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Cited by 115Anxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesMindfulness and Compassion InterventionsPsychological Treatments and Assessments

Trajectories of social anxiety, cognitive reappraisal, and mindfulness during an RCT of CBGT versus MBSR for social anxiety disorder

Open access
Goldin, Philippe R., Morrison, Amanda S., Jazaieri, Hooria, Heimberg, Richard G., Gross, James J.·2017·Behaviour Research and Therapy
DOI 10.1016/j.brat.2017.06.001PMC PMC5600696
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Abstract

Cognitive-Behavioral Group Therapy (CBGT) and Mindfulness-Based Stress Reduction (MBSR) are efficacious in treating social anxiety disorder (SAD). It is not yet clear, however, whether they share similar trajectories of change and underlying mechanisms in the context of SAD. This randomized controlled study of 108 unmedicated adults with generalized SAD investigated the impact of CBGT vs. MBSR on trajectories of social anxiety, cognitive reappraisal, and mindfulness during 12 weeks of treatment. CBGT and MBSR produced similar trajectories showing decreases in social anxiety and increases in reappraisal (changing the way of thinking) and mindfulness (mindful attitude). Compared to MBSR, CBGT produced greater increases in disputing anxious thoughts/feelings and reappraisal success. Compared to CBGT, MBSR produced greater acceptance of anxiety and acceptance success. Granger Causality analyses revealed that increases in weekly reappraisal and reappraisal success predicted subsequent decreases in weekly social anxiety during CBGT (but not MBSR), and that increases in weekly mindful attitude and disputing anxious thoughts/feelings predicted subsequent decreases in weekly social anxiety during MBSR (but not CBGT). This examination of temporal dynamics identified shared and distinct changes during CBGT and MBSR that both support and challenge current conceptualizations of these clinical interventions. ClinicalTrials.gov identifier NCT02036658. © 2017 Elsevier Ltd

Integrity signals

Registry

Crossref · 10.1016/j.brat.2017.06.001

Cites

59 of 59 references verified0 citation errors · 0 not checkable

Statistics

20 tests recomputed · 1 with the reported and recomputed p on opposite sides of .05

Claims the paper makes

16 of 35 cited sources checked · 12 supported · 0 flagged · accuracy not yet measured

  • Premisecitation

    A randomized controlled trial of CBGT versus MBSR in patients with SAD found similar improvements in social anxiety symptoms.

    “A recent randomized controlled trial of cognitive-behavioral group therapy (CBGT) versus MBSR in patients with SAD found similar improvements in social anxiety symptoms (Goldin et al., 2016).”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites Goldin et al., 2016 source
  • Premisecitation

    Formal mediation analyses support that changes in specific cognitive and behavioral variables, including cognitive reappraisal frequency and self-efficacy, mediate the impact of CBT for SAD on social anxiety symptoms.

    “Thus, there is evidence that changes in specific cognitive and behavioral variables mediate the impact of CBT for SAD on social anxiety symptoms.”
    Quote in the paperNot a substantial claim1 of 3 sources checked
    • cites Goldin et al., 2016 source
    • cites Kocovski et al., 2015 source
    • cites Goldin et al., 2012b

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Premisecitation

    There is growing evidence that during CBT earlier changes in cognitive processes may impact subsequent decreases in social anxiety symptoms.

    “Thus, there is growing evidence that during CBT earlier changes in cognitive processes may impact subsequent decreases in social anxiety symptoms.”
    Quote in the paperSubstantial claim2 of 3 sources checked
    • cites Kleim et al., 2013 source
    • cites Gallagher et al., 2013 source

      The Discussion (page not supplied) reports that changes in anxiety sensitivity early in CBT predicted subsequent decreases in panic symptoms. This supports the proposed sequence of cognitive change followed by symptom improvement, but the study examined panic disorder, not social anxiety symptoms. (LLM, conf=0.88)

      Experimental — accuracy not yet measured
    • cites Smits et al., 2006 source
  • Premisecitation

    In individual CBT for SAD, weekly increases in reappraisal success predicted subsequent decreases in weekly social anxiety.

    “and weekly increases in reappraisal success that predicted subsequent decreases in weekly social anxiety during individual CBT (Goldin et al., 2014).”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites Goldin et al., 2014 source
  • Premisecitation

    Two prior studies found increases in the ability to implement attention deployment emotion regulation strategies after MBSR for SAD.

