Mindfulness-Based Cognitive Therapy: A Preliminary Examination of the (Event-Related) Potential for Modifying Threat-Related Attentional Bias in Anxiety

OBJECTIVES: Mindfulness-based cognitive therapy (MBCT) can reduce anxiety and depression symptoms in adults with anxiety disorders, and changes in threat-related attentional bias may be a key mechanism driving the intervention’s effects on anxiety symptoms. Event-related potentials (ERPs) can illuminate the physiological mechanism through which MBCT targets threat bias and reduces symptoms of anxiety. This preliminary study examined whether P1 ERP threat–related attentional bias markers in anxious adults change from pre- to post-MBCT delivered in-person or virtually (via Zoom) and investigated the relationship between P1 threat–related attentional bias markers and treatment response. METHODS: Pre- and post-MBCT, participants with moderate to high levels of anxiety (N = 50) completed a dot-probe task with simultaneous EEG recording. Analyses focused on pre- and post-MBCT P1 amplitudes elicited by angry-neutral and happy-neutral face pair cues, probes, and reaction times in the dot-probe task and anxiety and depression symptoms. RESULTS: Pre- to post-MBCT, there was a significant reduction in P1-Probe amplitudes (d = .23), anxiety (d = .41) and depression (d = .80) symptoms, and reaction times (d = .10). Larger P1-Angry Cue amplitudes, indexing hypervigilance to angry faces, were associated with higher levels of anxiety both pre- and post-MBCT (d = .20). Post-MBCT, anxiety symptoms were lower in the in-person versus virtual group (d = .80). CONCLUSIONS: MBCT may increase processing efficiency and decreases anxiety and depression symptoms in anxious adults. However, changes in threat bias specifically were generally not supported. Replication with a comparison group is needed to clarify whether changes were MBCT-specific. CLINICAL TRIALS REGISTRATION: NCT03571386, June 18, 2018. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s12671-022-01910-x.