Review Article


DOI :10.26650/SP2020-847371   IUP :10.26650/SP2020-847371    Full Text (PDF)

The Effectiveness of Mindfulness Based Interventions in Adults with Social Anxiety Disorder: A Systematic Review

Gül MuhtarÖzlem Çakmak Tolan

Social Anxiety Disorder (SAD) is a common anxiety disorder causing individuals to feel anxious, nervous, and distressed in public situations requiring performance, such as public speaking. Today, psychotherapies are known to be effective in reducing SAD symptoms. Mindfulness is a significant component of third-wave cognitive therapies, effective in treating mental disorders with psychotherapy. This study examines research articles to evaluate the effectiveness of mindfulness-based interventions (MBI) in SAD. The national literature lacks a review study on this topic. International databases scanned with the keywords “mindfulness-based therapy,” “mindfulness-based intervention,” “social anxiety,” and “social phobia” revealed twenty-one studies that met inclusion criteria. These articles covered mindfulness-based stress reduction programs, acceptance-based treatment, and interventions with adult sampling related to SAD problems. In comparing the methodological and practical features of studies meeting the criteria, we observed that MBI generally reduced SAD symptoms and affected social anxiety-related attitudes and characteristics. Although MBI was more effective than the control group or wait-list group, some studies showed no significant differences compared to other treatment groups. MBI was effective and significantly reduced SAD symptoms in efficacy studies based on the pre-test, post-test, and follow-up data when excluding comparison and control groups. In light of these findings, new studies will need more methodological control and longer follow-up times to increase the reliability and generalizability of MBI in SAD.

DOI :10.26650/SP2020-847371   IUP :10.26650/SP2020-847371    Full Text (PDF)

Sosyal Anksiyete Bozukluğu Olan Yetişkinlerde Bilinçli Farkındalık Temelli Müdahalelerin Etkililiği: Sistematik Bir Gözden Geçirme

Gül MuhtarÖzlem Çakmak Tolan

Sosyal Anksiyete Bozukluğu (SAB) toplumda sık karşılaşılan anksiyete bozukluklarından biridir. SAB bireylerin, topluluk önünde konuşma yapma gibi diğerleri tarafından değerlendirilebileceği ve performans sergilemesini gerektirecek durumlarda kaygılanmasına, gergin ve rahatsız hissetmesine neden olmaktadır. Günümüzde psikoterapilerin SAB belirtilerini azaltmada etkili olduğu bilinmektedir. Üçüncü dalga bilişsel terapilerin önemli bir bileşeni olarak bilinçli farkındalığın psikoterapideki kullanımının ruhsal bozuklukların tedavi edilmesinde etkili olduğu görülmektedir. Mevcut sistematik gözden geçirme çalışmasında, SAB’da bilinçli farkındalık (mindfulness) temelli müdahalelerin etkililiğini değerlendirmek için araştırma makalelerinin incelenmesi amaçlanmıştır. Bilinçli farkındalık temelli müdahalelerin etkililiğini değerlendirmek amacıyla öncelikle ulusal alan yazın taranmış ancak bu konuda gerçekleşmiş bir derleme çalışmasına rastlanmamıştır. Bu nedenle, bu doğrultuda “mindfulness based therapy”, “mindfulness based intervention”, “social anxiety” ve “social phobia” anahtar sözcükleriyle uluslararası veritabanları taranmıştır. SAB bakımından sadece farkındalık temelli stres azaltma programı ve kabul temelli tedavi ve müdahaleleri ele alma, yetişkin örneklemiyle gerçekleştirilme gibi dahil etme kriterlerini karşılayan 21 çalışma incelenmiştir. Kriterleri karşılayan 21 çalışmanın yöntemsel ve uygulama özellikleri karşılaştırılarak sunulmuştur. Bu çalışmaların sonuçlarında genel olarak bilinçli farkındalık temelli müdahalelerin SAB belirtilerini azalttığı, sosyal anksiyete ile ilgili tutum ve özellikler üzerinde etkili olduğu görülmektedir. Gözden geçirilen çalışmaların sonuçları kıyaslandığında bilinçli farkındalık temelli müdahalelerin kontrol grubu ya da bekleme listesi grubuna göre daha etkili olduğu, ancak diğer tedavi grupları ile karşılaştırıldığı bazı çalışmalarda anlamlı farklılıklar bulunmadığı görülmüştür. Karşılaştırma ve kontrol grubunun dahil edilmediği ön test, son test ve izlem verilerine dayanan etkililik çalışmalarında FTM’nin etkili olduğu ve SAB belirtilerini anlamlı düzeyde azalttığı gösterilmiştir. Araştırma bulguları ışığında sosyal anksiyete bozukluğunda bilinçli farkındalık temelli uygulamaların güvenirliliğinin ve genellenebilirliğinin artması için yöntemsel olarak daha kontrollü, daha uzun izlem süreli yeni çalışmalara ihtiyaç olduğu düşünülmektedir.


