title: Randomized controlled trial of mindfulness meditation for generalized anxiety disorder: effects on anxiety and stress reactivity.
abstract: 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 (GAD), a disorder characterized by chronic worry and physiologic hyperarousal symptoms.
  
  
  METHODS
  Ninety-three individuals with DSM-IV-diagnosed GAD were randomly assigned 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 Rating Scale (HAMA; primary outcome measure), the Clinical Global Impressions-Severity of Illness and -Improvement scales (CGI-S and CGI-I), and the Beck Anxiety Inventory (BAI). Stress reactivity was assessed by comparing anxiety and distress during pretreatment and posttreatment administration of the Trier Social Stress Test (TSST).
  
  
  RESULTS
  A modified intent-to-treat analysis including participants who completed at least 1 session of MBSR (n = 48) or SME (n = 41) showed that both interventions led to significant (P < .0001) reductions in HAMA 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 P values < .05). MBSR was also associated with greater reductions than SME in anxiety and distress ratings in response to the TSST stress challenge (P < .05) and a greater increase in positive self-statements (P = .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.
  
  
  BACKGROUND
  ClinicalTrials.gov identifier: NCT01033851.
authors.affiliation: Center for Anxiety and Traumatic Stress Disorders, Massachusetts General Hospital, One Bowdoin Sq, 6th Floor, Boston, MA 02114 ehoge@partners.org.
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Hoge
authors.forename: Eric
authors.initials: E
authors.lastname: Bui
authors.forename: Luana
authors.initials: L
authors.lastname: Marques
authors.forename: Christina A
authors.initials: CA
authors.lastname: Metcalf
authors.forename: Laura K
authors.initials: LK
authors.lastname: Morris
authors.forename: Donald J
authors.initials: DJ
authors.lastname: Robinaugh
authors.forename: John J
authors.initials: JJ
authors.lastname: Worthington
authors.forename: Mark H
authors.initials: MH
authors.lastname: Pollack
authors.forename: Naomi M
authors.initials: NM
authors.lastname: Simon
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D001008:Anxiety Disorders / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D001143:Arousal; D001364:Awareness; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D019122:Meditation / Q000379:methods* / Q000523:psychology*; D008875:Middle Aged; D010353:Patient Education as Topic; D011340:Problem Solving; D012649:Self Concept; D012931:Social Environment; D013060:Speech; D013315:Stress, Psychological / Q000150:complications* / Q000523:psychology*; D011795:Surveys and Questionnaires; D015013:Yoga / Q000523:psychology
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