Treatment condition as a moderator and change in trait mindfulness as a mediator of a brief mindfulness ecological momentary intervention for generalized anxiety disorder.

BACKGROUND

Theories propose that judgment of and reactivity to inner experiences are mediators of the effect of mindfulness-based interventions on generalized anxiety disorder (GAD). However, no study has tested such theories using brief, mindfulness ecological momentary intervention (MEMI). We thus tested these theories using a 14-day MEMI versus self-monitoring app (SM) control for GAD.

METHODS

Participants (

RESULTS

Improvement in pre-post mindfulness domains (acceptance of emotions, describing feelings accurately, acting with awareness, judgment of inner experience, and reactivity to inner experience) predicted pre-1MFU reduction in GAD severity and pre-1MFU reduction in trait perseverative cognitions from MEMI but not SM. MEMI reduced pre-post reactivity to inner experiences (but not other mindfulness domains) significantly more than SM. Only reduced pre-post reactivity significantly mediated stronger efficacy of MEMI over SM on pre-1MFU reductions in GAD severity (indirect effect: β = -2.970 [-5.034, -0.904],

CONCLUSIONS

Reactivity to inner experience might be a mindfulness-based intervention change mechanism and should be targeted to optimize brief MEMIs for GAD.