    “Two studies have found increases in the ability to implement attention deployment emotion regulation strategies following MBSR for SAD, specifically, for participant-generated negative self-beliefs embedded in autobiographical social anxiety related situations (Goldin & Gross, 2010; Goldin, Ziv, Jazaieri, Hahn, & Gross, 2013a).”
    Quote in the paperSubstantial claim1 of 2 sources checked
    • cites Goldin & Gross, 2010 source

      The Abstract and Discussion (Behavioral Measures) report improved breath-focused attention regulation after MBSR in patients with SAD, but no improvement with distraction-focused attention. The Method (Regulation of Negative Self-Beliefs Task) says the beliefs were experimenter-selected, not participant-generated; the study therefore does not support that specific description of the stimuli. Page numbers are unavailable in our copy. (LLM, conf=0.91)

      Experimental — accuracy not yet measured
    • cites Goldin et al., 2013a

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Classified as probably not a substantial claim. 26
  • May combine two claims. 22
  • The quote only partly states this claim. 2

  • Classified as probably not a substantial claim.

    Premisecitation

    A study of trauma-focused CBT for PTSD found that weekly decreases in dysfunctional trauma-related appraisals predicted subsequent reduction in weekly PTSD symptoms.

    “A recent study of trauma-focused CBT for posttraumatic stress disorder found a unidirectional relationship of weekly decreases in dysfunctional trauma related appraisals predicting subsequent reduction in weekly PTSD symptoms (Kleim et al., 2013).”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites Kleim et al., 2013 source

  • Classified as probably not a substantial claim.

    Premisecitation

    A study of CBT for panic disorder found that antecedent changes in anxiety sensitivity and self-efficacy temporally preceded changes in panic symptoms.

    “A study of CBT for panic disorder found that antecedent changes in anxiety sensitivity and self-efficacy temporally preceded changes in panic symptoms (Gallagher et al., 2013).”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites Gallagher et al., 2013 source

  • May combine two claims.

    Premisecitation

    In patients with SAD, MBSR has been shown to increase mindfulness skills, attention regulation, self-esteem, functioning, and quality of life, and to decrease negative self-views, trait anxiety, negative emotional reactivity, and depression.

    “More specifically, in patients with SAD, MBSR has been shown to increase mindfulness skills, attention regulation, self-esteem, functioning and quality of life, as well as decrease negative self-views, trait anxiety, negative emotional reactivity, and depression (Goldin & Gross, 2010; Goldin, Ramel, & Gross, 2009; Goldin, Ziv, Jazaieri, & Gross, 2012a; Goldin, Ziv, Jazaieri, Hahn, & Gross, 2013b;”
    Quote in the paperNot a substantial claim2 of 3 sources checked
    • cites Goldin & Gross, 2010 source

      The Results (Clinical Results and Behavioral Results; page numbers unavailable) report increased self-esteem, decreased depression and reduced negative emotion during breath-focused attention, but no reduction in negative emotion when simply reacting to negative self-beliefs. The paper also reports earlier SAD studies finding improvements in functioning, quality of life and negative self-view. It does not establish increased mindfulness skills, and its measured reduction was in state anxiety, not trait anxiety. (LLM, conf=0.87)

      Experimental — accuracy not yet measured
    • cites Goldin et al., 2009 source

      Split into 2 atoms — 0 confirmed, 2 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.

      Experimental — accuracy not yet measured
    • cites Koszycki et al., 2007 source

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Mindfulness-based interventions reliably reduce anxiety symptoms across psychiatric and medical populations, with a larger effect in patients with anxiety and mood disorders.

    “A recent meta-analysis of mindfulness-based interventions (Hofmann, Sawyer, Witt, & Oh, 2010) showed that they reliably reduced anxiety symptoms across a variety of psychiatric and medical populations (Hedges's g = 0.63), and more so in patients with anxiety and mood disorders (g = 0.97).”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites Hofmann, Sawyer, Witt, & Oh, 2010 source

  • Classified as probably not a substantial claim. May combine two claims.

    Interpretationreasoning

    If MBSR reliably enhances emotion regulation ability, this may help explain the similar immediate and 1-year social anxiety decreases and maintenance after CBT and MBSR in this SAD sample.