EXTENDED ABSTRACT


Social Anxiety Disorder (SAD) negatively impacts people’s lives, causing anxiety and avoidance behaviors in public situations, such as speaking, eating, or meeting people (Işık & Taner, 2006). In the literature, cognitive-behavioral therapies are considered effective in treating SAD. Mindfulness-based therapeutic interventions are also effective in treating psychological disorders (such as depression, anxiety, psychosis, substance use) and reducing anxiety symptoms (Ivanovski & Malhi, 2007). In SAD therapy using mindfulness-based interventions (MBI), social anxiety symptoms and avoidance behaviors decrease (Goldin & Gross, 2010; Goldin, Jazaieri, Heimberg, & Gross, 2017; Kocovski, Fleming, Hawley, Huta, & Antony, 2013). In light of the effectiveness of SAD treatment, it is critical to consider MBI in the context of research results of related literature. For this reason, a systematic review examined the current status of mindfulness-based intervention studies in the context of SAD patients.

Method

Four databases, EBSCOHost, PubMed, PsycInfo, and PsycARTICLES, were scanned without any time restrictions. The keywords “social anxiety and mindfulness-based therapy,” “social anxiety and mindfulness-based intervention,” “social phobia and mindfulness-based therapy,” and “social phobia and mindfulness-based intervention” were searched in Turkish and English studies. Of the 114 studies found, 93 were excluded for not meeting the inclusion Method Four databases, EBSCOHost, PubMed, PsycInfo, and PsycARTICLES, were scanned without any time restrictions. The keywords “social anxiety and mindfulness-based therapy,” “social anxiety and mindfulness-based intervention,” “social phobia and mindfulness-based therapy,” and “social phobia and mindfulness-based intervention” were searched in Turkish and English studies. Of the 114 studies found, 93 were excluded for not meeting the inclusion

Results

A total of 1490 samples met the SAD diagnostic criteria of the 21 studies examined. Participants aged between 18 and 71 (M = 32). The study sample sizes varied between 16 and 152 individuals.

This study compared MBI with other treatment methods and control groups in 14 articles. Four studies compared Cognitive Behavioral Group Therapy (CBGT) and MindfulnessBased Stress Reduction (MBSR). Both were equally effective in reducing SAD symptoms. Two studies showed that CBGT is more effective at reducing SAD symptoms than MBSR. Inthetwo studies comparing MBSR and Aerobics Exercises Program (AEP), MBSR and AEP both reduced SAD symptoms, with no significant difference between the two groups in one study. Another comparative study of acceptance-based exposure (ABE) and habituationbased exposure (HAB) intervention programs found ABE to be more effective in reducing public speaking anxiety than HAB. In a study comparing Mindfulness and Acceptance-Based Group Therapy (MAGT) with CBGT, no significant difference was found between them, while another study reported that CBGT was more effective in reducing social anxiety symptoms than MAGT.

Five studies (23.80%) examined the effectiveness of pre-test, post-test, and follow-up studies without comparison groups. The results concluded that SAD symptoms decreased and MBSR and MAGT intervention programs were effective.

