Establishment of a reliable change index for the GAD-7

Bischoff, Thomas; Anderson, Shayne R.; Heafner, Joy; Tambling, Rachel B.

doi:10.5964/pch.v8i1.309

Cited by 48 publications

(26 citation statements)

References 40 publications

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“…At the end of therapy, AB’s anxiety, as measured by the GAD-7, reduced from moderate (12) to within normal thresholds (4). This indicates a reliable change in score, in line with the index devised by Bischoff et al (2020) .…”

Section: Course Of Treatment and Assessment Of Progresssupporting

confidence: 79%

Transitioning Transdiagnostic CBT from Face-to-Face to Telephone Delivery During the Coronavirus Pandemic: A Case Study

Saunders

Allen

2021

Clinical Case Studies

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The coronavirus pandemic led to worldwide disruption in the delivery of face-to-face mental health services. This impact was marked for individuals with long-term health conditions and comorbid depression and anxiety. Many face-to-face mental health services switched to remote delivery or paused therapeutic input entirely, despite the lack of research on the efficacy of switching between modalities mid-therapy or having breaks in therapy. This paper presents the case of a patient with long-term health conditions who experienced both breaks in therapy and a switch in modalities from face-to-face to telephone delivery. The intervention used was based on transdiagnostic cognitive behavioral therapy and self-report measures were completed at the beginning and end of the twelve sessions. Despite the shift in modalities, the patient experienced clinically significant recovery on all measures, indicating the efficacy of therapy was not greatly affected by the shift in modalities. Long breaks in therapy were linked to deterioration in mental health, although this could be due to the deterioration in physical health that necessitated these breaks. This case highlights the benefits and challenges of a shifting modality of therapy during treatment and in response to a pandemic for a shielding population. From the work presented here, it seems beneficial for services to be able to work across multiple modalities to suit the needs of the patients and ensure continuity of treatment. It also indicates that pauses in therapy may risk deterioration. Further work is needed to prevent digital exclusion of patients.

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Section: Course Of Treatment and Assessment Of Progresssupporting

confidence: 79%

Transitioning Transdiagnostic CBT from Face-to-Face to Telephone Delivery During the Coronavirus Pandemic: A Case Study

Saunders

Allen

2021

Clinical Case Studies

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“…This 5.8 point decrease is considered a clinically meaningful improvement (≥ 5 point change on PHQ-9 41,42 ). Likewise, anxiety symptoms also improved from baseline (Mean GAD-7 = 13.5; SD = 3.5) to 3 months (Mean GAD-7 = 7.2; SD = 6.9) among those with follow-up data (n = 11), and the 6.4 point decrease is a meaningful improvement in anxiety symptoms (≥ 5 point change on the GAD-7 47 ).…”

Section: Depressive and Anxiety Symptomsmentioning

confidence: 86%

A pilot feasibility study of an unguided, internet‐delivered cognitive behavioral therapy program for irritable bowel syndrome

Owusu

Sibelli

Moss‐Morris

et al. 2021

Neurogastroenterology Motil

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Background: Irritable bowel syndrome (IBS) is linked with lower health-related quality of life. Cognitive behavioral therapy (CBT) designed for IBS management can improve outcomes but further research of more accessible implementations of this treatment approach for IBS is needed. This study assessed the feasibility of a web-delivered CBT program among adults with IBS to apply to a future clinical trial. Methods: Twenty-five participants were randomized to receive an unguided webbased, CBT program for IBS. The primary outcome was changes in IBS symptom severity (IBS Symptom Severity Scale [IBS-SSS]). Secondary outcomes included IBSspecific CBT therapeutic mechanisms of change (GI-specific anxiety, unhelpful IBS behaviors, and GI-focused cognitions) and changes in depressive (Patient Health Questionnaire-9 [PHQ-9]) and anxiety (Generalized Anxiety Disorder-7 scale [GAD-7]) symptom severity.Key Results: Among participants randomized to receive web-based CBT, the average baseline IBS-SSS score was 296.3 (SD=100.9). IBS symptom severity significantly improved at 2-month (p < 0.001) and 3-month follow-up (p < 0.0001); the withingroup effect size between baseline and 3-month follow-up IBS-SSS scores was large (d = 1.14) and 63.6% experienced a clinically meaningful improvement (ie, ≥50-point IBS-SSS score reduction). GI-specific anxiety symptoms and cognitions significantly improved at 2-month follow-up, as did unhelpful IBS safety behaviors. Additionally, clinically meaningful improvement was observed in depressive and anxiety symptoms at 3-month follow-up among participants with symptoms above the clinical threshold (ie, PHQ-9 ≥ 10 and GAD-7 ≥ 10, respectively) at baseline. Conclusions & Inferences:These preliminary findings warrant a larger trial to investigate an unguided, web-based CBT for IBS symptom management that is powered to detect between-group treatment effects.

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“…Short-term events can have persistent mental health outcomes, and in the case of the enduring pandemic, the pathogenic effects of stress over time will likely take time to reach their full peak before normalizing in the months ahead (McGuire et al, 2018). Further, evidence from other measures of psychological distress, including anxiety (Bischoff et al, 2020), suggest that an optimal time frame for establishing reliable change in scores is approximately 4 weeks, or 30 days (Jacobson & Truax, 1991). Therefore, changes in depression over a 30-day period may be meaningful changes.…”

Section: Discussionmentioning

confidence: 99%

Clinically significant depression among parents during the COVID-19 pandemic: Examining the protective role of family relationships.

Russell

Tambling

Horton

et al. 2021

Couple and Family Psychology: Research and Practice

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Responding to families at heightened risk for mental health burdens during the COVID-19 pandemic is critical-evidence suggests parents face elevated burdens compared to their nonparent counterparts. Building on studies that demonstrate a spillover of stress across domains and individuals within families, this study examines longitudinal predictors of elevated risks for clinical depression among parents based on relational family indicators, COVID-specific stressors, and stress and emotion regulation indicators. Baseline data were collected from parents (n = 176; average age 37.04, 50% female) on April 27-28, 2020, 5 weeks after the first U.S. quarantines began. Follow-up data were collected 30 days later. Results indicated concerning levels of parents' mental health symptoms over this short time span, including elevated stressors and exacerbated mental health symptoms for approximately one-quarter of parents. Given the need for agile service responses for those at the greatest risk, this article examines predictions of clinically significant depression through binary logistic regression. These individuals were more likely to report greater anxiety and stress symptoms, as well as report less closeness in their parent-child relationships; couple satisfaction was not a significant predictor of depression. Implications include recommended agile responses to alleviate distress and expand access to mental health supports, particularly in light of pervasive shelter-in place orders that limit access to previously established coping supports and sources of social connection (e.g., schools or community centers), that are anticipated to recur in the months ahead.

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Establishment of a reliable change index for the GAD-7

Cited by 48 publications

References 40 publications

Transitioning Transdiagnostic CBT from Face-to-Face to Telephone Delivery During the Coronavirus Pandemic: A Case Study

Transitioning Transdiagnostic CBT from Face-to-Face to Telephone Delivery During the Coronavirus Pandemic: A Case Study

A pilot feasibility study of an unguided, internet‐delivered cognitive behavioral therapy program for irritable bowel syndrome

Clinically significant depression among parents during the COVID-19 pandemic: Examining the protective role of family relationships.

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