open access
메뉴E-ISSN : 2733-4538
The purpose of this study is to investigate the effects of Mindfulness-based Cognitive Therapy (MBCT) with add-on exposure procedure among university students with speech anxiety, as well as to examine how their mindfulness levels and emotion regulation ability changes during the therapy process. Thirteen students with speech anxiety without high depression participated in this research, and they were randomly assigned to either the experimental group (7 students) or the wait-list control group (6 students). The pre-test, post-test, and a follow-up test(a month later) were administered. The results showed that the speech anxiety score was reduced more in the experimental group compared with the control group, and the effect was maintained a month later. The mindfulness levels of the experimental group was enhanced more than that of control group. Observation ability and sub-factor of mindfulness was significantly enhanced in the experimental group. As for emotion regulation ability, the experimental group did not improved more compared to the control group, but post-test score was significantly increased more than the pre-test score in the experimental group only. This result was due to the reduction of impulsive control difficulties and inaccessibility to emotional regulation strategies, the sub-factors of emotion regulation difficulties. The results of analyzing the individual cases of the experimental group showed that all participants improved significantly in their mindfulness levels and emotion regulation ability. Almost all participants showed a significant improvement of mindfulness leves after the 7th or 8th session. An improvement of emotion regulation ability was faster than that of the mindfulness level. That is, three participants improved after the 5th session, but there was remarkable variability. This study has significance in finding the effects of MBCT with an add-on exposure procedure against speech anxiety and in exploring the changes of patterns with respect to the mindfulness level and emotion regulation ability during the therapy process.
Aldao, A., Nolen-Hoeksema, S., & Schweizer, S. (2010). Emotionregulation strategies across psychopathology: A meta-analytic review. Clinical Psychology Review, 30, 217-237.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: American Psychiatric Publishing.
Baer, R. A. (2009). Self-focused attention and mechanisms of change in mindfulness-based treatment. Cognitive Behaviour Therapy, 38, 15-20.
Baer, R. A., Smith, G. T., Hopkins, J., Krietemeyer, J., & Toney, L. (2006). Using self-report assessment methods to explore facets of mindfulness. Assessment, 13, 27-45.
Beck, A. T., Rush, A. J., Shaw, B. F., & Emery, G. (1979). Cognitive therapy of depression. New York: Guilford Press.
Bögels, S. M., & Mansell, W. (2004). Attention processes in the maintenance and treatment of social phobia: Hypervigilance, avoidance and self-focused attention. Clinical Psychology Review, 24, 827-856.
Bögels, S. M., Sijbers, G. F. V. M., & Voncken, M. (2006). Mindfulness and task concentration training for social phobia: A pilot study. Journal of Cognitive Psychotherapy, 20, 33-44.
Brown, K. W., & Ryan, R. M. (2003). The benefits of being present:Mindfulness and its role in psychological well-being. Journal of Personality and Social Psychology, 84, 822.
Carmody, J., & Baer, R. A. (2008). Relationships between mindfulness practice and levels of mindfulness, medical and psychological symptoms and well-being in a mindfulness-based stress reduction program. Journal of Behavioral Medicine, 31, 23-33.
Cho, Y. R. (1999). Tests of mediating effect of maladaptive automatic thoughts in the relationship between dysfunctional beliefs and socially phobic symptoms: Using structural equation modeling, Korean Journal of Clinical Psychology, 18, 17-36.
Cho, Y. R. (2001). The effectiveness of cognitive-behavioral group therapy for speech anxiety. Korean Journal of Clinical Psychology, 20, 399-411.
Cho, Y. R. (2006). Mediational effect of negative automatic thoughts in the relationship between dysfunctional beliefs and anxiety responding to a public speaking situation. Korean Journal of Clinical Psychology, 25, 205-219.
Cho, Y. R. (2007). Assessing emotion dysregulation: Psychometric properties of the korean version of the difficulties in emotion regulation scale. Korean Journal of Clinical Psychology, 26, 1015-1038.
Cho, Y. R., Lee, M. K., & Park, S. H. (1999). A study on the reliability and validity of the korean version of speech anxiety scale. Korean Journal of Clinical Psychology, 18, 165-178.
Cho, Y. R., Noh, S. S., Jo, K. H., & Hong, S. H. (2014). The effect of mindfulness-based intervention on depression and anxiety symptoms: A meta-analysis. Korean Journal of Psychology: General, 33, 903-931.