    “If enhancement of emotion regulation ability is a reliable result of MBSR, then this may help explain the similar decrease and maintenance of social anxiety immediately and 1-year post-CBT and post-MBSR in this sample of patients with SAD (Goldin et al., 2016).”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites Goldin et al., 2016 source

  • Classified as probably not a substantial claim.

    Premisecitation

    Mindfulness-to-meaning theory proposes that mindfulness meditation practice facilitates reappraisal of adversity and savoring of positive experience by enhancing interoceptive attention and cognitive flexibility.

    “Garland and colleagues (Garland, Farb, Goldin, & Fredrickson, 2015) recently introduced a mindfulness-to-meaning theory (MMT) that suggests mindfulness meditation practice will facilitate reappraisal of adversity and savoring of positive experience by enhancing interoceptive attention and cognitive flexibility.”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites Garland et al., 2015 source

  • Classified as probably not a substantial claim.

    Premisecitation

    Mindfulness-to-meaning theory predicts that mindfulness meditation training should increase the ability to implement various emotion regulation strategies, including reappraisal, attention deployment, and acceptance.

    “MMT predicts that mindfulness meditation training should increase the ability to implement a variety of emotion regulation strategies, including reappraisal, attention deployment, and acceptance.”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites Garland et al., 2015 source

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Prior studies of SAD patients have observed CBT-related increases in cognitive reappraisal processes.

    “CBT-related increases in cognitive reappraisal processes have been observed in prior studies of patients with SAD (Goldin et al., 2014; Goldin et al., 2012b).”
    Quote in the paperNot a substantial claim1 of 2 sources checked
    • cites Goldin et al., 2014 source
    • cites Goldin et al., 2012b

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Classified as probably not a substantial claim.

    Premisecitation

    Mindfulness-to-meaning theory proposes that increases in emotion regulation are an important consequence of mindfulness training.

    “Such an interpretation is in alignment with mindfulness-to-meaning theory (Garland et al., 2015), which proposes increases in emotion regulation as an important sequela of mindfulness training.”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites Garland et al., 2015 source

  • May combine two claims.

    Findingown data

    Acceptance of anxiety did not increase during CBGT; it decreased by 7%.

    “Acceptance of anxiety increased during MBSR (37% increase), but not during CBT (7% decrease) (Figure 5), with a significant interaction of group by session indicating greater increases in acceptance during MBSR.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    During CBGT, weekly changes in social anxiety predicted subsequent changes in mindful attitude.

    “However, the inverse relationship was significant, F(2,11) = 7.17, p < .05, ΔR2 = .13, unstandardized b = −.56, SE of b = .22, 95% CI [−1.06, −.07], standardized β = −.78, t(11) = 2.55, p = .029.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S1 (asserted), S3 (load-bearing), S4 (based). The quote only partly states this claim.

    Findingown data

    During MBSR, weekly changes in social anxiety predicted subsequent changes in mindful attitude.

    “The inverse relationship was also significant, F(2,11) = 4.41, p < .05, ΔR2 = .09, unstandardized b = −1.01, SE of b = .51, 95% CI [−2.15, .11], standardized β = −.93, t(11) = 2.00, p = .07, suggesting a bi-directional relationship.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    At baseline, the MBSR-related variables were significantly inter-correlated.

    “as were the two MBSR related variables”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Prior decreases in social anxiety predicted later increases in mindful attitude during both CBGT and MBSR, and later increases in acceptance success during MBSR only.

    “We also found that prior decreases in social anxiety predicted subsequent increases in mindful attitude during both CBGT and MBSR, and subsequent increases in acceptance success during MBSR only.”
    Quote in the paperSubstantial claim

  • The quote only partly states this claim.

    Findingown data

    During MBSR, weekly social anxiety predicted subsequent weekly acceptance success.

    “However, the inverse relationship was significant, F(2,11) = 5.40, p > .05, ΔR2 = .12.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationown data

    All three reappraisal indicators improved significantly during both CBGT and MBSR, but CBGT produced greater improvement than MBSR for disputing and reappraisal success.

    “In summary, all three indicators of reappraisal improved significantly during both CBGT and MBSR, but CBGT resulted in greater improvement than MBSR for disputing and reappraisal success.”
    • Also stated in: § The Role of Cognitive Reappraisal in CBGT and MBSR · plain
      “Compared to MBSR, CBGT led to greater increases in the weekly trajectories of disputing and reappraisal success.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Cognitive-behavioral therapy is regarded as the most efficacious and effective psychosocial treatment for social anxiety disorder.

