A Randomized Controlled Trial of a 14-Day Mindfulness Ecological Momentary Intervention (MEMI) for Generalized Anxiety Disorder
Open Access
- Author:
- Zainal, Nur Hani
- Graduate Program:
- Psychology
- Degree:
- Doctor of Philosophy
- Document Type:
- Dissertation
- Date of Defense:
- June 12, 2022
- Committee Members:
- Kyle Murdock, Outside Unit & Field Member
Michelle Newman, Chair & Dissertation Advisor
Christopher Cameron, Major Field Member
Peter Arnett, Major Field Member
Kristin Buss (she/her), Program Head/Chair - Keywords:
- generalized anxiety disorder
mindfulness
ecological momentary intervention
executive functioning - Abstract:
- Background: Little is known about whether brief mindfulness ecological momentary interventions (MEMI) yield clinically beneficial effects. This gap exists despite the rapid growth of smartphone mindfulness applications. Specifically, no prior brief MEMI has targeted generalized anxiety disorder (GAD). Moreover, although theories propose that MEMI can boost executive functioning (EF), they have largely gone untested. Thus, this randomized controlled trial (RCT) aimed to address these gaps by assessing the efficacy of a 14-day smartphone MEMI (vs. self-monitoring placebo (SMP)). Method: Participants with GAD were randomly assigned to either condition (68 MEMI, 42 SMP). MEMI participants exercised multiple core mindfulness strategies and were instructed to practice mindfulness continually. Comparatively, SMP participants were prompted to practice self-monitoring and were not taught any mindfulness strategies. All prompts occurred five times a day for 14 consecutive days. All participants completed self-reports and neuropsychological assessments at baseline, post-treatment, and 1-month-follow-up (1MFU). Piecewise multilevel modeling analyses were conducted. Results: MEMI (vs. SMP) led to larger pre-post-treatment reductions in state depression and anxiety and more mindfulness gains (|d| = 0.50 – 1.13). Further, MEMI (vs. SMP) produced greater pre-1-month-follow-up reductions in GAD severity and perseverative thoughts (between-group d = -0.394 – -0.393) and stronger improvements in performance-based inhibition and EF errors (d = -0.363 – -0.280). However, there were no notable treatment effects for working memory and verbal fluency. Overall, results were stronger at pre-1MFU than pre-post-treatment. Discussion: An unguided, technology-assisted, brief MEMI effectively targeted GAD and specific EF facets. Other theoretical and clinical implications were discussed.