The effectiveness of mindfulness on intolerance of uncertainty and cognitive flexibility in students with social anxiety
Subject Areas : Psychological Models and Methods
زهرا نقش
1
,
reza ali tarkhan
2
,
Sharare Nankali
3
1 - دانشگاه تهران
2 - Assistant Prof. of Curriculum, College of Education and Psychology, Shahed University, Tehran, Iran
3 - MSc Student of Educational Psychology, College Education and Psychology, Tehran University, Kish International Campus, Tehran, Iran
Keywords: mindfulness-based intervention, intolerance of uncertainty, cognitive flexibility ,
Abstract :
Abstract
Background and purpose: Reducing uncertainty intolerance and increasing cognitive flexibility in students with social anxiety improves their performance in academic and social areas and prevents the occurrence of behavioral problems. The aim of this study is to develop a mindfulness-based intervention for students with social anxiety and to investigate the effectiveness of this program on intolerance of uncertainty and increasing cognitive flexibility.
Methods: A quasi-experimental research design with a pre-test-post-test design with a control group was conducted to investigate the effectiveness of mindfulness-based intervention. In order to investigate the effectiveness of the program, 30 students with social anxiety were randomly divided into two groups: experimental and control. Participants in the experimental group received mindfulness-based intervention as a group, and the control group did not receive any intervention. The Freston et al. (1994) scale was used to measure intolerance of uncertainty, and the Dennis and Vanderwaal (2010) scale was used to measure cognitive flexibility. Data were analyzed using SPSS software.
Findings: Compared to the control group, the experimental group showed significant improvement in adaptive emotion regulation, instability/negativity, total attention efficiency, total error, and concentration efficiency.
Conclusion: Considering the findings of the effectiveness of the mindfulness-based intervention, it is recommended to increase flexibility and tolerance of uncertainty in anxious students.
References
1. Stein DJ, Lim CCW, Roest AM, et al. The cross-national epidemiology of social anxiety disorder: Data from the World Mental Health Survey Initiative. BMC Med. 2017;15(1):143. doi:10.1186/s12916-017-0889-2
2. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed, text revision. American Psychiatric Association; 2022.
3. Hofmann SG, Otto MW. Cognitive Behavioral Therapy for Social Anxiety Disorder: Evidence-Based and Disorder-Specific Treatment Techniques. Routledge; 2017.
4. Schneier FR, Rodebaugh TL, Blanco C, Lewin H, Liebowitz MR. Fear and avoidance of eye contact in social anxiety disorder. Compr Psychiatry. 2011;52(1):81-87. doi:10.1016/j.comppsych.2010.04.006
5. Norouzi M, Mikaieli Mani F, Issazadegan A. Epidemiology of Social Anxiety Disorder among Students of Urmia University. J Res Med Sci. 2016;27(2):155-66. Available from: https://sid.ir/paper/63751/fa
6. Kessler RC, Petukhova M, Sampson NA, Zaslavsky AM, Wittchen HU. Twelve-month and lifetime prevalence and lifetime morbid risk of anxiety and mood disorders in the United States. Int J Methods Psychiatr Res. 2012;21(3):169-184. doi:10.1002/mpr.1359
