Improve the Regulation of Emotions in Social Anxiety Disorder with Mindfulness
By John M. de Castro, Ph.D.
“One way to do this . . . is mindfulness meditation, in which you observe your thoughts and feelings with the objectivity of a disinterested, nonjudgmental witness. This form of mental training gives you the wherewithal to pause, observe how easily the mind can exaggerate the severity of a setback, note that it as an interesting mental process, and resist getting drawn into the abyss,” – Ritchie Davidson
Mindfulness practices have been shown to have a large number of beneficial effects on the psychological, emotional, and physical health of the individual and is helpful in the treatment of mental and physical illness. They have also been shown to effect a large number of physiological and psychological processes, including emotion regulation, attention, sensory awareness, decentering, and reappraisal. It is not known how mindfulness practices produce the myriad effects on the individual’s health and well-being, whether mindfulness has a direct effect or works through intermediary effects to produce the improved well-being.
There has been some research on this question, for instance mindfulness has been found to improve some symptoms of mental illness by increasing reappraisal which then affects the symptoms. In today’s Research News article “Testing the mindfulness-to-meaning theory: Evidence for mindful positive emotion regulation from a reanalysis of longitudinal data.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5718463/ ), Garland and colleagues examine the hypothesis that mindfulness practices influence social anxiety disorder (SAD) through a series of intermediaries. They postulate that mindfulness training increases attention which, in turn increases decentering, which, in turn, broadens sensory awareness, which, in turn increases reappraisal, which increases emotion regulation and reductions in social anxiety disorder (SAD).
To examine this idea they reanalyzed the data from a longitudinal study of the effects of Mindfulness-Based Stress Reduction (MBSR) and Cognitive Behavioral Therapy (CBT) on social anxiety disorder (SAD) to determine the temporal sequence of mindfulness effects. Participants with SAD were randomly assigned to receive either 12 weeks of MBSR or CBT group therapy or on a wait-list control condition. MBSR consists of a combination of meditation, body scanning, and yoga practices. The participants were measured pretreatment, post-treatment, and 3, 6, 9, and 12 months later for attentional control, decentering, reappraisal, sensory awareness, dispositional mindfulness, emotion regulation and positive emotions. The data were analyzed with a sophisticated multivariate path analysis.
The best fit path revealed by the analysis had excellent model fit. It revealed that both MBSR and CBT produced significant improvements in attentional control at the end of the 12-week treatment. These attentional improvements were significantly associated with increases in decentering 3 months later. Similarly, change in decentering was significantly associated with broadened sensory awareness at the 6-month follow-up measurement. In turn, the broadened sensory awareness was significantly associated with increases in reappraisal at the 9-month follow-up measurement. Finally, increases in reappraisal were significantly associated with increases in positive emotions at the 12-month follow-up measurement. In comparing Mindfulness-Based Stress Reduction (MBSR) with Cognitive Behavioral Therapy (CBT) in this model, it was found that MBSR produced significantly greater decentering and broadened sensory awareness. So, both MBSR and CBT would appear effective for social anxiety disorder (SAD) but MBSR would appear to be the superior treatment.
These are interesting and important findings suggest the mechanism by which mindfulness training improves emotion regulation in patients with social anxiety disorder (SAD). They suggest that mindfulness training sets off a chain of events consisting of improved attention followed by increased decentering followed by broadened sensory awareness, followed by increased reappraisal, followed by increased emotion regulation and reduced social anxiety disorder (SAD). It remains for future research to determine if this sequence events accounts for any other of the mental or physical health benefits of mindfulness training.
So, improve the regulation of emotions in social anxiety disorder with mindfulness.
“Through your mindful acceptance, you can embrace or hold the feeling in your awareness– this alone can calm and soothe you. This is an act of self-compassion and responsiveness to your own distress, and it is so much more effective than punishing yourself for having this feeling.” – Melli O’Brien
CMCS – Center for Mindfulness and Contemplative Studies
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Study Summary
Garland, E. L., Hanley, A. W., Goldin, P. R., & Gross, J. J. (2017). Testing the mindfulness-to-meaning theory: Evidence for mindful positive emotion regulation from a reanalysis of longitudinal data. PLoS ONE, 12(12), e0187727. http://doi.org/10.1371/journal.pone.0187727
Abstract
Background and objective
The Mindfulness to Meaning Theory (MMT) provides a detailed process model of mindful positive emotion regulation.
Design
We conducted a post-hoc reanalysis of longitudinal data (N = 107) derived from a RCT of mindfulness-based stress reduction (MBSR) versus cognitive-behavioral therapy (CBT) for social anxiety disorder to model the core constructs of the MMT (attentional control, decentering, broadened awareness, reappraisal, and positive affect) in a multivariate path analysis.
Results
Findings indicated that increases in attentional control from baseline to post-training predicted increases in decentering by 3 months post-treatment (p<.01) that in turn predicted increases in broadened awareness of interoceptive and exteroceptive data by 6 months post-treatment (p<.001). In turn, broadened awareness predicted increases in the use of reappraisal by 9 months post-treatment (p<.01), which culminated in greater positive affect at 12 months post-treatment (p<.001). MBSR led to significantly greater increases in decentering (p<.05) and broadened awareness than CBT (p<.05). Significant indirect effects indicated that increases in decentering mediated the effect of mindfulness training on broadening awareness, which in turn mediated enhanced reappraisal efficacy.
Conclusion
Results suggest that the mechanisms of change identified by the MMT form an iterative chain that promotes long-term increases in positive affectivity. Though these mechanisms may reflect common therapeutic factors that cut across mindfulness-based and cognitive-behavioral interventions, MBSR specifically boosts the MMT cycle by producing significantly greater increases in decentering and broadened awareness than CBT, providing support for the foundational assumption in the MMT that mindfulness training may be a key means of stimulating downstream positive psychological processes.