    “Cognitive-behavioral therapy (CBT) is considered the most efficacious and effective psychosocial intervention for SAD (Gordon et al., 2014).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Gordon et al., 2014 source

  • May combine two claims.

    Study design and conductown data

    Based on a criterion of 9 of 12 sessions attended, 33 (92%) of patients completed CBGT and 33 (92%) completed MBSR, with no significant difference in mean sessions attended.

    “Based on a criterion of 9 of 12 sessions attended for treatment completer status, 33 (92%) of patients completed CBGT and 33 (92%) completed MBSR. Mean number of sessions attended for CBGT (Mean ± SD = 10.47 ± 1.56) and MBSR (10.37 ± 2.09) was not significantly different, t(71) = 0.22, p = .82.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    The sequence of groups was determined by a random number generator constrained to 6 instances for each of the three types of group.

    “The sequence of groups was determined by a random number generator constrained to 6 instances for each of the three types of group so that at the end of the study we had 18 groups of 6 patients, with 6 groups each for CBGT, MBSR or WL.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Premisecitation

    A recent review concluded that methodological weaknesses limit confidence in results reported for MBSR in patients with SAD.

    “However, a recent review (Norton, Abbott, Norberg, & Hunt, 2015) concluded that, although mindfulness and acceptance-based treatments may reduce social anxiety symptoms in adults with SAD, methodological weaknesses (e.g., small sample sizes, lack of an active treatment comparisons or control groups) limit the confidence that should be placed in the results reported for MBSR in patients with SAD.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Norton, Abbott, Norberg, & Hunt, 2015 source

  • Classified as probably not a substantial claim.

    Premisecitation

    It remains unclear whether CBT and MBSR produce similar changes across therapeutic processes during treatment.

    “However, it is still not clear whether CBT and MBSR produce similar changes across therapeutic processes during treatment.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Norton et al., 2015 source

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductcitation

    The ADIS-IV has demonstrated excellent inter-rater reliability.

    “The ADIS-IV has demonstrated excellent inter-rater reliability (Brown, Di Nardo, Lehman, & Campbell, 2001).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Brown, Di Nardo, Lehman, & Campbell, 2001 source

  • May combine two claims.

    Interpretationown data

    Granger causality analysis showed that two of three reappraisal indicators during CBGT and one reappraisal indicator during MBSR predicted later social anxiety reduction during treatment.

    “In summary, the Granger Causality analysis showed that 2 of 3 cognitive reappraisal indicators during CBGT and one cognitive reappraisal indicator during MBSR predicted subsequent social anxiety reduction during treatment.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Study design and conductown data

    Treatment adherence was rated in every CBGT and MBSR session, and both CBGT therapists and MBSR instructors were 'in protocol' (rating > 4 of 5) with no between-group differences.

    “Adherence ratings indicated that both CBGT therapists and MBSR instructors were “in protocol” (rating > 4 of 5 for each session) with no between-group differences, t(11) = 0.83, p = .43, in adherence for CBGT (Mean ± SD: 4.92 ± 0.27) versus MBSR (4.81 ± 0.17).”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductreasoning

    The final sample for weekly change intent-to-treat analyses was 106 patients, excluding two who did not provide weekly data.

    “Weekly change intent-to-treat analyses included all patients except two who did not provide weekly data. Thus, the final sample was 106 patients.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisereasoning

    Weekly trajectories of mindfulness and cognitive reappraisal and their relationship to clinical symptoms have not been examined during MBSR and have not been compared to CBT for SAD.

    “Furthermore, weekly trajectories of mindfulness and cognitive reappraisal and their relationship to clinical symptoms have not been examined during MBSR and have not been compared to CBT for SAD.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationown data

    Both CBGT and MBSR increased weekly mindful attitude, but only MBSR increased acceptance and acceptance success.

    “In summary, while both CBGT and MBSR produced increases in weekly mindful attitude, only MBSR produced increases in acceptance and acceptance success.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Study design and conductown data

    There were no between-group differences in pre-to-post-treatment changes in each dependent variable among patients randomized to immediate versus delayed treatment, so data from immediate and delayed treatment arms were combined.