7. Rutschmann R, Romanczuk-Seiferth N, Gloster A, Richter C. Increasing psychological flexibility is associated with positive therapy outcomes following a transdiagnostic ACT treatment. Front Psychiatry. 2024;15:1403718. doi: 10.3389/fpsyt.2024.1403718
8. Cañas J, Quesada JF, Antoli A, Fajardo I. Cognitive flexibility and adaptability to environmental changes in dynamic complex problem-solving tasks. Ergonomics. 2003;46(5):482-501. doi: 10.1080/0014013031000061640
9. Dennis JP, Vander Wal JS. The cognitive flexibility inventory: Instrument development and estimates of reliability and validity. Cogn Ther Res. 2010;34(3):241-253. doi: 10.1007/s10608-009-9287-4
10. Gopnik A, O'Grady S, Lucas CG, Griffiths TL, Wente A, Bridgers S, Aboody R, Fung H, Dahl RE. Changes in cognitive flexibility and hypothesis search across human life history from childhood to adolescence to adulthood. Proc Natl Acad Sci U S A. 2017;114(30):7892-7899. doi: 10.1073/pnas.1700811114
11. Dajani DR, Uddin LQ. Demystifying cognitive flexibility: Implications for clinical and developmental neuroscience. Trends Neurosci. 2015;38(9):571-578. doi: 10.1016/j.tins.2015.07.003
12. Grant JE, Chamberlain SR. Impaired cognitive flexibility across psychiatric disorders. CNS Spectr. 2023;28(6):688-692. doi: 10.1017/S1092852923002237
13. Hayes SC, Luoma JB, Bond FW, Masuda A, Lillis J. Acceptance and commitment therapy: Model, processes and outcomes. Behav Res Ther. 2006;44(1):1-25. doi: 10.1016/j.brat.2005.06.006
14. Hayes SC, Strosahl KD, Wilson KG. Acceptance and Commitment Therapy: The Process and Practice of Mindful Change. 2nd ed. New York: Guilford Press; 2012
15. Hayes SC, Luoma JB, Bond FW, Masuda A, Lillis J. Acceptance and commitment therapy: Model, processes and outcomes. Behav Res Ther. 2006;44(1):1-25. doi:10.1016/j.brat.2005.06.006
16. Figueredo JM, García-Alandete J, Gallego-Largo T. Psychological flexibility and social fixéanxiety: A systematic review and meta-analysis. Clin Psychol Rev. 2024;101:102-15. doi:10.1016/j.cpr.2024.102415
17. Dennis JP, Vander Wal JS. The cognitive flexibility inventory: Instrument development and estimates of reliability and validity. Cognit Ther Res. 2010;34(3):241-53. doi:10.1007/s10608-009-9276-4
18. Strohschein L, Scholte R, Engels R. Cognitive flexibility in adolescence: Neural and behavioral mechanisms. Dev Rev. 2013;33(4):291-310. doi:10.1016/j.dr.2013.07.002
19. Brockmeyer T, Pellegrino J, Münch H, Herzog W, Endrass T. Cognitive flexibility in emotional disorders: A meta-analysis. J Affect Disord. 2014;169:99-107. doi:10.1016/j.jad.2014.08.015
20. Twohig MP, Levin ME. Acceptance and commitment therapy as a treatment for anxiety disorders: A review. Psychiatr Clin North Am. 2017;40(4):729-44. doi:10.1016/j.psc.2017.08.008
15. Buhr K, Dugas MJ. The intolerance of uncertainty scale: psychometric properties of the English version. Behav Res Ther. 2002;40(8):931-945. doi: 10.1016/S0005-7967(01)00092-4
16. Freeston MH, Rhéaume J, Letarte H, Dugas MJ, Ladouceur R. Why do people worry? Pers Individ Dif. 1994;17(6):791-802. doi: 10.1016/0191-8869(94)90048-5
17. Krohne HW. Vigilance and cognitive avoidance as concepts in coping research. In: Krohne HW, editor. Attention and Avoidance: Strategies in Coping with Aversiveness. Seattle: Hogrefe & Huber Publishers; 1989. p. 19-50.
