This study investigates the impact of mindfulness based cognitive therapy (MBCT) on social anxiety in adults with alopecia areata. A single-group case-series design will be adopted.
Alopecia areata (AA) is an immunological disorder which is characterised by round/oval patches of non-scarring hair loss. People living with AA are at higher risk of developing depression, anxiety and social phobia than the general population (Koo et al., 1994; Ruiz-Doblado, Carrizosa, \& García-Hernández, 2003). Interventions that aim to reduce engagement in negative appearance related thoughts, and attentional bias towards negative self-referential information may be helpful for this population. Mindfulness-based cognitive therapy (MBCT) offers one potential method of reducing social anxiety in individuals with AA. MBC is a structured eight-week programme that has been recommended by the National Institute of Clinical Excellence as an effective intervention to reduce the risk of relapse in depression since 2009. The main aim of the current study is to investigate whether an MBCT course can reduce social anxiety in individuals with AA. A single-group case-series design will be adopted, whereby participants will act as their own control; data collected from participants during and after they have received the intervention will be compared to data collected before they have received the intervention. Semi-structured interviews will be carried out at the end of the study to investigate participants experiences of the intervention. The investigators predict that MBCT will reduce social anxiety in individuals with AA. More specifically, the hypothesis are: (i) participants will experience an increase in mindfulness during the intervention period, relative to the baseline phase and this will be maintained at follow-up (ii) increases in mindfulness will be associated with decreases in social anxiety, anxiety and depression, and increases in dermatology quality of life.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
6
Mindfulness based cognitive group therapy (MBCT) is a structured eight-week programme (although an extra introductory week will be added in the current study) that combines mindfulness-based exercises with cognitive therapy.
The University of Sheffield
Sheffield, South Yorkshire, United Kingdom
Royal Hallamshire Hospital (Sheffield Teaching Hospital)
Sheffield, South Yorkshire, United Kingdom
Change in social anxiety (idiosyncratic measure)
The primary outcome measures for the proposed study are idiosyncratic measures of social anxiety which will be assessed daily by text message. Participants will be asked to identify one social anxiety-related positive target (something the participant would like to improve) and one negative target (something the participant would like to reduce). Participants will respond to the daily text messages with a score on a 0-100 scale
Time frame: Daily for 20 weeks (baseline-intervention-follow-up)
Social Anxiety
The Brief Fear of Negative Evaluation straight forward items (BFNE-S: Carleton, Collimore, McCabe, \& Antony, 2011) will be used to assess social anxiety. The measure consists of 8 questions rated on a 5-point Likert scale (from "not at all characteristic of me" to "entirely characteristic of me").
Time frame: Weekly for 21 weeks (baseline-intervention-follow-up)
Mindfulness
The Five Factor Mindfulness Questionnaire-15 (FFMQ-15; Baer, Carmody, \& Hunsinger, 2012) will be used to measure mindfulness. Items are rated on a five-point Likert scale (from "never or very rarely true" to "very often or always true").
Time frame: Weekly for 21 weeks (baseline-intervention-follow-up)
Mindfulness
The Five Factor Mindfulness Questionnaire (FFMQ; Baer, Smith, Hopkins, Krietemeyer \& Toney, 2006) will also be used to measure mindfulness. Items are rated on a five-point Likert scale (from "never or very rarely true" to "very often or always true").
Time frame: 4 time-points. Assessment (beginning of study) beginning of intervention (4 weeks later) end of intervention (9 weeks later) follow-up (8 weeks later)
Depression
The 9-item self-report Patient Health Questionnaire (PHQ-9; Spitzer, Kroenke, \& Williams, 1999) will be used to measure symptoms of depression. Items are rated on a four-point Likert scale (from "not at all" to "nearly every day").
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Time frame: 4 time-points. Assessment (beginning of study) beginning of intervention (4 weeks later) end of intervention (9 weeks later) follow-up (8 weeks later)
Anxiety
The Generalised Anxiety Disorder Questionnaire (GAD-7; Spitzer, Kronke, Williams, \& Lowe, 2006) is a 7 item self-report scale to measure generalized anxiety symptoms. Items are rated on a four-point Likert scale (from "not at all" to "nearly every day").
Time frame: 4 time-points. Assessment (beginning of study) beginning of intervention (4 weeks later) end of intervention (9 weeks later) follow-up (8 weeks later)
Quality of life (dermatology-related)
The Dermatology Quality of Life Index (DLQI: Findlay \& Khan, 1994) consists of 10 questions concerning the impact of the skin condition over the last week. Questions relate to symptoms and feelings, daily activity, leisure, work/school, personal relationships and side effects of treatment. Items are rated on a 4-point Likert scale (from "not at all" to "very much").
Time frame: 4 time-points. Assessment (beginning of study) beginning of intervention (4 weeks later) end of intervention (9 weeks later) follow-up (8 weeks later)
Service use
The Client Service and Receipt Inventory (CSRI; Beecham \& Knapp, 2001) is a 6 question measure of client service utilization. More specifically, the CSRI measures how often participants have met with a healthcare professional, visited A \& E, been an inpatient, used an ambulance, received a diagnostic test, and days spent away from work due to ill health.
Time frame: 3-time points. 4 time-points. Beginning of intervention (4 weeks after assessment) end of intervention (9 weeks later) follow-up (8 weeks later)
Work and social adjustment
The Work and Social Adjustment Scale (WSAS; Mundt \& Marks, 2002) is a 5-item measure of the impact of mental health issues on an individual's social life and ability to work.
Time frame: 3-time points. 4 time-points. Beginning of intervention (4 weeks after assessment) end of intervention (9 weeks later) follow-up (8 weeks later)