Loving-kindness meditation for anxiety and mood disorders: a multiple baseline, single-case experimental evaluation
Bourgeois, Michelle L.
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In recent years, kindness-based meditation practices, including loving-kindness meditation (LKM), have gained empirical support for decreasing depression and anxiety symptoms. LKM is defined as the intentional transmission of unselfish kindness toward all beings. It is practiced by contemplating an object of meditation (e.g., self, difficult person) and offering goodwill by silently repeating phrases (e.g., “May you be happy”). Given LKM’s focus on cultivating positive emotional states, researchers have hypothesized that LKM may work by increasing positive affect (PA), promoting cognitive and behavioral flexibility, and reducing negative affect (NA). This study was the first to employ a multiple baseline, single-case design to evaluate the acceptability and clinical efficacy of a brief, individual LKM intervention for individuals (N = 9) with unipolar depressive disorders, social anxiety disorder, or generalized anxiety disorder and low PA. Participants were randomized to a 2-, 4-, or 6-week baseline and completed weekly assessments during baseline, 7 weeks of treatment, and at 1-, 2- and 4-week follow-up. LKM was hypothesized to be acceptable and effective for reducing depression and anxiety symptoms and increasing PA. Secondary hypotheses were that (1) improvements in PA would precede disorder symptom improvement and (2) LKM would lead to improvements in other treatment variables (e.g., NA, anger, mindfulness, affective regulation styles, quality of life, etc.) Results revealed that the study intervention had good feasibility and acceptability. Per visual inspection, LKM led to improvements in principal disorder symptoms for four participants during treatment and five participants at follow-up (three of whom showed clinically reliable change). Contrary to study hypotheses, only one participant demonstrated reliable improvements in PA during treatment. For this participant, increases in PA occurred simultaneously with reductions in depression. Across participants, LKM exerted moderate to large effects on disorder severity, depression and anxiety symptoms, quality of life, mindful nonreactivity, and tolerating affective style. Overall, individuals with principal unipolar depressive disorders showed the strongest response to the study intervention. In summary, this study provided preliminary evidence for the effectiveness of brief, individual LKM for reducing depression and anxiety in a transdiagnostic outpatient sample with low positive affect.