title: Group CBT versus MBSR for social anxiety disorder: A randomized controlled trial.
abstract: OBJECTIVE
  The goal of this study was to investigate treatment outcome and mediators of cognitive-behavioral group therapy (CBGT) versus mindfulness-based stress reduction (MBSR) versus waitlist (WL) in patients with generalized social anxiety disorder (SAD).
  
  
  METHODS
  One hundred eight unmedicated patients (55.6% female; mean age = 32.7 years, SD = 8.0; 43.5% Caucasian, 39% Asian, 9.3% Hispanic, 8.3% other) were randomized to CBGT versus MBSR versus WL and completed assessments at baseline, posttreatment/WL, and at 1-year follow-up, including the Liebowitz Social Anxiety Scale-Self-Report (primary outcome; Liebowitz, 1987) as well as measures of treatment-related processes.
  
  
  RESULTS
  Linear mixed model analysis showed that CBGT and MBSR both produced greater improvements on most measures compared with WL. Both treatments yielded similar improvements in social anxiety symptoms, cognitive reappraisal frequency and self-efficacy, cognitive distortions, mindfulness skills, attention focusing, and rumination. There were greater decreases in subtle avoidance behaviors following CBGT than MBSR. Mediation analyses revealed that increases in reappraisal frequency, mindfulness skills, attention focusing, and attention shifting, and decreases in subtle avoidance behaviors and cognitive distortions, mediated the impact of both CBGT and MBSR on social anxiety symptoms. However, increases in reappraisal self-efficacy and decreases in avoidance behaviors mediated the impact of CBGT (vs. MBSR) on social anxiety symptoms.
  
  
  CONCLUSIONS
  CBGT and MBSR both appear to be efficacious for SAD. However, their effects may be a result of both shared and unique changes in underlying psychological processes.
authors.affiliation: Betty Irene Moore School of Nursing, University of California, Davis.
authors.forename: Philippe R
authors.identifier: 0000-0001-6861-4752
authors.initials: PR
authors.lastname: Goldin
authors.affiliation: Department of Psychology, Stanford University.
authors.forename: Amanda
authors.initials: A
authors.lastname: Morrison
authors.affiliation: Department of Psychology, University of California, Berkeley.
authors.forename: Hooria
authors.initials: H
authors.lastname: Jazaieri
authors.affiliation: Department of Psychology, Stanford University.
authors.forename: Faith
authors.initials: F
authors.lastname: Brozovich
authors.affiliation: Department of Psychology, Temple University.
authors.forename: Richard
authors.initials: R
authors.lastname: Heimberg
authors.affiliation: Department of Psychology, Stanford University.
authors.forename: James J
authors.initials: JJ
authors.lastname: Gross
mesh_terms: D000328:Adult; D015928:Cognitive Behavioral Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D064866:Mindfulness; D000072861:Phobia, Social / Q000523:psychology / Q000628:therapy*; D011615:Psychotherapy, Group; D020377:Self Efficacy; D016896:Treatment Outcome