1. Introduction Results Methods Discussion
Preliminary Findings From a Pilot Randomized Controlled Trial of Mindfulness and Interoceptive Exposure for Anxiety Sensitivity in Atrial Fibrillation.
1Khan, A. J., 2Gruner, G., 2Zinser, J., 2,3Kolodziej, M., 3,4Epstein, L., & 2,3Oser, M.
1Psychology Department, Suffolk University, Boston, MA, USA , 2Department of Psychiatry, Brigham and Women’s Hospital, Boston, MA, USA, 3Harvard Medical School, Cambridge, MA USA, 4Department of Cardiology, Brigham and Women’s Hospital, Boston, MA USA
Introduction
Results
Atrial Fibrillation (AFib) is the most common arrhythmia (Lloyd-Jones et al., 2009).
Symptoms of AFib overlap with physiological sensations of anxiety and people with AFib can demonstrate elevated anxiety sensitivity (AS) even in the absence of actual Afib symptoms (Bhandari et al., 2002; Hazelton, Sears, & Rodriguez, 2012).
Interoceptive exposure (IE) is effective in treating AS and hypervigilance to physiological sensations (Craske & Barlow, 2007) and mindfulness may serve as an enhancement strategy to facilitating inhibitory learning (Treanor, 2011).
Current study piloted a mindfulness and IE treatment for AS in Afib.
ASI-3
Baseline
M (SD)
Post
Change Pre-Post
95% CI
Significance
Completer
N = 7
32.14 (14.62)
15.43 (10.52)
16.71
5.03, 28.40
p = .01
ITT
N = 8
32.63 (13.61)
18.00 (12.15)
14.63
3.67, 25.58
p = .02
Methods
Note. Post-hoc tests using Bonferroni correction showed reduction in ASI from baseline (M = 32.63, SD = 18.00) to mid-treatment (M = 25.38, SD = 19.29) was not significant.
Sample
N = 8 (50% female, Meanage= 60, SD = (Range = 46-87), 100% Caucasian).
Participants with AFib were recruited from the Cardiology Department within an academic hospital setting
Half of the sample had one ablation in an effort to resolve Afib symptoms.
Procedure
Treatment randomization = 2:1 ratio Mindfulness+IE vs. Care as usual
8 hours of individual therapy across hour sessions.
Anxiety Sensitivity Index (ASI-3; Taylor et al., 2007) completed at baseline, mid-and post-treatment.
Hypothesis
Treatment group will demonstrate significant reductions in AS from pre-to-post.
Analysis
Completer (N = 7) and Intent-to Treat Analyses (ITT; N = 8) were conducted. Only one participant discontinued treatment (12.5% attrition).
Repeated measures ANOVA was performed to determine if ASI differed between time points within the treatment group.
MO comments :
BWH logo has to be larger and more prominent than HMS logo. – DONE
Shorten Intro to be less wordy. Instead of complete sentences, use bullet points to convey main points. -DONE
Input mid treatment ASIs too – can’t do until MO sends mid ITT ASI
Perhaps state that one P discontinued treatment (this is low attrition rate and nice to draw attention to) -- DONE
Consider how you want to speak to control group given we are unable to present results here. -- DONE
Session 1 = Assessment & Treatment Rationale
Session 2 = Mindfulness & IE Rationale & Introductory Mindfulness Exercises
15 minute Phone Coaching
Discussion
Session 3 = Mindfulness & IE
Session 4 =
More advanced Mindfulness & IE
Session 5 = Final Mindfulness & IE, Skill Generalization, Relapse Prevention
First known study to employ mindfulness and IE for AS related to Afib symptoms.
Early findings suggest an 8-hour intervention results in significant reduction in AS, but not after only 4 hours of intervention.
Mindful exposures may increase awareness, defusion, and acceptance of feared sensations through facilitating new learning that competes with prior learned associations (Craske et al., 2014; Treanor, 2011).
Although findings presented were not compared to a control group, preliminary results show promise for efficacy of this brief intervention in a cardiac- specific behavioral medicine setting.
References available upon request.
#allthefeels #exposuretoallthethings