The Effects of Mindfulness and Acceptance-Based Interventions and Cognitive-Behavioral Interventions on Positive and Negative Affect: A Meta-Analysis
Research suggests a high degree of comorbidity among Axis I disorders. A partial explanation for comorbidity is that there are commonalities among mental disorders. Research on a transdiagnostic model of emotional disorders has identified the constructs of negative affect (NA) and positive affect (PA) as higher-order, temperamental factors related to mental illness. While meta-analytic studies have demonstrated that mindfulness-based and traditional CBT interventions improve mental health, little attention has been devoted to higher-order factors. The present study used meta-analytic techniques to address four unanswered questions. First, do traditional CBT interventions and mindfulness/acceptance-based interventions produce changes in the temperamental factors of NA and PA? Second, if so, do these therapies produce different degrees of change in NA vs. PA? Third, do changes vary if an intervention is modeled on traditional CBT or acceptance-based components? Finally, do aspects of the intervention, clients, or study moderate effects? Included studies contained a mindfulness/acceptance-based or traditional CBT intervention with an adult sample. Studies were located for both a broader within-groups analysis of pre-post studies and a narrower between-groups analysis of randomized controlled trials. Keyword searches were performed in PsycINFO, Google Scholar, PubMed, and The Cochrane Library through April 2013 for articles using the PANAS (Watson et al., 1988) or the PANAS-X (Watson & Clark, 1999). The search yielded 4,377 abstracts for review and 366 articles for full-text review. There were 56 studies included for within-groups analysis and 24 studies for between-groups analysis. Results indicated that time-limited mindfulness and CBT interventions are each associated with improvements in longstanding higher-order variables, with small-to-medium effect sizes. Analyses identified no differences between the amount of change in NA vs. PA or for mindfulness interventions vs. CBT interventions. Results provided some evidence of greater improvement in CBT for longer interventions, individual interventions, and interventions including an exposure component. Overall, results suggest that targeted interventions promote improvement in higher-order factors, and that the effects of mindfulness and CBT interventions on temperament are more similar than they are different.
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