MBCT improves working memory and sustained attention in generalized anxiety disorder: A randomized controlled trial

Mindfulness-based cognitive therapy (MBCT) is a promising intervention for generalized anxiety disorder (GAD). Although GAD is associated with cognitive impairments, it remains unclear whether MBCT benefits cognitive functioning in clinical practice. This study examined outcomes of MBCT among adults with GAD in a routine clinical setting.

In this assessor blinded randomized trial, 140 adults with GAD received 8 weeks of group-based MBCT or structured psychoeducation alongside stable pharmacological treatment. Anxiety, mindfulness, working memory, sustained attention, and inhibitory control were assessed at baseline and post-intervention. Linear mixed models tested intervention effects, and within-group regression analyses examined factors associated with cognitive improvement.

GAD patients receiving MBCT showed greater reductions in clinician-rated and self-reported anxiety and greater improvements in mindfulness, sustained attention, and working memory than those receiving psychoeducation. No between group difference in change was found for inhibitory control. Within the MBCT group, lower baseline cognitive performance predicted greater gains. Reduced self-reported anxiety was associated with working memory and subsequent sustained attention gains.

These findings support the effectiveness of MBCT in reducing anxiety symptoms and increasing mindfulness in adults with GAD. MBCT also improved sustained attention and working memory without significantly affecting inhibitory control. Cognitive gains varied with baseline performance, self-reported anxiety reduction, and improvement in related cognitive domains. Trial registration Chinese Clinical Trial Registry, ChiCTR2400090284.