Journal of Anxiety Disorders最新文献

{"title":"Metacognitive therapy versus exposure and response prevention for obsessive-compulsive disorder – A non-inferiority randomized controlled trial","authors":"Cornelia Exner ,&nbsp;Alexandra Kleiman ,&nbsp;Anke Haberkamp ,&nbsp;Jana Hansmeier ,&nbsp;Christopher Milde ,&nbsp;Julia Anna Glombiewski","doi":"10.1016/j.janxdis.2024.102873","DOIUrl":"https://doi.org/10.1016/j.janxdis.2024.102873","url":null,"abstract":"<div><h3>Objective</h3><p>Exposure with response prevention (ERP) is the first-line treatment for obsessive-compulsive disorder (OCD). However, refusals, dropouts and the required high time and logistic effort constitute barriers to the use of ERP. In a non-inferiority randomized controlled trial, we compared metacognitive therapy (MCT) to exposure with response prevention (ERP) as treatments for OCD.</p></div><div><h3>Method</h3><p>74 outpatients received 12 weekly sessions of either manualized MCT or ERP, with primary outcomes assessed by blinded assessors using the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) at pre-treatment, mid-treatment, post-treatment, and 6-month follow-up. Secondary outcomes included measures of depression and anxiety. Non-inferiority margin was specified at no less than <em>d</em> = 0.38 below the improvement reached by ERP, corresponding to a difference of about 3 points on the Y-BOCS.</p></div><div><h3>Results</h3><p>Drop-out rates were low (&lt;14%) and similar in both groups. Linear models indicated non-inferiority of MCT to ERP at post-treatment, but not at 6-month follow-up. While both groups showed comparable Y-BOCS improvements, the MCT group demonstrated a significantly greater reduction in state anxiety scores at post-treatment and follow-up.</p></div><div><h3>Conclusions</h3><p>Overall, MCT was not inferior to ERP, especially at post-treatment, suggesting it could be a treatment alternative. However, further research is needed to explore differential treatment indications.</p></div>","PeriodicalId":48390,"journal":{"name":"Journal of Anxiety Disorders","volume":"104 ","pages":"Article 102873"},"PeriodicalIF":10.3,"publicationDate":"2024-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0887618524000495/pdfft?md5=caef3d97c88fe64eb485ebf0e8c8e2b1&pid=1-s2.0-S0887618524000495-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140901353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intensive longitudinal assessment following index trauma to predict development of PTSD using machine learning","authors":"Adam Horwitz ,&nbsp;Kaitlyn McCarthy ,&nbsp;Stacey L. House ,&nbsp;Francesca L. Beaudoin ,&nbsp;Xinming An ,&nbsp;Thomas C. Neylan ,&nbsp;Gari D. Clifford ,&nbsp;Sarah D. Linnstaedt ,&nbsp;Laura T. Germine ,&nbsp;Scott L. Rauch ,&nbsp;John P. Haran ,&nbsp;Alan B. Storrow ,&nbsp;Christopher Lewandowski ,&nbsp;Paul I. Musey Jr. ,&nbsp;Phyllis L. Hendry ,&nbsp;Sophia Sheikh ,&nbsp;Christopher W. Jones ,&nbsp;Brittany E. Punches ,&nbsp;Robert A. Swor ,&nbsp;Lauren A. Hudak ,&nbsp;Srijan Sen","doi":"10.1016/j.janxdis.2024.102876","DOIUrl":"https://doi.org/10.1016/j.janxdis.2024.102876","url":null,"abstract":"<div><p>There are significant challenges to identifying which individuals require intervention following exposure to trauma, and a need for strategies to identify and provide individuals at risk for developing PTSD with timely interventions. The present study seeks to identify a minimal set of trauma-related symptoms, assessed during the weeks following traumatic exposure, that can accurately predict PTSD. Participants were 2185 adults (Mean age=36.4 years; 64% women; 50% Black) presenting for emergency care following traumatic exposure. Participants received a ‘flash survey’ with 6–8 varying symptoms (from a pool of 26 trauma symptoms) several times per week for eight weeks following the trauma exposure (each symptom assessed ∼6 times). Features (mean, sd, last, worst, peak-end scores) from the repeatedly assessed symptoms were included as candidate variables in a CART machine learning analysis to develop a pragmatic predictive algorithm. PTSD (PCL-5 ≥38) was present for 669 (31%) participants at the 8-week follow-up. A classification tree with three splits, based on mean scores of nervousness, rehashing, and fatigue, predicted PTSD with an Area Under the Curve of 0.836. Findings suggest feasibility for a 3-item assessment protocol, delivered once per week, following traumatic exposure to assess and potentially facilitate follow-up care for those at risk.