The Effectiveness of Mindfulness Based Interventions in Adults with Social Anxiety Disorder: A Systematic Review

Öz

Social Anxiety Disorder (SAD) is a common anxiety disorder causing individuals to feel anxious, nervous, and distressed in public situations requiring performance, such as public speaking. Today, psychotherapies are known to be effective in reducing SAD symptoms. Mindfulness is a significant component of third-wave cognitive therapies, effective in treating mental disorders with psychotherapy. This study examines research articles to evaluate the effectiveness of mindfulness-based interventions (MBI) in SAD. The national literature lacks a review study on this topic. International databases scanned with the keywords “mindfulness-based therapy,” “mindfulness-based intervention,” “social anxiety,” and “social phobia” revealed twenty-one studies that met inclusion criteria. These articles covered mindfulness-based stress reduction programs, acceptance-based treatment, and interventions with adult sampling related to SAD problems. In comparing the methodological and practical features of studies meeting the criteria, we observed that MBI generally reduced SAD symptoms and affected social anxiety-related attitudes and characteristics. Although MBI was more effective than the control group or wait-list group, some studies showed no significant differences compared to other treatment groups. MBI was effective and significantly reduced SAD symptoms in efficacy studies based on the pre-test, post-test, and follow-up data when excluding comparison and control groups. In light of these findings, new studies will need more methodological control and longer follow-up times to increase the reliability and generalizability of MBI in SAD.

Anahtar Kelimeler

• Mindfulness
• social anxiety
• social phobia
• systematic review

Sosyal Anksiyete Bozukluğu Olan Yetişkinlerde Bilinçli Farkındalık Temelli Müdahalelerin Etkililiği: Sistematik Bir Gözden Geçirme

Öz

Sosyal Anksiyete Bozukluğu (SAB) toplumda sık karşılaşılan anksiyete bozukluklarından biridir. SAB olan bireylerin, topluluk önünde konuşma yapma gibi diğerleri tarafından değerlendirilebileceği ve performans sergilemesini gerektirecek durumlarda kaygılanmasına, gergin ve rahatsız hissetmesine neden olmaktadır. Günümüzde psikoterapilerin SAB belirtilerini azaltmada etkili olduğu bilinmektedir. Üçüncü dalga bilişsel terapilerin önemli bir bileşeni olarak bilinçli farkındalığın psikoterapideki kullanımının ruhsal bozuklukların tedavi edilmesinde etkili olduğu görülmektedir. Mevcut sistematik gözden geçirme çalışmasında, SAB’da bilinçli farkındalık (mindfulness) temelli müdahalelerin etkililiğini değerlendirmek için araştırma makalelerinin incelenmesi amaçlanmıştır. Bilinçli farkındalık temelli müdahalelerin etkililiğini değerlendirmek amacıyla öncelikle ulusal alan yazın taranmış ancak bu konuda gerçekleşmiş bir derleme çalışmasına rastlanmamıştır. Bu nedenle, bu doğrultuda “mindfulness based therapy”, “mindfulness based intervention”, “social anxiety” ve “social phobia” anahtar sözcükleriyle uluslararası veritabanları taranmıştır. SAB bakımından sadece farkındalık temelli stres azaltma programı ve kabul temelli tedavi ve müdahaleleri ele alma, yetişkin örneklemiyle gerçekleştirilme gibi dahil etme kriterlerini karşılayan 21 çalışma incelenmiştir. Kriterleri karşılayan 21 çalışmanın yöntemsel ve uygulama özellikleri karşılaştırılarak sunulmuştur. Bu çalışmaların sonuçlarında genel olarak bilinçli farkındalık temelli müdahalelerin SAB belirtilerini azalttığı, sosyal anksiyete ile ilgili tutum ve özellikler üzerinde etkili olduğu görülmektedir. Gözden geçirilen çalışmaların sonuçları kıyaslandığında bilinçli farkındalık temelli müdahalelerin kontrol grubu ya da bekleme listesi grubuna göre daha etkili olduğu, ancak diğer tedavi grupları ile karşılaştırıldığı bazı çalışmalarda anlamlı farklılıklar bulunmadığı görülmüştür. Karşılaştırma ve kontrol grubunun dahil edilmediği ön test, son test ve izlem verilerine dayanan etkililik çalışmalarında FTM’nin etkili olduğu ve SAB belirtilerini anlamlı düzeyde azalttığı gösterilmiştir. Araştırma bulguları ışığında sosyal anksiyete bozukluğunda bilinçli farkındalık temelli uygulamaların güvenirliliğinin ve genellenebilirliğinin artması için yöntemsel olarak daha kontrollü, daha uzun izlem süreli yeni çalışmalara ihtiyaç olduğu düşünülmektedir.

Anahtar Kelimeler

• Bilinçli farkındalık
• sosyal anksiyete
• sosyal fobi
• sistematik gözden geçirme

Kaynakça

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