Psychology Professor to Lead Study of
Anxiety Disorder Treatment
By Peter Grennen of The University Reporter (September 2007)
People who experience psychological difficulties have reason to keep tabs on the work being done at leading research institutions to improve treatments for these difficulties. A project under way at UMass Boston and Boston University has received financial backing from the National Institute of Mental Health (NIMH) that may well lead to widespread use of a new therapy for generalized anxiety disorder (GAD) that has shown much promise in clinical trials.
A team of investigators led by UMass Boston associate professor of psychology Lizabeth Roemer has been awarded an NIMH grant of $2.4 million for a study that will compare a mindfulness- and acceptance-based behavior therapy for GAD (developed in 2001 by Roemer and her collaborator, Dr. Susan Orsillo) to an older, established treatment. In addition to other objectives, the project will investigate mechanisms of change—how the therapies appear to work; and predictors of outcome—who responds to them, which should lead to better matching of treatments to clients.
GAD, a psychological disorder characterized by chronic and debilitating worry usually focused on possibly negative future events, has been linked to a lower sense of overall wellbeing, reduced life satisfaction, and the onset of clinical depression. Commonly occurring with other psychological disorders, it has been the least successfully treated of the anxiety disorders. “More efficacious treatments are needed,” says Roemer, principal investigator of the study, “and investigations are needed to assess the impact of these treatments on psychosocial impairment.”
Roemer and her colleagues believe that better targeting of the function of worry and the nature of GAD is necessary. “Recent developments in understanding worry and GAD suggest the potential utility of mindfulness and acceptance-based elements in treating GAD,” she says. In the context of this work, mindfulness is understood as “paying attention, on purpose, in the present moment in a nonevaluative and expanded way to both internal and external sensations.” There searchers propose that though mindfulness will not eliminate psychological distress, it may help individuals to respond to their naturally occurring internal experiences more adaptively and to lead richer, more satisfying lives.
That hypothesis appears to be well-supported by the body of work on the subject. Studies have shown that worry plays an “avoidant” role in GAD that may be highly responsive to the practice of mindfulness. “Worry appears to reduce distressing internal experiences in the short term, although it likely prolongs them over time by interfering with emotional processing… and limiting the ability to respond adaptively,” says the study’s coprincipal investigator, Dr. Susan Orsillo of Suffolk University. “If this experiential avoidance is a central problem in GAD, then experiential acceptance, which mindfulness practice promotes, may be the solution.”
Preliminary findings from an open trial have been encouraging, as has a controlled trial that compared the treatment to the effects of normal maturation and other influences. “This novel treatment seems to be targeting the phenomena at which it is directed, with corresponding improvements in symptoms and quality of life,” says Roemer.
Even so, the researchers point out, other questions remain and further development of the treatment is needed. The latest NIMH funding has been earmarked for a specific approach to assessing the effectiveness of this newly developed therapy. “The current grant,” says Roemer, “is for a large-scale follow-up study in which we see whether this treatment is comparable to or more effective than applied relaxation, an empirically supported treatment for GAD”—that is, determine if and how the unique features of mindfulness and acceptance-based behavior therapy make it more effective than the older treatment. The results of that study will be telling, but regardless, individuals with generalized anxiety disorder can now look to the future with more optimism.