Mindfulness based stress reduction for generalized anxiety disorder: A review of the current literature

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Moore, Lisa
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Introduction: Anxiety disorders are widespread and often debilitating conditions that can impair social, occupational and educational performance, resulting in lower quality of life for affected individuals and their families. Generalized Anxiety Disorder (GAD) has a lifetime prevalence of 5.7 and is characterized by six months or more of frequent, poorly-controlled worry and anxiety about multiple events or issues that negative affect sleep, mood, concentration and can result in a broad variety of somatic complaints. While both drug and psychotherapeutic treatments are widely available, GAD is often resistant to treatment, with a long and relapsing-remitting course. Mindfulness Based Stress Reduction (MBSR) is an 8-week stress relief group program that includes meditation, body awareness and yoga components developed by Jon Kabat-Zinn and first utilized in a clinical context at the University of Massachusetts Medical School in 1979. MBSR integrates contemplative spiritual practices including Zen Buddhism with secular concepts of health and wellness with the goal of reducing the effects of stress on patients. In recent years MBSR and other mindfulness practices have become widely available via Internet, books and structured programs. MBSR is now routinely promoted as effective and safe method with which to reduce stress, depression and anxiety. Methods: To answer the clinical question: in adults with generalized anxiety disorder, what is the efficacy of a MBSR program in relieving anxiety from baseline/pre-treatment? The current medical literature (published from 2006-2016) was surveyed to identify studies focused on the MBSR program and its effectiveness in alleviating symptoms of GAD. Using SCOPUS, Pubmed and Google Scholar databases, nine unique studies were located from 2006-2016 using search terms “generalized anxiety disorder”, “mindfulness based stress reduction”, “MBSR” and “GAD”. Results: Four recent studies were identified that specifically addressed the useful of MBSR program in treating GAD. All four studies concluded that MBSR likely has value in reducing symptoms of GAD. However, all four studies were small in size, with MBSR groups ranging from 16 to 79 participants. A number of methodological issues also problematize the real world value of the studies findings in the majority of the studies. Conclusions: Few current studies specifically evaluate the effectiveness of MBSR in treating GAD. Existing studies are generally small and the majority lack robust designs and long term follow up components, which limits their ability to confidently evaluate the real life usefulness of MBSR in treating GAD. While good evidence exists to support the use of MBSR as a low-cost, low-risk treatment for depression, chronic pain and other conditions, further research is needed to determine the usefulness of MBSR in treating GAD and how MBSR could be used confidently in practice to improve outcomes for GAD patients.