Evaluating the unique effects of the primary components of mindfulness in a clinically anxious sample
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Abstract
Despite the popularity of mindfulness-based treatments for anxiety and related-disorders, there is inconsistency in how mindfulness is defined and applied. This has led to challenges in researching the basic components of mindfulness in therapeutic contexts. This study evaluates the two most consistent components of mindfulness, present-focused and nonjudgmental awareness, to work toward a basic understanding of mindfulness that transcends protocol-specific conceptualizations. These mindfulness components were isolated into two independent 4-week interventions. Utilizing single case experimental design, this study evaluated the effects of these mindfulness components in isolation (during first intervention phase) and in combination on mindfulness outcomes (primary aim) and symptom outcomes (exploratory aim). It was predicted that the combination of interventions would result in greater improvement on global measures of mindfulness than either intervention in isolation. It was also hypothesized that each component of mindfulness would increase the mindfulness subscale specific to that component (i.e., increase on measures of nonjudgment following nonjudgment intervention) and that this change would be greater than change on measures of the other component not targeted in that intervention. Participants were recruited from an adult treatment-seeking waitlist for anxiety disorders (N = 8; all female, majority White, mean age 26.5, range 20-41). Participants reported significant increases in global mindfulness after the first intervention phase. As predicted, participants also reported significantly greater global mindfulness scores after receiving both interventions compared to one in isolation. After both interventions, participants who received the nonjudgment intervention first had significantly greater nonjudgment scores, but there were no significant differences between conditions for global mindfulness or present-moment awareness. In isolation, the present-focused intervention did not significantly increase measures of present-moment awareness for most participants. However, when examining nonjudgment in isolation, most participants demonstrated significant improvement on measures of present-moment awareness and nonjudgment. There was no significant impact on symptoms or proposed mechanisms. In sum, both interventions increased mindfulness, with the greatest increases after the combination of interventions, and introducing nonjudgment prior to present-focused awareness may optimize continued gains in nonjudgment. These findings may inform future improvements to the content and sequence of mindfulness components in mindfulness-based treatments for anxiety.