</p></div>","PeriodicalId":48390,"journal":{"name":"Journal of Anxiety Disorders","volume":"104 ","pages":"Article 102876"},"PeriodicalIF":10.3,"publicationDate":"2024-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140894180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"No harmful effect of propranolol administered prior to fear memory extinction in rats and humans","authors":"Laura Luyten ,&nbsp;Anastasia Chalkia ,&nbsp;Anna Elisabeth Schnell ,&nbsp;Burcu Özcan ,&nbsp;Lu Leng ,&nbsp;Natalie Schroyens ,&nbsp;Lukas Van Oudenhove ,&nbsp;Wolf Vanpaemel ,&nbsp;Tom Beckers","doi":"10.1016/j.janxdis.2024.102870","DOIUrl":"https://doi.org/10.1016/j.janxdis.2024.102870","url":null,"abstract":"<div><p>Exposure therapy is an evidence-based treatment option for anxiety-related disorders. Many patients also take medication that could, in principle, affect exposure therapy efficacy. Clinical and laboratory evidence indeed suggests that benzodiazepines may have detrimental effects. Large clinical trials with propranolol, a common beta-blocker, are currently lacking, but several preclinical studies do indicate impaired establishment of safety memories. Here, we investigated the effects of propranolol given prior to extinction training in 9 rat studies (N = 215) and one human study (N = 72). A Bayesian meta-analysis of our rat studies provided strong evidence against propranolol-induced extinction memory impairment during a drug-free test, and the human study found no significant difference with placebo. Two of the rat studies actually suggested a small beneficial effect of propranolol. Lastly, two rat studies with a benzodiazepine (midazolam) group provided some evidence for a harmful effect on extinction memory, i.e., impaired extinction retention. In conclusion, our midazolam findings are in line with prior literature (i.e., an extinction retention impairment), but this is not the case for the 10 studies with propranolol. Our data thus support caution regarding the use of benzodiazepines during exposure therapy, but argue against a harmful effect of propranolol on extinction learning.</p></div>","PeriodicalId":48390,"journal":{"name":"Journal of Anxiety Disorders","volume":"104 ","pages":"Article 102870"},"PeriodicalIF":10.3,"publicationDate":"2024-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140905985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fear of negative and positive evaluation as mediators and moderators of treatment outcome in social anxiety disorder","authors":"Amanda S. Morrison ,&nbsp;Philippe R. Goldin ,&nbsp;James J. Gross","doi":"10.1016/j.janxdis.2024.102874","DOIUrl":"https://doi.org/10.1016/j.janxdis.2024.102874","url":null,"abstract":"<div><h3>Introduction</h3><p>Elevated fear of negative evaluation (FNE) and fear of positive evaluation (FPE) are thought to play key roles in the maintenance of social anxiety disorder (SAD). Although efficacious therapies exist for SAD, the potential mediating and moderating effects of FNE and FPE on social anxiety treatment outcome have not been examined.</p></div><div><h3>Methods</h3><p>This sample comprised a secondary analysis of 210 individuals who participated in one of three randomized controlled trials for the treatment of SAD. Participants were randomized to: individual cognitive behavioral therapy (CBT), group CBT, community mindfulness-based stress reduction (MBSR), group MBSR, or they were randomized to waitlist and offered treatment after waitlist. Assessments were completed pre- and post-treatment/waitlist and, for the treatment groups, at three-month follow-up.</p></div><div><h3>Results</h3><p>CBT and MBSR led to greater reductions in FNE and FPE than waitlist, with CBT more efficacious in reducing FPE than MBSR. For both CBT (vs. waitlist) and MBSR (vs. waitlist), there were significant indirect effects on post-treatment social anxiety through both FNE and FPE, and the indirect effect through FPE was greater for CBT than MBSR. However, in the fully longitudinal model testing mediation, CBT and MBSR were not differentially mediated by FPE. Baseline FNE and FPE each moderated CBT treatment outcome compared to waitlist – higher baseline FNE and FPE were associated with higher baseline social anxiety and greater reductions in social anxiety during CBT.</p></div><div><h3>Discussion</h3><p>FNE and FPE contributed in sometimes similar and sometimes distinct ways to the mediation and moderation of psychosocial approaches for treating SAD. This supports the importance of distinguishing between fears of negative and positive evaluation in the assessment and treatment of SAD.