18. Carleton RN. Into the unknown: A review and synthesis of contemporary models involving intolerance of uncertainty. Clin Psychol Rev. 2016;49:45-55. doi: 10.1016/j.cpr.2016.09.007
19. McEvoy PM, Mahoney AEJ. To be sure, to be sure: Intolerance of uncertainty mediates symptoms of various anxiety disorders and depression. Behav Ther. 2013;44(4):533-545. doi: 10.1016/j.beth.2012.06.007
20. Shihata S, McEvoy PM, Mullan BA, Carleton RN. Intolerance of uncertainty in emotional disorders: What uncertainties remain? J Anxiety Disord. 2016;41:115-124. doi: 10.1016/j.janxdis.2016.05.008
21. Boelen PA, Reijntjes A, Carleton RN. Intolerance of uncertainty and social anxiety: A multiple mediation model. J Anxiety Disord. 2014;28(2):216-221. doi: 10.1016/j.janxdis.2013.12.005
22. Hofmann SG, Sawyer AT, Witt AA, Oh D. The effect of mindfulness-based therapy on anxiety and depression: A meta-analytic review. J Consult Clin Psychol. 2010;78(2):169-183. doi: 10.1037/a0018555
23. Barnhofer T, Crane C, Brennan K, et al. Mindfulness-based cognitive therapy (MBCT) reduces the association between depressive symptoms and suicidal cognitions in patients with a history of suicidal depression. J Consult Clin Psychol. 2019;87(12):1035-1044. doi: 10.1037/ccp0000440
24. Heinrich M, Zagorscak P, Eid M, Knaevelsrud C. Mindfulness-based interventions for psychological distress in cancer patients: A meta-analysis. Psychooncology. 2020;29(1):3-12. doi: 10.1002/pon.5281
25. Mathur S, Sharma MP, Balachander S, et al. Mindfulness-based cognitive therapy for depression: A randomized controlled trial in India. Indian J Psychiatry. 2021;63(5):459-467. doi: 10.4103/psychiatry.IndianJPsychiatry_453_20
26. Segal ZV, Anderson AK, Gulamani T, et al. Mindfulness-based cognitive therapy for relapse prevention in mood disorders. Curr Opin Psychiatry. 2019;32(1):21-27. doi: 10.1097/YCO.0000000000000466
27. Shallcross AJ, Willroth EC, Fisher A, et al. Mindfulness-based cognitive therapy improves emotional regulation in recurrent depression: A randomized controlled trial. J Affect Disord. 2022;300:151-159. doi: 10.1016/j.jad.2021.12.058
28. Kuyken W, Warren FC, Taylor RS, et al. Efficacy of mindfulness-based cognitive therapy in prevention of depressive relapse: An individual patient data meta-analysis from randomized trials. JAMA Psychiatry. 2016;73(6):565-574. doi: 10.1001/jamapsychiatry.2016.0076
29. Massa A, Hayes M, O’Connor M, et al. Mindfulness-based cognitive therapy for psychological distress, fear of cancer recurrence, fatigue, and quality of life in patients with breast cancer: A randomized controlled trial. J Psychosoc Oncol. 2021;39(5):616-631. doi: 10.1080/07347332.2021.1891352
30. Connor, K.M., Davidson, J.R., Churchill, L.E., Sherwood, A., Foa, E., & Weisler, R.H. (2000). Psychometric properties of the Social Phobia Inventory (SPIN). Br J Psychiatry, 176 (4), 379-86. https://doi.org/10.1192/bjp.176.4.379
31. Hasanvand Amouzadeh M. Standardization of the Social Anxiety Inventory in a non-clinical Iranian sample. Urmia Med J. 2015;26(1):17-30.
32. Freeston MH, Rhéaume J, Letarte H, Dugas MJ, Ladouceur R. Why do people worry? Pers
Individ Dif. 1994;17(6):791-802.
33. Ebrahimzadeh Z. The study of cognitive beliefs, perfectionism and social problem-solving ability according to uncertainty levels among OCD and MDD [MA dissertation]. Ardabil: Ardabil University; 2006
34. Dennis JP, Vander Wal JS. The Cognitive Flexibility Inventory: Instrument development and estimates of reliability and validity. Cogn Ther Res. 2010;34(3):241-53. doi:10.1007/s10608-009-9276-4.
35. Allah Kai MY, Khoshkonesh A, Asgharnezhad Farid AA. The efficacy of mindfulness training techniques on emotional malaise and social anxiety based on brain-behavioral systems. J Psychol Sci. 2022;21(120):2487-98. doi:10.52547/JPS.21.120.2487
36. Marais GAB, Lantheaume S, Fiault R, Shankland R. Mindfulness-based programs improve psychological flexibility, mental health, well-being, and time management in academics. Eur J Investig Health Psychol Educ. 2020;10(4):1035-50. doi:10.3390/ejihpe10040073