Generally, the study results showed that the gains were consistent in the follow-up studies of MBI (with varying time intervals between 6weeks and 12 months). Twelve studies (57.14%) produced follow-up studies. Two (9.52%) of these performed 1-year follow-up studies, and three (14.28%) completed follow-up studies at the third, sixth, ninth, and twelfth-month date after treatment completion. One study performed a 6-week follow-up. Another completed a1-month follow-up. Five studies (23.80%) did a 3-month follow-up study.

Discussion

Our findings show that mindfulness-based intervention methods are a new and effective treatment of SAD and its symptoms, as in other anxiety disorders. Nevertheless, randomized controlled trials and long-term studies are needed. 


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APA

Muhtar, G., & Çakmak Tolan, Ö. (2021). The Effectiveness of Mindfulness Based Interventions in Adults with Social Anxiety Disorder: A Systematic Review. Studies in Psychology, 41(2), 427-458. https://doi.org/10.26650/SP2020-847371


AMA

Muhtar G, Çakmak Tolan Ö. The Effectiveness of Mindfulness Based Interventions in Adults with Social Anxiety Disorder: A Systematic Review. Studies in Psychology. 2021;41(2):427-458. https://doi.org/10.26650/SP2020-847371


ABNT

Muhtar, G.; Çakmak Tolan, Ö. The Effectiveness of Mindfulness Based Interventions in Adults with Social Anxiety Disorder: A Systematic Review. Studies in Psychology, [Publisher Location], v. 41, n. 2, p. 427-458, 2021.


Chicago: Author-Date Style

Muhtar, Gül, and Özlem Çakmak Tolan. 2021. “The Effectiveness of Mindfulness Based Interventions in Adults with Social Anxiety Disorder: A Systematic Review.” Studies in Psychology 41, no. 2: 427-458. https://doi.org/10.26650/SP2020-847371


Chicago: Humanities Style

Muhtar, Gül, and Özlem Çakmak Tolan. The Effectiveness of Mindfulness Based Interventions in Adults with Social Anxiety Disorder: A Systematic Review.” Studies in Psychology 41, no. 2 (Sep. 2021): 427-458. https://doi.org/10.26650/SP2020-847371


Harvard: Australian Style

Muhtar, G & Çakmak Tolan, Ö 2021, 'The Effectiveness of Mindfulness Based Interventions in Adults with Social Anxiety Disorder: A Systematic Review', Studies in Psychology, vol. 41, no. 2, pp. 427-458, viewed 24 Sep. 2021, https://doi.org/10.26650/SP2020-847371


Harvard: Author-Date Style

Muhtar, G. and Çakmak Tolan, Ö. (2021) ‘The Effectiveness of Mindfulness Based Interventions in Adults with Social Anxiety Disorder: A Systematic Review’, Studies in Psychology, 41(2), pp. 427-458. https://doi.org/10.26650/SP2020-847371 (24 Sep. 2021).


MLA

Muhtar, Gül, and Özlem Çakmak Tolan. The Effectiveness of Mindfulness Based Interventions in Adults with Social Anxiety Disorder: A Systematic Review.” Studies in Psychology, vol. 41, no. 2, 2021, pp. 427-458. [Database Container], https://doi.org/10.26650/SP2020-847371


Vancouver

Muhtar G, Çakmak Tolan Ö. The Effectiveness of Mindfulness Based Interventions in Adults with Social Anxiety Disorder: A Systematic Review. Studies in Psychology [Internet]. 24 Sep. 2021 [cited 24 Sep. 2021];41(2):427-458. Available from: https://doi.org/10.26650/SP2020-847371 doi: 10.26650/SP2020-847371


ISNAD

Muhtar, Gül - Çakmak Tolan, Özlem. The Effectiveness of Mindfulness Based Interventions in Adults with Social Anxiety Disorder: A Systematic Review”. Studies in Psychology 41/2 (Sep. 2021): 427-458. https://doi.org/10.26650/SP2020-847371



TIMELINE


Submitted26.11.2020
Accepted01.02.2021
Published Online29.07.2021

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