2 - (OP31) A 12-week Loving-kindness Meditation Program for Social Anxiety Disorder: A Randomized Controlled Trial

Compassion-based contemplative practices may reduce social threat responding and strengthen adaptive emotion regulation, yet controlled evidence for social anxiety disorder (SAD) remains limited. We conducted a randomized controlled trial evaluating a 12-week loving-kindness meditation (LKM) program versus waitlist among adults meeting SAD criteria. Of 418 applicants, 85 met SAD criteria on the Anxiety Disorders Interview Schedule for DSM-5 (ADIS-5); 80 consented and were randomized (LKM n=40; waitlist n=40). Assessments were completed at pre, post, and 3-month follow-up. Post-treatment completion was 30/40 (75%) for LKM and 35/40 (87.5%) for waitlist; at follow-up, 25 participants per group provided complete data (cumulative dropout: 15 per group). The primary outcome was LSAS-Fear; secondary outcomes were LSAS-Avoidance, total self-compassion (SC), compassion-love, positive/negative affect (PANAS), depression (BDI), and dispositional positive emotions (DPES). Group×Time effects were tested using mixed-design repeated-measures ANOVA (multivariate tests: Pillai’s trace; effect size: partial η²). Intention-to-treat analyses including all randomized participants yielded the same pattern of findings and conclusions.

Significant Group×Time effects favored LKM for social anxiety: LSAS-Fear, Pillai=.272, F(2,47)=8.761, p<.001, ηp²=.272 (LKM 41.16→27.76→25.20; waitlist 40.64→38.84→28.68), and LSAS-Avoidance, Pillai=.251, F(2,47)=7.878, p=.001, ηp²=.251 (30.68→18.84→20.00 vs. 33.56→29.48→20.56). SC increased with a robust interaction, Pillai=.356, F(2,47)=12.975, p<.001, ηp²=.356 (14.48→19.07→19.95 vs. 13.27→13.25→18.30). Depression showed a significant interaction, Pillai=.407, F(2,47)=16.102, p<.001, ηp²=.407 (BDI 15.12→6.68→7.16 vs. 16.88→17.88→7.92). DPES also showed a significant interaction, Pillai=.197, F(2,47)=5.758, p=.006, ηp²=.197 (152.68→178.48→183.20 vs. 143.16→146.04→169.36). Group×Time effects were not significant for PANAS-Positive (p=.771) or PANAS-Negative (p=.104), although time effects were present; compassion-love showed a trend-level interaction (p=.068). Between-group differences generally attenuated by follow-up as the waitlist group improved.

A 12-week LKM program produced meaningful short-term reductions in SAD symptoms and depression and increases in self-compassion and discrete positive emotions relative to waitlist, with robustness to ITT. Convergence by 3-month follow-up highlights the importance of longer follow-up and clear documentation of post-randomization treatment access and subsequent care.