    “Because there were no significant differences, we combined data from the immediate and delayed treatment groups to increase statistical power to detect changes during CBGT (n = 54) versus MBSR (n = 52).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    Many patients do not have access to quality CBT or are hesitant to enter psychotherapy.

    “Furthermore, many patients do not have access to quality CBT or are hesitant to enter psychotherapy (Wolitzky-Taylor et al., 2015).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Wolitzky-Taylor et al., 2015 source

  • May combine two claims.

    Study design and conductown data

    Older age was associated with greater likelihood of missing data for the last three sessions, so age was included as a covariate in all multilevel modeling analyses; no other variables predicted missingness.

    “Older age was associated with greater likelihood of missing data for the last three sessions, b = 0.06, Wald’s Z = 4.62, p = .031, Odds Ratio = 1.06. Therefore, we included age as a covariate in all multilevel modeling analyses. No other variables predicted missingness.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationreasoning

    The lack of differentiation in the meaning of weekly questions may have interfered with accurate responses.

    “This non-differentiation of the meaning of weekly questions may have interfered with accurate responses.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    A prior direct comparison of CBGT and MBSR in SAD found comparable pre-to-post improvement in mood, functioning, and quality of life, and greater improvement for CBGT than MBSR in social anxiety, response rates, and remission rates.

    “The single study that directly compared CBGT (n = 27) to MBSR (n = 26) in patients with SAD (Koszycki et al., 2007) found comparable pre-to-post-treatment improvement in mood, functioning, and quality of life, and, importantly, greater improvement for CBGT vs. MBSR in social anxiety, response rates and remission rates.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Koszycki et al., 2007 source

  • May combine two claims.

    Interpretationown data

    The findings confirm the expected effect of CBGT on cognitive reappraisal and suggest that MBSR may also increase cognitive reappraisal ability and implementation.

    “Thus, our findings confirm the expected impact of CBGT on cognitive reappraisal and suggest that MBSR also may increase cognitive reappraisal ability and implementation.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Interpretationnone given

    Acceptance of experience may be viewed as an emotion regulation strategy that initially incorporates aspects of cognitive reappraisal and later differs more when acceptance is implemented spontaneously rather than volitionally.

    “More broadly, acceptance of experience may be viewed as an emotion regulation strategy that may incorporate aspects of cognitive reappraisal, at least initially, and then may differ more when the individual begins to implement acceptance more spontaneously rather than volitionally.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationreasoning

    The findings both support and contradict the current conceptualization of how MBSR is expected to work.

    “These findings both support and contradict our current conceptualization of how we expect MBSR to work.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationown data

    Granger causality analysis showed that no mindfulness indicator during CBGT and only one mindfulness indicator during MBSR predicted later social anxiety reduction during treatment.

    “In summary, the Granger Causality analysis showed that none of the mindfulness indicators during CBGT and only one mindfulness indicator during MBSR predicted subsequent social anxiety reduction during treatment.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationown data

    Hypothesis 3 was partially supported: two of three reappraisal indicators predicted later social anxiety decreases during CBGT but not MBSR, and one of three mindfulness indicators predicted later social anxiety decreases during MBSR but not CBGT.

    “We found partial support for Hypothesis 3, with prior increases in 2 of 3 weekly reappraisal indicators (reappraisal, reappraisal success) predicting subsequent decreases in social anxiety during CBGT (but not during MBSR), and increases in 1 of 3 weekly mindfulness indicators (mindful attitude) predicting subsequent decreases in social anxiety during MBSR (but not during CBGT).”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationreasoning

    Mindfulness skills such as acceptance and cognitive reappraisal may have a synergistic relationship.

    “This suggests a synergistic relationship between mindfulness skills (e.g., acceptance) and cognitive reappraisal.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Traditional Buddhist models describe mindfulness meditation training as tools for enhancing mental qualities, skills, and attitudes that already exist in humans but need refinement.

    “It is important to note that traditional Buddhist models characterize mindfulness meditation training as a set of tools for enhancing mental qualities, skills and attitudes that already exist in human beings but require enhancement and refinement (Thera, 1998).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Thera, 1998

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Interpretationreasoning

    Implementing mindfulness skills may require less effort than cognitive reappraisal, so even small social anxiety reductions may more easily affect mindfulness skills than reappraisal strategies.

