Efficacy of a cognitive–behavioral treatment for generalized anxiety disorder: Evaluation in a controlled clinical trial.

Abstract

Recent advances in the understanding of worry have led to the development of treatments for generalized anxiety disorder (GAD). The present study tested a GAD treatment that targeted intolerance of uncertainty, erroneous beliefs about worry, poor problem orientation, and cognitive avoidance. Twenty-six primary GAD patients were randomly allocated to a treatment condition (n = 14) or a delayed treatment control condition (n = 12). Self-report, clinician, and significant other ratings assessed GAD and associated symptoms. The results show that the treatment led to statistically and clinically significant change at posttest and that gains were maintained at 6- and 12-month follow-ups. Furthermore, 20 of 26 participants (77%) no longer met GAD diagnostic criteria following treatment. With regard to the treatment's underlying model, the results show that intolerance of uncertainty significantly decreased over treatment and that gains were maintained at both follow-ups. Although nonspecific factors were not significant predictors of treatment outcome, their role in the treatment of GAD requires further investigation.

World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for the Pharmacological Treatment of Anxiety, Obsessive-Compulsive and Post-Traumatic Stress Disorders – First Revision

“…A number of studies showed superiority of CBT to a waiting list group (Barlow et al 1992;Butler et al 1991;Dugas et al 2003;Ladouceur et al 2000;Lindsay et al 1987;Mohlman et al 2003). Moreover, comparisons with a ''psychological placebo'', a pill placebo or comparable control group conditions showed that CBT has not only unspecific psychotherapy effects, but also specific ingredients (Borkovec et al 1987;Borkovec and Costello 1993;Linden et al 2005;Power et al 1990;Stanley et al 2003).…”

Age-Related Differences in Worry and Related Processes

“…However, it is impossible to avoid uncertainty or ambiguity in life, which means that individuals who are severely intolerant of uncertainty would be constantly faced with situations that they experience as anxiety provoking. Intolerance of uncertainty has been viewed as a central process in conceptualizations of pathological worrying and is also an important target for clinical intervention in the treatment of Generalized Anxiety Disorder Ladouceur et al, 2000), characterized by excessive and uncontrollable worry and anxiety (American Psychiatric Association, 1994).…”

Penn State Worry Questionnaire: structure and psychometric properties of the Chinese version

“…Since 1990, the PSWQ has been widely used as a self-report measure of worry and GAD. The PSWQ has also been used in most treatment outcome studies of GAD Borkovec and Costello, 1993;Ladouceur et al, 2000), laboratory investigations (Butler et al, 1995), and GAD psychopathology studies (Beck et al, 1996).…”