</p></div>","PeriodicalId":48390,"journal":{"name":"Journal of Anxiety Disorders","volume":"104 ","pages":"Article 102874"},"PeriodicalIF":10.3,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0887618524000501/pdfft?md5=5580ab63d135da502baf04bcac5e0b5f&pid=1-s2.0-S0887618524000501-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140948708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Longitudinal changes in the PTSD symptom network following trauma-focused treatment in military populations: Identifying central symptoms and the role of military sexual trauma","authors":"Bingyu Xu ,&nbsp;Soyeong Kim ,&nbsp;Rebecca K. Blais ,&nbsp;Molly Nadel ,&nbsp;Qiyue Cai ,&nbsp;Kaloyan S. Tanev","doi":"10.1016/j.janxdis.2024.102872","DOIUrl":"https://doi.org/10.1016/j.janxdis.2024.102872","url":null,"abstract":"<div><p>Posttraumatic stress disorder (PTSD) is a debilitating condition affecting military populations, with a higher prevalence compared to the general population. Despite the development of first-line trauma-focused treatments such as Cognitive Processing Therapy (CPT) and Prolonged Exposure Therapy (PE), a significant proportion of patients continue to experience persistent PTSD symptoms following treatment. This study utilized network analysis to explore the PTSD symptom network's dynamics pre- and post- trauma-focused treatment and investigated the role of military sexual trauma (MST) history in shaping the network. Network analysis is a novel approach that can guide treatment target areas. The sample was comprised of 1648 service members and veterans who participated in a two-week intensive PTSD treatment program, which included completion of evidenced-based individual therapy as well as skill-building focused group therapy. PTSD severity was assessed using the PTSD Checklist for DSM-5 at baseline and post-treatment. Network analyses revealed strong connections within symptom clusters, with negative emotions emerging as one of the most central symptoms. Interestingly, the symptom network's overall structure remained stable following treatment, whereas global strength significantly increased. MST history did not significantly impact the network's structure or its change relative to treatment. Future research should further examine whether targeting negative emotions optimizes PTSD treatment outcomes for military populations.</p></div>","PeriodicalId":48390,"journal":{"name":"Journal of Anxiety Disorders","volume":"104 ","pages":"Article 102872"},"PeriodicalIF":10.3,"publicationDate":"2024-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140825081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of transdiagnostic internet-delivered cognitive behavioural therapy tailored to public safety personnel: A longitudinal observational study","authors":"Heather D. Hadjistavropoulos ,&nbsp;Hugh C. McCall ,&nbsp;Blake F. Dear ,&nbsp;Janine D. Beahm ,&nbsp;R. Nicholas Carleton ,&nbsp;Nickolai Titov","doi":"10.1016/j.janxdis.2024.102861","DOIUrl":"https://doi.org/10.1016/j.janxdis.2024.102861","url":null,"abstract":"<div><p>First responders and other public safety personnel (PSP) experience high rates of mental health problems and face barriers to accessing mental healthcare. Internet-delivered cognitive behavioural therapy (ICBT) is an effective and accessible treatment for various mental health concerns. Canadian PSP report favorable attitudes toward ICBT, and preliminary outcomes demonstrate that they benefit from it. Expanding on this research, the current study consisted of a longitudinal observational study of 560 Canadian PSP who participated in ICBT. It was designed to assess the longer term effectiveness of ICBT and moderators of outcomes by gender, linguistic and occupational group, and years of occupational experience. We evaluated symptom change at 8, 26, and 52 weeks post-enrollment, and results among PSP who had elevated clinical scores, showed large reductions (Hedges’ g) in symptoms of depression (<em>g</em> = 1.3), anxiety (g =1.48), posttraumatic stress (<em>g</em> =1.24), panic (<em>g</em> =1.19), and anger (<em>g</em> =1.07) and moderate reductions in symptoms of social anxiety (<em>g</em> =.48–.56). Moderator analyses revealed modest differences in pre-treatment symptoms among certain groups but no group differences in symptom change over time. Clients showed good completion of treatment materials and reported high treatment satisfaction. The results suggest further study of ICBT tailored to PSP is warranted, including evaluating ICBT tailored for PSP in other countries.