Cho, Y. R., & Won, H. T. (1997). Cognitive assessment of social anxiety: A study on the reliability and validity of the korean version of social interaction self-statement test. Psychological Issues, 4, 397-434.
Chon, K. K., Choi, S. C., & Yang, B. C. (2001). Integrated adaptation of CES-D in korea. Korean Journal of Health Psychology, 6, 59-76.
Daly, J. A., Vangelisti, A. L., & Lawrence, S. G. (1989). Self-focused attention and public speaking anxiety. Personality and Individual Differences, 10, 903-913.
Davis, D. M., & Hayes, J. A. (2011). What are the benefits of mindfulness? A practice review of psychotherapy-related research. Psychotherapy, 48, 198-208.
Evans, S., Ferrando, S., Findler, M., Stowell, C., Smart, C., & Haglin, D. (2008). Mindfulness-based cognitive therapy for generalized anxiety disorder. Journal of Anxiety Disorders, 22, 716-721.
Fremouw, W. J., & Breitenstein, J. L. (1990). Speech anxiety. In Handbook of social and evaluation anxiety. New York, NY:Springer US.
Germer, C. K., Siegel, R. D., & Fulton, P. R. (2005). Anxiety: Accepting what comes and doing what matters. In L. Roemer., & S. M. Orisillo(Ed.). Mindfulness and psychotherapy (pp. 167-183). NY: Guilford Press.
Gratz, K. L., & Roemer, L. (2004). Multidimensional assessment of emotion regulation and dysregulation: Development, factor structure, and initial validation of the difficulties in emotion regulation scale. Journal of Psychopathology and Behavioral Assessment, 26, 41-54.
Grossman, P., Niemann, L., Schmidt, S., & Walach, H. (2004). Mindfulness-based stress reduction and health benefits: A metaanalysis. Journal of Psychosomatic Research, 57, 35-43.
Hayes, A. F. (2009). Beyond baron and kenny: Statistical mediation analysis in the new millennium. Communication Monographs, 76, 408-420.
Hayes, A. M., & Feldman, G. (2004). Clarifying the construct of mindfulness in the context of emotion regulation and the process of change in therapy. Clinical Psychology: Science and Practice, 11, 255-262.
Heimberg, R. G., & Barlow, D. H. (1991). New developments in cognitive-behavioral therapy for social phobia. Journal of Clinical Psychiatry, 52, 21-30.
Hill, C. L., & Updegraff, J. A. (2012). Mindfulness and its relationship to emotional regulation. Emotion, 12, 81-90.
Hofmann, S. G., & Otto, M. W. (2008). Cognitive behavioral therapy for social anxiety disorder: Evidence-based and disorder-specific treatment techniques. New York, NY: Routledge.
Hofmann, S. G., Sawyer, A. T., Witt, A. A., & Oh, D. (2010). The effect of mindfulness-based therapy on anxiety and depression:A meta-analytic review. Journal of Consulting and Clinical Psychology, 78, 169-183.
Hofmann, S. G., Wu J. Q., & Boettcher, H. (2014). Effect of cognitive-behavioral therapy for anxiety disorders on quality of life: A meta-analysis, Journal of Consulting and Clinical Psychology, 82, 375-391.
Jacobson, N. S., & Truax, P. (1991). Clinical significance: A statistical approach to defining meaningful change in psychotherapy research. Journal of Consulting and Clinical Psychology, 59, 12-19.
Jeon, M. A., & Kim, J. M. (2011). The effects of mindfulness-based cognitive therapy for emotion regulation in a patient group. Korean Journal of Clinical Psychology, 30, 113-135.
Kabat-Zinn, J. (1990). Full catastrophe living: Using the wisdom of your body and mind to face stress, pain, and illness. New York:Delacorte Press.
Kabat-Zinn, J. (2003). Mindfulness‐based interventions in context:Past, present, and future. Clinical Psychology: Science and Practice, 10, 144-156.
Kim, J. C., & Son, C. N. (2010). The effects of the mindfulnessbased cognitive-behavioral group therapy on reduction of speech anxiety. Korean Journal of Stress Research, 18, 59-68.
Kim, Y. W., Lee, S. H., Choi, T. K., Suh, S. Y., Kim, B., Kim, C. M., . . ., & Song, S. K. (2009). Effectiveness of mindfulness‐based cognitive therapy as an adjuvant to pharmacotherapy in patients with panic disorder or generalized anxiety disorder. Depression and Anxiety, 26, 601-606.
