Cognitive processes as mediators of the relation between mindfulness and change in social anxiety symptoms following cognitive behavioral treatment

Abstract

The present study examined whether pretreatment mindfulness exerts an indirect effect on outcomes following cognitive-behavioral therapy (CBT). Cognitive processes of probability and cost bias (i.e., overestimations of the likelihood that negative social events will occur, and that these events will have negative consequences when they do occur) were explored as potential mediators of the relation between mindfulness and social anxiety symptom change. People with higher levels of mindfulness may be better able to benefit from treatments that reduce biases because mindfulness may aid in regulation of attention. Sixty-seven individuals with a primary diagnosis of social phobia identifying public speaking as their greatest fear received eight sessions of one of two types of exposure-based CBT delivered according to treatment manuals. Participants completed self-report measures of mindfulness, probability bias, cost bias, and social anxiety symptoms. Mediation hypotheses were assessed by a bootstrapped regression using treatment outcome data. Pretreatment mindfulness was not related to change in social anxiety symptoms from pre- to posttreatment. However, mindfulness had an indirect effect on treatment outcome via its association with probability bias, but not cost bias, at midtreatment. These findings were consistent across three metrics of social anxiety symptoms. Mindfulness may play a role in response to CBT among individuals with social phobia through its relation with probability bias – even when the treatment does not target mindfulness.

The Role of Emotion and Emotion Regulation in Social Anxiety Disorder

“…Cognitive behavioral conceptualizations of SAD may benefit from integrating constructs aligned with alternative treatments. For example, researchers have begun to examine the role of trait mindfulness in CBT for SAD [75]. One study found that cognitive restructuring and mindfulness strategies together reduced post-event processing, a ruminative and anxiety-maintaining cognitive process common among individuals with SAD, and improved affect [76].…”

Does Mindfulness Enhance Critical Thinking? Evidence for the Mediating Effects of Executive Functioning in the Relationship between Mindfulness and Critical Thinking

“…Dispositional mindfulness has also been found to be negatively correlated with engagement in intuitive thinking ( Remmers et al, 2014 ). In light of recent research suggesting a link between mindfulness, self-regulation, and EF ( Feltman et al, 2009 ; Tang and Posner, 2009 ; Sahdra et al, 2011 ; Moore et al, 2012 ; Lyvers et al, 2013 ; Morgan et al, 2013 ; Ostafin et al, 2013a ) and work suggesting a link between self-regulation, EF, and CT performance ( West et al, 2008 ; Sanz de Acedo Lizarraga et al, 2012 ; Evans and Stanovich, 2013 ; Dwyer et al, 2014 ), the current study sought to investigate whether the relationship between dispositional mindfulness and CT performance is mediated by EF performance.…”

What are They Thinking? Examining Complex Links Among Social Withdrawal, Maladaptive Cognitions, and Internalizing Problems in Children and Emerging Adults

“…Summary scores were generated by averaging the items within each scale, with higher values reflecting greater probability or cost of negative events. Consistent with previous findings (Morgan et al, 2014;Uren et al, 2004;Weeks et al, 2016), high internal consistencies were found for the social subscales of both the OPQ (α = .91) and the OCQ (α = .94).…”