</p></div>","PeriodicalId":48390,"journal":{"name":"Journal of Anxiety Disorders","volume":"104 ","pages":"Article 102861"},"PeriodicalIF":10.3,"publicationDate":"2024-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0887618524000379/pdfft?md5=8c956154cfd6496e38480b2356c1f7fc&pid=1-s2.0-S0887618524000379-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140618041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Group schema therapy versus group cognitive behavioral therapy for patients with social anxiety disorder and comorbid avoidant personality disorder: A randomized controlled trial","authors":"Astrid E. Baljé ,&nbsp;Anja Greeven ,&nbsp;Mathijs Deen ,&nbsp;Anne E. van Giezen ,&nbsp;Arnoud Arntz ,&nbsp;Philip Spinhoven","doi":"10.1016/j.janxdis.2024.102860","DOIUrl":"https://doi.org/10.1016/j.janxdis.2024.102860","url":null,"abstract":"<div><h3>Background</h3><p>Patients with social anxiety (SAD) and comorbid avoidant personality disorder (AVPD) are severely impaired. Group cognitive behavioral therapy (GCBT) is considered an effective treatment for SAD. More knowledge on treatment of SAD with comorbid AVPD is needed. Schema therapy, developed for personality and chronic mental disorders, may be a promising treatment.</p></div><div><h3>Methods</h3><p>We conducted a randomized controlled trial in an outpatient population (n = 154) with both SAD and AVPD. Group Schema Therapy (GST) and GCBT were compared on SAD symptoms (Liebowitz Social Anxiety Scale) and manifestations of AVPD (Avoidant Personality Disorder Severity Index).</p></div><div><h3>Results</h3><p>Intention-to-treat analysis showed no significant differences between treatments at 3 months post-treatment and one-year follow-up. Both modalities led to significant and substantial improvements. No significant between-differences were found in depressive symptoms (Inventory of Depressive Symptoms) and quality of life (World Health Organization Quality of Life-BREF). Per-protocol analysis showed similar outcomes and no significant differences in recovery from SAD and AVPD. Significantly more patients completed GST.</p></div><div><h3>Conclusion</h3><p>GST and GCBT are valuable treatments for SAD with comorbid AVPD. The higher treatment retention in ST indicates ST is more acceptable than GCBT. Future studies should focus on enhancing treatment effects and improving retention to GCBT.</p></div>","PeriodicalId":48390,"journal":{"name":"Journal of Anxiety Disorders","volume":"104 ","pages":"Article 102860"},"PeriodicalIF":10.3,"publicationDate":"2024-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0887618524000367/pdfft?md5=b5c6c379cfea2b821c3c9ae2a1f4dadd&pid=1-s2.0-S0887618524000367-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140842699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is a brief mindfulness ecological momentary intervention more efficacious than a self-monitoring app for social anxiety disorder? A randomized controlled trial","authors":"Nur Hani Zainal ,&nbsp;Hui Han Tan ,&nbsp;Ryan Y. Hong ,&nbsp;Michelle G. Newman","doi":"10.1016/j.janxdis.2024.102858","DOIUrl":"10.1016/j.janxdis.2024.102858","url":null,"abstract":"<div><p>Despite their proliferation, limited knowledge exists regarding possible benefits of brief mindfulness ecological momentary interventions (MEMIs) for social anxiety disorder (SAD). Propositions that MEMIs could alleviate SAD symptoms and related clinical outcomes remain untested. This trial evaluated a 14-day MEMI for SAD. Participants with self-reported SAD were randomized to MEMI (<em>n</em> = 96) or self-monitoring app (SM; <em>n</em> = 95). Whereas MEMI instructed mindfulness exercises, SM prompted only self-monitoring five times daily for 14 days. Participants completed state-level self-reports of depression, anxiety, and mindfulness pre-post-mindfulness practice and SAD symptoms, worry, depression severity, repetitive negative thinking, and trait mindfulness at pre-randomization, post-intervention, and 1-month follow-up (1MFU). Hierarchical linear modeling was conducted. The MEMI yielded statistically significantly larger improvements in momentary depression, anxiety, and mindfulness (Cohen's <em>d</em> = −0.10–0.11). Although no between-group effects emerged in alleviating SAD fear and avoidance, excessive worry, depression severity, repetitive negative thinking, and trait mindfulness (−0.13–0.15), within-group effects were significantly small-to-large from pre-post and pre-1MFU (−4.62–0.67). A significant reduction in depression severity occurred in MEMI (−0.63–−0.60) but not SM (−0.31–−0.29). Brief MEMI and SM yielded nondifferent sustained effects on SAD, comorbid symptoms, and risk factors, highlighting its potential value within stepped-care delivery settings.