    “Implementation of mindfulness skills may be less effortful than cognitive reappraisal, and thus the access to cognitive resources and executive functioning afforded by even small reductions in social anxiety impact mindfulness skills more easily relative to cognitive reappraisal strategies.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductreasoning

    The meanings assessed by some weekly questions are subtle, and participants may have cultivated and implemented an alternative strategy after 12 weeks of MBSR or CBGT.

    “Furthermore, differences in the meaning of what is being assessed by some of the weekly questions, for example, “try to change the way you were thinking” (cognitive change strategy of reappraisal) versus “adopting a mindful, open, curious, and willing attitude” (observing/noticing/accepting/allowing strategy) are subtle, and there is no guarantee that the participants in our study after 12 weeks”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing).

    Interpretationreasoning

    The low increase in acceptance may be because accepting emotion is difficult and unfamiliar for SAD patients.

    “This may be due to acceptance of emotion being difficult to do and being unfamiliar in patients with SAD.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing).

    Interpretationnone given

    Under the rubric of mindfulness, various practices likely affect different types of mindfulness skills and attitudes.

    “However, under the rubric of mindfulness, there are a variety of practices that likely impact different types of mindfulness skills and attitudes.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    A community cross-sectional study found that acceptance of emotion is used more across situations than any other emotion regulation strategy, including cognitive reappraisal, and negatively predicted psychopathology.

    “A cross-sectional study in a community sample demonstrated that acceptance of emotion is implemented to a greater extent across different situations than any other emotion regulation strategy, including cognitive reappraisal, and negatively predicted psychopathology (Aldao & Nolen-Hoeksema, 2012).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Aldao & Nolen-Hoeksema, 2012 source

  • Classified as probably not a substantial claim.

    Interpretationreasoning

    During CBGT, increases in reappraisal skills and decreases in anxiety may disinhibit latent mindfulness skills and attitudes that had been chronically suppressed in SAD patients.

    “One explanation is that during CBGT reappraisal skills increase, anxiety decreases, and these changes may disinhibit latent mindfulness skills and attitudes that had been chronically suppressed in patients with SAD.”
    Quote in the paperSubstantial claim
45 of 45

  • The paper relies on this without support.

    The weekly single-item self-report ratings validly measure the constructs of social anxiety, cognitive reappraisal, and mindfulness.

    “To investigate weekly changes, we used Qualtrics software to administer a set of questions once a week on the day prior to each group session. The weekly questions assessed indicators of social anxiety, cognitive reappraisal, and mindfulness during CBGT and MBSR.”

  • The paper relies on this without support.

    Before this study, no published work had examined weekly social anxiety trajectories in CBT and MBSR.

    “No prior studies have examined the weekly trajectories of social anxiety in CBT and MBSR.”
2 of 2

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Statistics that don’t add up

Each reported p-value recomputed from its test statistic and degrees of freedom.

  • Inconsistent p-value across alpha = .05: F(2,11) = 5.40, p > .05

    Major

    The paper reports p > .05 here; recomputing from the test statistic and its degrees of freedom gives p = .023. The two fall on opposite sides of alpha = .05. The check cannot tell whether the statistic or the p-value is the misprint.

    Reported p > .05 · recomputed p = .023

  • Inconsistent p-value: F(2,11) = 0.34, p > .75

    Minor

    The paper reports p > .75 here; recomputing from the test statistic and its degrees of freedom gives p = .719. The check cannot tell whether the statistic or the p-value is the misprint.

    Reported p > .75 · recomputed p = .719

  • Inconsistent p-value: t(11) = 2.55, p = .029

    Minor

    The paper reports p = .029 here; recomputing from the test statistic and its degrees of freedom gives p = .027 (two-tailed). The check cannot tell whether the statistic or the p-value is the misprint.

    Reported p = .029 · recomputed p = .027

3 of 3

Statistics recomputed

Every reported test result, recomputed from its test statistic and degrees of freedom. A result shows as not adding up only once an independent check has confirmed it.

