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The Efficacy of Mindfulness-based Exposure Therapy on Speech Anxiety and Baseline Depressive Symptom Severity as a Moderator: Compared with Cognitive Behavioral Group Therapy

Abstract

The primary aim of this study was to evaluate the question of whether the efficacy of mindfulness-based exposure therapy (MBET) would be comparable to that of cognitive behavioral group therapy(CBGT). The secondary aim was to examine the role of baseline depressive symptom severity as a moderator in these treatment effects. Sixty participants(male=17) with high speech anxiety were randomly assigned to the MBET(n=20), CBGT(n=22), or wait-list control (WL; n=18) groups. For 3 weeks, participants in the MBET and CBGT groups completed 6 sessions twice a week. According to the results, the MBET group outperformed the WL group, with no significant difference between the MBET and CBGT groups. These effects were still maintained at one-month follow-up. At post-treatment, on the measures of discomfort of negative self-referential thoughts and believability of these thoughts, the MBET group outperformed the CBGT group among those with a high level of baseline depressive symptoms. In contrast, the CBGT group was superior to the MBET group among those with a low level of baseline depressive symptoms. However, this moderating effect was not observed at follow-up, and on the other outcome measures, it was not observed at post-treatment and follow-up. In conclusion, the findings suggest that mindfulness and acceptance-based treatment may be a viable alternative to the traditional CBGT for speech anxiety and that integration of exposure training into MBET for speech anxiety is particularly important. In addition, this is the first study to identify baseline depressive symptom severity as a moderator for the outcomes of CBGT versus MBET for speech anxiety.

keywords
speech anxiety, baseline depressive symptoms, mindfulness, exposure, cognitive behavioral group therapy, negative self- referential thoughts, 발표불안, 기저선 우울증상, 마음챙김, 노출, 인지행동치료, 자기-참조적인 부정적 사고

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