Mindfulness-Based Cognitive Therapy: A Preliminary Examination of the (Event-Related) Potential for Modifying Threat-Related Attentional Bias in Anxiety

Resh S Gupta, Autumn Kujawa, David M Fresco, Hakmook Kang, David R Vago, Resh S Gupta, Autumn Kujawa, David M Fresco, Hakmook Kang, David R Vago

Abstract

Objectives: Mindfulness-based cognitive therapy (MBCT) can reduce anxiety and depression symptoms in adults with anxiety disorders, and changes in threat-related attentional bias may be a key mechanism driving the intervention's effects on anxiety symptoms. Event-related potentials (ERPs) can illuminate the physiological mechanism through which MBCT targets threat bias and reduces symptoms of anxiety. This preliminary study examined whether P1 ERP threat-related attentional bias markers in anxious adults change from pre- to post-MBCT delivered in-person or virtually (via Zoom) and investigated the relationship between P1 threat-related attentional bias markers and treatment response.

Methods: Pre- and post-MBCT, participants with moderate to high levels of anxiety (N = 50) completed a dot-probe task with simultaneous EEG recording. Analyses focused on pre- and post-MBCT P1 amplitudes elicited by angry-neutral and happy-neutral face pair cues, probes, and reaction times in the dot-probe task and anxiety and depression symptoms.

Results: Pre- to post-MBCT, there was a significant reduction in P1-Probe amplitudes (d = .23), anxiety (d = .41) and depression (d = .80) symptoms, and reaction times (d = .10). Larger P1-Angry Cue amplitudes, indexing hypervigilance to angry faces, were associated with higher levels of anxiety both pre- and post-MBCT (d = .20). Post-MBCT, anxiety symptoms were lower in the in-person versus virtual group (d = .80).

Conclusions: MBCT may increase processing efficiency and decreases anxiety and depression symptoms in anxious adults. However, changes in threat bias specifically were generally not supported. Replication with a comparison group is needed to clarify whether changes were MBCT-specific.

Clinical trials registration: NCT03571386, June 18, 2018.

Supplementary information: The online version contains supplementary material available at 10.1007/s12671-022-01910-x.

Keywords: Anxiety; Depression; Event-related potentials; Mindfulness-based cognitive therapy; Threat-related attentional bias.

Conflict of interest statement

Conflict of InterestDr. David Vago is the research lead at RoundGlass.

© The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2022.

Figures

Fig. 1
Fig. 1
Schematic of the dot-probe task
Fig. 2
Fig. 2
P1-Cue ERPs and scalp distributions for the full sample (N = 50). Left: Pre- and post-MBCT grand average ERP waveforms time-locked to the presentation of angry and happy face pair cues at electrode P8 (indicated with black circles on scalp distribution figures). Right: Mean P1 amplitudes as a function of time and emotion (error bars represent standard error of the mean) and scalp distribution figures for each condition at the approximate peak time point (92 ms)
Fig. 3
Fig. 3
P1-Probe ERPs and scalp distributions for the full sample (N = 50). Left: Pre- and post-MBCT grand average ERP waveforms time-locked to the onset of angry congruent and angry incongruent probes (top) and happy congruent and happy incongruent probes (bottom) at electrode P8 (indicated with black circles on scalp distribution figures). Right: Mean P1-Probe amplitudes as a function of time, emotion, and congruency (error bars represent standard error of the mean) and scalp distribution figures for each condition at the approximate peak time point (132 ms)
Fig. 4
Fig. 4
Mean reaction times to probes as a function of time, emotion, and congruency in the full sample (N = 50). Error bars represent standard error of the mean

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