  • Doesn’t add upF(2, 11) = 5.4reported p > .05 · recomputed p = .023The two fall on opposite sides of .05

    “F(2,11) = 5.40, p > .05”

  • Doesn’t add upt(11) = 2.55reported p = .029 · recomputed p = .027

    “t(11) = 2.55, p = .029”

  • Doesn’t add upF(2, 11) = 0.34reported p > .75 · recomputed p = .719

    “F(2,11) = 0.34, p > .75”

  • Not confirmedz = 4.62reported p = .031 · recomputed p < .001

    “Z = 4.62, p = .031”

  • Consistentt(11) = 0.83reported p = .43 · recomputed p = .424

    “t(11) = 0.83, p = .43”

  • Consistentt(71) = 0.22reported p = .82 · recomputed p = .827

    “t(71) = 0.22, p = .82”

  • ConsistentF(2, 11) = 0.63reported p > .05 · recomputed p = .551

    “F(2,11) = 0.63, p > .05”

  • ConsistentF(2, 11) = 1.86reported p > .05 · recomputed p = .201

    “F(2,11) = 1.86, p > .05”

  • ConsistentF(2, 11) = 0.93reported p > .05 · recomputed p = .423

    “F(2,11) = 0.93, p > .05”

  • ConsistentF(2, 11) = 0.58reported p > .05 · recomputed p = .576

    “F(2,11) = 0.58, p > .05”

  • ConsistentF(2, 11) = 2.96reported p > .05 · recomputed p = .094

    “F(2,11) = 2.96, p > .05”

  • ConsistentF(2, 11) = 1.22reported p > .05 · recomputed p = .332

    “F(2,11) = 1.22, p > .05”

  • ConsistentF(2, 11) = 0.12reported p > .05 · recomputed p = .888

    “F(2,11) = 0.12, p > .05”

  • ConsistentF(2, 11) = 7.17reported p < .05 · recomputed p = .010

    “F(2,11) = 7.17, p < .05”

  • ConsistentF(2, 11) = 4.41reported p < .05 · recomputed p = .039

    “F(2,11) = 4.41, p < .05”

  • Consistentt(11) = 2reported p = .07 · recomputed p = .071

    “t(11) = 2.00, p = .07”

  • ConsistentF(2, 11) = 1.16reported p > .05 · recomputed p = .349

    “F(2,11) = 1.16, p > .05”

  • ConsistentF(2, 11) = 1.51reported p > .05 · recomputed p = .263

    “F(2,11) = 1.51, p > .05”

  • ConsistentF(2, 11) = 3.34reported p > .05 · recomputed p = .074

    “F(2,11) = 3.34, p > .05”

  • ConsistentF(2, 11) = 2.77reported p > .05 · recomputed p = .106

    “F(2,11) = 2.77, p > .05”

20 of 20

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Acceptance-success result is called significant despite p > .05

    Minor

    The paper uses .05 as its significance criterion, but calls this inverse relationship significant while reporting p > .05.

1 of 1

Cites

Flagged first, then by citations

3 of the 62 references couldn’t be matched to a known paper.

Cited by

Sorted by citations

Related

Authors
Goldin, P. R., Morrison, A. S., Jazaieri, H., Heimberg, R. G., & Gross, J. J.
Affiliations
  • University of California, Davis (US)
  • Stanford University (US)
  • University of California, Berkeley (US)
  • Temple University (US)
Corresponding author
Goldin, Philippe R.
ORCID
Venue
Behaviour Research and Therapy
Publisher
Elsevier BV
Published
2017-10
Volume
97
Pages
1-13
ISSN
0005-7967 (ISSN-L)
DOI
10.1016/j.brat.2017.06.001
PMC
PMC5600696
OpenAlex
W2621240808
Cited by
115
References
62
Citations by year
2026: 6 · 2025: 6 · 2024: 11 · 2023: 4 · 2022: 10 · 2021: 10 · 2020: 58 · 2019: 5 · 2018: 5
FWCI
24.06
Type
journal article
Language
en
Open access
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Behaviour Research and Therapy (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
  • eScholarship (California Digital Library) (submittedVersion)
Funders
NIMH (R01 MH076074)
Topics
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
  • Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
  • Social Sciences › Psychology › Clinical Psychology › Psychological Treatments and Assessments
Keywords
social anxiety disorder, cognitive reappraisal, mindfulness, group cognitive behavioral therapy, mindfulness-based stress reduction, treatment trajectories, Granger causality, therapeutic mechanisms
MeSH terms
Phobia, Social, Adult, Cognition, Female, Humans, Male, Psychotherapy, Group, Cognitive Behavioral Therapy, Treatment Outcome, Young Adult, Mindfulness

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read under definition version 3 (extract-v3) on 2026-09-28.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-09-28.

Cited sources are checked by gpt-6-sol.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

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