preliminary evidence for independent and overlapping contributions. Behav Ther. 2009;40:142–54.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Bishop SR, Lau M, Shapiro S, Carlson L, Anderson ND, Carmody J, et al. Mindfulness: a proposed operational definition. Clin Psychol Sci Prac. 2004;11:230–41.

    Article  Google Scholar 

  24. Kabat-Zinn J. Wherever you go there you are: mindfulness meditation in everyday life. New York, NY: Hyperion; 1994. p. 53.

    Google Scholar 

  25. Roemer L, Orsillo SM. An open trial of an acceptance-based behavior therapy for generalized anxiety disorder. Behav Ther. 2007;38:72–85.

    Article  PubMed  Google Scholar 

  26. Evans S, Ferrando S, Findler M, Stowell C, Smart C, Haglin D. Mindfulness-based cognitive therapy for generalized anxiety disorder. J Anxiety Disord. 2008;22:716–21.

    Article  PubMed  Google Scholar 

  27. Segal ZV, Williams JMG, Teasdale JD. Mindfulness-based cognitive therapy for depression: a new approach to preventing relapse. New York, NY: Guilford; 2002.

    Google Scholar 

  28. Kim YW, Lee S-H, Choi TK, et al. Effectiveness of mindfulness-based cognitive therapy as an adjuvant to pharmacotherapy in patients with panic disorder of generalized anxiety disorder. Depress Anxiety. 2009;26:601–6.

    Article  PubMed  Google Scholar 

  29. Hofmann S, Sawyer AT, Witt AA, Oh D. The effect of mindfulness-based therapy on anxiety and depression: a meta-analytic review. J Consult Clin Psychol. 2010;78(2):169–83.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Krisanaprakornkit T, Krisanaprakornkit W, Piyavhatkul N, Loapaiboon M. Meditation therapy for anxiety disorders (review). The Cochrane Collaboration. New York, NY: Wiley; 2006.

    Google Scholar 

  31. Brown KW, Ryan RM. The benefits of being present: the role of mindfulness in psychological well-being. Am J Psychiatry. 2003;151:1272–80.

    Google Scholar 

  32. Wells A. Emotional disorders & Metacognition: Innovative cognitive therapy. New York, NY: Wiley; 2000.

    Google Scholar 

  33. Burns D. Feeling good: the new mood therapy. New York, NY: Avon Books; 1999.

    Google Scholar 

  34. Leahy RL. The worry cure. New York, NY: Harmony Books; 2005.

    Google Scholar 

  35. Moyne J, Barks C. Say I am you. Poems of Rumi. Maypop; 1994.

    Google Scholar 

  36. Edwards AR, Evans S, Aldao A, Haglin D, Ferrando SJ. Implementing a mindfulness–based stress reduction program in the community: lessons learned and suggestions for the future. Behav Ther. 2014;37(1):13–7.

    Google Scholar 

  37. Kabat-Zinn J. Mindfulness-based interventions in context: past, present & future. Clin Psychol Sci Pract. 2003;10:144–56.

    Article  Google Scholar 

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Correspondence to Susan Evans Ph.D. .

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Evans, S. (2016). Mindfulness-Based Cognitive Therapy for Generalized Anxiety Disorder. In: Eisendrath, S. (eds) Mindfulness-Based Cognitive Therapy. Springer, Cham. https://doi.org/10.1007/978-3-319-29866-5_13

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  • DOI: https://doi.org/10.1007/978-3-319-29866-5_13

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-29864-1

  • Online ISBN: 978-3-319-29866-5

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