Effects of mindfulness meditation and citalopram on worry and brain activation in patients with Generalized Anxiety Disorder(GAD)

Generalized anxiety disorder (GAD) is a type of anxiety disorder that affects over four million Americans in any year (NIMH, 2000). There is much research that shows anxiety can lead to a magnitude of health ailments, including cardiovascular disease, hypertension, suppressed immune system, and depression (Krisanaprakornkit et al., 2006). For this study, functional magnetic imaging (fMRI) and self-report questionnaires will be used to measure the effects of auditory statements describing a personal worry in patients with GAD before and after anxiety therapy with citalopram - a serotonin reuptake inhibitor (Hoehn-Saric, Schlund, and Wong, 2004) - mindfulness-based meditation, or a combination of the two. Purpose: The purpose of this research proposal is to investigate the efficacy of mindfulness-based stress reduction (MBSR) as a treatment for generalized anxiety disorder and determine how it compares with the effectiveness of anxiolytic therapy (citalopram).

[...] Journal of Clinical Psychiatry 49, 293–301 Hoehn-Saric Schlund MW and Wong SHY (2004) Effects of citalopram on worry and brain activation in patients with generalized anxiety disorder. Psychiatry Research: Neuroimaging 131:11-21 Kabat-Zinn J (1990) Full catastrophe living: using the wisdom of your body and mind to face stress, pain and illness. New York: Delacorte Kabat-Zinn Massion AO, Kristeller Peterson LG, Fletcher KE, Pbert Lenderking WR and Santorelli SF (1992) Effectiveness of a meditation-based stress reduction program in the treatment of anxiety disorders. [...]

[...] Archives of General Psychiatry 50, 884–895 Speca Carlson LE, Goodey Angen M (2000) A randomized, wait-list controlled clinical trial: the effect of a mindfulness meditation-based stress reduction program on mood and symptoms of stress in cancer outpatients. Psychosom Med 62:613–22. Spielberger CD (1983) State-Trait Inventory. Palo Alto, CA: Consulting Psychologists Press Spielberger CD, Gorsuch RL and Lushene RE (1970) Manual for the State-Trait Anxiety Inventory. Consulting Psychologists Press, Palo Alto, CA Tacón AM, McComb Caldera Y and Randolph P (2003) Mindfulness meditation, anxiety reduction, and heart disease. [...]

[...] RESEARCH DESIGN AND METHODS Subjects: Forty participants will be recruited within medical settings (Emory Hospital and Emory Clinic) to participate in a study to explore the effects of a stress reduction and relaxation program for people with diagnosed GAD (Tacón et al., 2003). The criteria for participation in this study includes that the participants must be right-handed females between the age of 18-50 and have a primary diagnosis of GAD, confirmed by the Structured Clinical Interview for DSM-IV (SCID) (First et al., 1997), a State-Trait Inventory (STAI) Trait Form (Spielberger et al., 1970) score above 37, and a low score on the Hamilton Depression Scale (Hedlund and Vieweg, 1979; Hoehn-Saric, Schlund and Wong, 2004) without another comorbid psychiatric condition. [...]