Baker Amanda W, Frumkin Madelyn R, Hoeppner Susanne S, LeBlanc Nicole J, Bui Eric, Hofmann Stefan G, Simon Naomi M
Department of Psychiatry, Massachusetts General Hospital, Boston, MA.
Harvard Medical School, Boston, MA.
Mindfulness (N Y). 2019 May;10(5):903-912. doi: 10.1007/s12671-018-1059-0. Epub 2018 Nov 7.
Anxiety and depressive symptoms are associated with lower levels of mindfulness, yet few studies to date have examined facets of mindfulness in adults with Generalized Anxiety Disorder (GAD). In this study, we examined differences in mindfulness between individuals with GAD with and without concurrent Major Depressive Disorder (MDD) and/or Dysthymic Disorder (DD). We also examined the associations of anxiety and depressive symptoms with facets (subscales) of mindfulness. We hypothesized that individuals with primary GAD and co-occurring MDD/DD would exhibit lower mindfulness than those without a concurrent depressive disorder. We also hypothesized that mindfulness would be negatively correlated with worry and depressive symptom severity. Subjects were 140 adults (M (SD) age = 33.4 (12.9); 73% female) with a primary diagnosis of GAD; 30.8% (n = 43) also met criteria for current MDD/DD as determined by a structured clinical interview for DSM-IV. Current worry and depressive symptoms were assessed using self-report measures at baseline of a 12-week treatment study. Individuals with GAD and co-occurring MDD/DD exhibited significantly lower mindfulness than those without a depressive disorder diagnosis and specifically lower scores on the Awareness sub-scale compared to individuals with primary GAD and no comorbid depression. In terms of the dimensional impact of worry and depression ratings, depression symptoms independently predicted lower Awareness scores and worry independently predicted lower levels of Nonreacting and Nonjudging sub-scales. This may have direct treatment implications.
焦虑和抑郁症状与较低水平的正念相关，但迄今为止，很少有研究探讨广泛性焦虑症（GAD）成年患者的正念方面。在本研究中，我们考察了患有和未患有共病重度抑郁症（MDD）和/或恶劣心境障碍（DD）的GAD患者在正念方面的差异。我们还考察了焦虑和抑郁症状与正念各方面（分量表）之间的关联。我们假设，原发性GAD且伴有MDD/DD的个体比没有共病抑郁症的个体表现出更低的正念水平。我们还假设，正念与担忧及抑郁症状严重程度呈负相关。研究对象为140名成年患者（M（标准差）年龄 = 33.4（12.9）；73%为女性），他们被初步诊断为GAD；根据《精神疾病诊断与统计手册》第四版（DSM-IV）的结构化临床访谈确定，30.8%（n = 43）的患者还符合当前MDD/DD的标准。在一项为期12周的治疗研究的基线期，使用自我报告测量方法评估当前的担忧和抑郁症状。患有GAD且伴有MDD/DD的个体比没有抑郁症诊断的个体表现出显著更低的正念水平，与原发性GAD且无共病抑郁症的个体相比，在“觉察”分量表上的得分尤其低。就担忧和抑郁评分的维度影响而言，抑郁症状独立预测更低的“觉察”得分，担忧独立预测更低水平的“不反应”和“不评判”分量表得分。这可能具有直接的治疗意义。