Lee, C. H., Cho, Y., R., & Oh, E. H. (2016). The efficacy of mindfulness-based exposure therapy on speech anxiety and baseline depressive symptom severity as a moderator -Compared with cognitive behavioral group therapy-. Korean Journal of Clinical Psychology, 35, 335-363.
Lee, H. J., & Park, H. I. (2015). The effects of mindfulness-based therapy: A meta-analytic study. Korean Journal of Clinical Psychology, 34, 991-1038.
Lim, M. C., & Son, C. N. (2012). Effects of Mindfulness-Based Cognitive Therapy(MBCT) on body image satisfaction, anxiety, and self-esteem in university students with negative body image. Korean Journal of Health Psychology, 17, 823-840.
McKee, L., Zvolensky, M. J., Solomon, S. E., Bernstein, A., & Leen‐ Feldner, E. (2007). Emotional‐vulnerability and mindfulness: A preliminary test of associations among negative affectivity, anxiety sensitivity, and mindfulness skills. Cognitive Behaviour Therapy, 36, 91-101.
Norton, A. R., Abbott, M. J., Norberg, M. M., & Hunt, C. (2015). A systematic review of mindfulness and acceptance‐based treatments for social anxiety disorder. Journal of Clinical Psychology, 71, 283-301
Oh, J. Y., & Son, C. N. (2009). The effects of cognitive-behavioral group therapy on the reduction of public self-consciousness, interpersonal anxiety and fear of negative evaluation with social phobia-prone students. Social Science Research Institute, 33, 285-308.
Park, H. M., & Chae, P. K. (2012). The mediating effects of emotion regulation strategies on the relationship between mindfulness and psychological well-being. Cognitive Behavior Therapy in Korea, 12, 259-274.
Park, K. H., & Ahn, C. Y. (2001). The outcome of cognitive-behavioral group treatment for social phobia. Korean Journal of Clinical Psychology, 20, 1-18.
Paul, G. (1966). Insight versus desensitization in psychotherapy: An experiment in anxiety reduction. Stanford, CA: University Press.
Piet, J., Hougaard, E., Heckster, M. S., & Rosenberg, N. K. (2010). A randomized pilot study of mindfulness-based cognitive therapy and group cognitive-behavioral therapy for young adults with social phobia. Scandinavian Journal of Psychology, 51, 403-410.
Pilkonis, P. A., & Zimbardo, P. G. (1979). The personal and social dynamics of shyness. In emotions in personality and psychopathology. New York, NY: Springer US.
Seekles, W., Cuijpers, P., Kok, R., Beekman, A., van Marwijk, H., & van Straten, A. (2013). Psychological treatment of anxiety in primary care: A meta-analysis. Psychological Medicine, 43, 351-361.
Segal, Z. V., Williams, J. M. G., & Teasdale, J. D. (2006). Mindfulness-based cognitive therapy for depression: A new approach to preventing relapse. (U. K. Lee, S. M. Jo, & T. E. Hwang, Trans.). Seoul: Hakjisa. (Original work published 2002)
Shapiro, S. L., Carlson, L. E., Astin, J. A., & Freedman, B. (2006). Mechanisms of mindfulness. Journal of Clinical Psychology, 62, 373-386.
Shin, J. E. (2009). The effects of cognitive and behavioral group counseling program to relieve college students of public speaking anxiety. Korea Journal of Counseling, 10, 285-297.
Shin, J. S., Lee, B. K., & Lee, H. K. (2014). The effects of acceptance and mindfulness on catastrophizing, depression, and pain in chronic pain patients: The moderating effects of acceptance and mindfulness. Korean Journal of Stress Research, 22, 11-21.
Williams, J. M., Russell, I., & Russell, D. (2008). Mindfulness-based cognitive therapy: Further issues in current evidence and future research. Journal of Consulting and Clinical Psychology, 76, 524-529.
Wolitzky-Taylor, K. B., Arch, J. J., Rosenfield, D., & Craske, M. G. (2012). Moderators and non-specific predictors of treatment outcome for anxiety disorders: A comparison of cognitive behavioral therapy to acceptance and commitment therapy. Journal of Consulting and Clinical Psychology, 80, 786-799.
Won, D. R., & Kim, K. H. (2006). Validation of the korean version of five-factor mindfulness questionnaire. Korean Journal of Health Psychology, 11, 871-886.