</p></div>","PeriodicalId":48390,"journal":{"name":"Journal of Anxiety Disorders","volume":"104 ","pages":"Article 102858"},"PeriodicalIF":10.3,"publicationDate":"2024-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140399664","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The epidemiology of obsessive-compulsive disorder in the Kingdom of Saudi Arabia: Data from the Saudi National Mental Health Survey","authors":"Yasmin Altwaijri ,&nbsp;Dan J. Stein ,&nbsp;Marya Akkad ,&nbsp;Lisa Bilal ,&nbsp;Mohammad Talal Naseem ,&nbsp;Abdullah Al-Subaie ,&nbsp;Abdulhameed Al-Habeeb ,&nbsp;Ronald C. Kessler","doi":"10.1016/j.janxdis.2024.102856","DOIUrl":"10.1016/j.janxdis.2024.102856","url":null,"abstract":"<div><h3>Aims</h3><p>There is ongoing debate about the extent to which the epidemiology of OCD is similar across the world, given the lack of nationally representative data from key regions like the Middle East and North Africa. Using the nationally representative dataset from the Saudi National Mental Health Survey (SNMHS), we aimed to delineate the epidemiological profile of OCD in the Saudi population.</p></div><div><h3>Methods</h3><p>A subsample of 1981 participants from the SNMHS was assessed. Prevalence estimates and correlates of OCD were determined using logistic regressions and cross tabulations.</p></div><div><h3>Results</h3><p>The lifetime, 12-month, and 30-day prevalence estimates for OCD were 4.2%, 1.8%, and 1.6%, respectively, with hoarding being the most common symptom dimension. The mean age-of-onset of OCD was 16.8 years. In over two-thirds of respondents with lifetime (72.2%) or 12-month (71.2%), OCD was accompanied by comorbid mental disorder, particularly impulse control, anxiety, and mood disorders. Among individuals with 12-month OCD, 77.5% reported severe impairment, and only 9.2% received treatment.</p></div><div><h3>Conclusions</h3><p>In Saudi Arabia, OCD is a prevalent and persistent condition, characterized by early onset, high odds of mental comorbidity, and significant associated impairment. These findings emphasize the universality of OCD epidemiology and the need for improved diagnosis and treatment globally.</p></div>","PeriodicalId":48390,"journal":{"name":"Journal of Anxiety Disorders","volume":"103 ","pages":"Article 102856"},"PeriodicalIF":10.3,"publicationDate":"2024-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S088761852400032X/pdfft?md5=7d7f9309d30ef29a60ef134ed36e0765&pid=1-s2.0-S088761852400032X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140181807","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Can mindfulness-based interventions reduce PTSD symptoms? An umbrella review","authors":"Branislav Jovanovic ,&nbsp;Dana Rose Garfin","doi":"10.1016/j.janxdis.2024.102859","DOIUrl":"10.1016/j.janxdis.2024.102859","url":null,"abstract":"<div><p>Post-traumatic stress disorder (PTSD) is a debilitating, often chronic condition with substantial cross-national lifetime prevalence. Although mindfulness-based interventions (MBIs) may help reduce PTSD symptoms, efficacy results are inconsistent. Despite many systematic reviews (SRs) examining MBIs for PTSD, SR quality has been neither evaluated nor synthesized. We conducted an umbrella review to summarize and evaluate existing evidence regarding MBIs for PTSD, identifying 69 SRs (27 meta-analyses), consisting of 83 primary studies. Using AMSTAR2 (a valid SR quality assessment tool), we evaluated each SR on key domains relevant to methodological rigor and rated the confidence of inferences. Results found SRs were 65.2% non-rigorous, 27.5% likely rigorous, and 7.2% rigorous; common limitations included inadequate risk of bias assessment, extractions not completed in duplicate, and lack of pre-registration, highlighting the need for higher quality SRs. We then performed a meta-meta-analysis to estimate the efficacy of MBIs to reduce PTSD symptoms, yielding a medium effect size (SMD=0.41<em>, p &lt;</em> .001<em>)</em>, derived from 22 meta-analyses (with replicable data) and 35 unique articles. Analyses were consistent across control conditions and MBI type (first-generation/narrow [i.e., MBIs with well-established protocols]) versus broad (i.e., other MBI types), comparable with second-line treatments (e.g., pharmacotherapy). Findings were narratively synthesized; areas for methodological improvements in MBI research were identified.</p></div>","PeriodicalId":48390,"journal":{"name":"Journal of Anxiety Disorders","volume":"104 ","pages":"Article 102859"},"PeriodicalIF":10.3,"publicationDate":"2024-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0887618524000355/pdfft?md5=bad8e237cbaeee04f8e67bc17987ba26&pid=1-s2.0-S0887618524000355-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140181882","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}