A Pilot Study of Loving-Kindness Meditation for Social Anxiety Disorder
Condition: Social Anxiety Disorder; Compassion
MeSH terms: Anxiety Disorders; Phobia, Social
Study type: Interventional

Summary: 
      The purpose of this study is to develop and test a mindfulness and loving-kindness based
      intervention, Positive Affect Training (PAT), to enhance positive affect such as compassion,
      love, and gratitude and reduce symptoms of social anxiety disorder (SAD). PAT involves a
      combination of practicing mindfulness meditation and loving kindness meditation in groups.
      Although PAT has been shown to be effective for dysthymic disorder, one area that remains
      unclear is whether the PAT protocol for SAD can address the social anxiety symptoms in
      Japanese adults with SAD. The goal of the research is to test the initial feasibility and
      efficacy in increasing positive affect and decreasing negative affect in individuals
      recruited from the general community who are social anxious. If PAT is also effective for
      Japanese SAD patients, it could be more cost-effective and noninvasive option to address
      social anxiety disorder.
    

Detailed description: 
      Mindfulness based stress reduction (MBSR) and mindfulness based cognitive therapy (MBCT),
      which are based on Buddhist tradition, has been shown to be effective for many psychological
      disorders including anxiety disorders. Buddhist tradition, however, has many kinds of
      meditation which would be able to address psychological distress but MBSR and MBCT has not
      focused. Loving kindness meditation (LKM) is one of promising meditation to be effective for
      psychological disorders because it is designed to increase feelings of social connection and
      compassion for one's self and others, whose focus is different from mindfulness meditation.
      Since mindfulness meditation is designed to observe and accept current internal experiences
      as they are while maintaining a primary focus on the breath sensations, it would cultivate
      less compassion than LKM would. Because patients with SAD tend to be self-critical,
      cultivating compassion for self and others with LKM would be more effective to reduce
      symptoms of SAD than MBSR and MBCT. In support of the view that KM increases positive mood
      and a sense of connection and positivity towards others, previous studies with non-clinical
      samples, schizophrenia, dysthymia, and PTSD had decreased the mental illness. The
      intervention protocol that the investigators plan to use was developed by Dr. Kearney and Dr.
      Hofmann. The PAT protocol has been shown to generate positive, and attenuating negative
      affect in patients with PTSD and mood disorder. The investigators aim to test the initial
      efficacy of PAT in individuals with SAD. The investigators hypothesize the intervention would
      show significant improvement in subjects' self-reported ratings of negative and positive
      affect and the brain asymmetry. Dr. Hofmann, a prominent researcher and clinical psychologist
      who is the foremost expert in LKM will serve as a collaborator. Dr. Kaiya, a Japanese CBT
      therapist for anxiety disorders will serve as an outside consultant for the study.
    

Intervention name(s): Positive Affect Training for SAD
Intervention type(s): Behavioral
Intervention description(s): The PAT-S protocol will teach the participants the basics of mindfulness and how to be aware of their physical sensation, thoughts, and emotion at present moment by a nonjudgmental way in breathing, standing, or eating. After two mindfulness sessions, lovingkindness meditation (LKM) will be introduced. The participants will be taught to identify and focus the positive feelings such as gratitude, love, kindness, peacefulness, or friendliness when they wish their benefactor and beloved ones who they feel grateful or respectful, and transfer these feelings first to themselves, then to a neutral individual, to people whom they dislike, and finally to all living beings.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Investigator)
Primary purpose: Treatment