Generalized anxiety disorder: A comparison of symptom change in adults receiving cognitive-behavioral therapy or applied relaxation.

Donegan, Eleanor; Dugas, Michel J.

doi:10.1037/a0028132

Cited by 41 publications

(35 citation statements)

References 20 publications

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“…The finding that improvement in RNT was strongly linked with subsequent decreases in depression and anxiety builds on previous work indicating that changes in rumination and/or worry (pre-to mid-treatment) are associated with later changes in symptoms (e.g., Donegan & Dugas, 2012;Van Aalderen et al, 2012). The design of the current study provides even stronger evidence than earlier work for the role of RNT in symptom improvement, as we were able to establish the temporal precedence of RNT relative to changes in depression and anxiety and also controlling for potentially confounding influences.…”

Section: Discussionsupporting

confidence: 64%

“…Two studies of mindfulness-based treatment for depression also found that decreased levels of worry and rumination (change scores) mediated the effect of treatment on depression outcome (Van Aalderen et al, 2012). Similarly, changes in worry (measured daily) have been shown to partially mediate the effect of time on decreased anxiety in CBT and applied relaxation for GAD (Donegan & Dugas, 2012).…”

mentioning

confidence: 95%

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Repetitive negative thinking predicts depression and anxiety symptom improvement during brief cognitive behavioral therapy

Kertz

Koran

Stevens

et al. 2015

Behaviour Research and Therapy

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Section: Discussionsupporting

confidence: 64%

mentioning

confidence: 95%

Repetitive negative thinking predicts depression and anxiety symptom improvement during brief cognitive behavioral therapy

Kertz

Koran

Stevens

et al. 2015

Behaviour Research and Therapy

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“…We subsequently tested a reverse mediation model, where changes in worry predicted changes in IU over time. Repeated assessments allowed us to include the mediator as a “lagged“ variable with temporal precedence; that is, we examined whether changes in the mediator at time point t influenced the outcome variable at time point t + 1 (see for example Aderka, Foa, Applebaum, Shafran, & Gilboa-Schechtman, 2011; Donegan & Dugas, 2012). For each model we also indexed the significance of potential mediated effects using the Prodclin program (MacKinnon et al, 2007), which provides confidence intervals for the indirect effect, and calculated the percent mediation for each model using the procedures described by Kenny and colleagues (2003).…”

Section: Methodsmentioning

confidence: 99%

Intolerance of uncertainty as a mediator of reductions in worry in a cognitive behavioral treatment program for generalized anxiety disorder

Bomyea

Ramsawh

Ball³

et al. 2015

Journal of Anxiety Disorders

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Growing evidence suggests that intolerance of uncertainty (IU) is a cognitive vulnerability that is a central feature across diverse anxiety disorders, including generalized anxiety disorder (GAD). Although cognitive behavioral therapy (CBT) has been shown to reduce IU, it remains to be established whether or not reductions in IU mediate reductions in worry. This study examined the process of change in IU and worry in a sample of 28 individuals with GAD who completed CBT. Changes in IU and worry, assessed bi-weekly during treatment, were analyzed using multilevel mediation models. Results revealed that change in IU mediated change in worry (ab = -0.20; 95% CI [-.35, -.09]), but change in worry did not mediate change in IU (ab = -0.16; 95% CI [-.06, .12]). Findings indicated that reductions in IU accounted for 59% of the reductions in worry observed over the course of treatment, suggesting that changes in IU are not simply concomitants of changes in worry. Findings support the idea that IU is a critical construct underlying GAD.

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“…More precisely, a number of studies have investigated the potential for internet-delivered treatments for GAD and they have reported significant post-treatment and follow-up gains [33,48-51] similar to those found in face-to-face treatment studies [52]. A recent meta-analysis of internet-delivered treatments for GAD demonstrated large post-treatment effects for GAD symptoms ( d = 0.91) and pathological worry ( d = 0.73) in favor of the active interventions when compared to waiting list control groups [53].…”

Section: Introductionmentioning

confidence: 94%

Low-intensity internet-delivered treatment for generalized anxiety symptoms in routine care: protocol for a randomized controlled trial

Richards

Timulák

Doherty

et al. 2014

Trials

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BackgroundWorldwide prevalence of generalized anxiety disorder (GAD) is considered high; in Europe lifetime prevalence has been estimated at 4.3 to 5.9%. High levels of anxiety disorders have been reported in university students, affecting 25 to 30% of the population. Young adults are some of the most vulnerable for the onset of mental health disorders and any stressors may act as a catalyst for their onset. The absence of resources can often mean that many do not seek treatment. Other factors that impede access to resources include such things as a lack of trained professionals, personal stigma, and waiting lists. Anxiety disorders can be treated successfully; indeed brief forms of cognitive-behavior therapy have been recommended. One potential avenue for research and development is that of delivering low-intensity interventions online for students with GAD. Therefore, the current study seeks to investigate the potential effectiveness for a low-intensity online CBT-based treatment for GAD in a service-based setting; implemented as one step in a stepped-care model.Methods/DesignThe research is a service-based effectiveness study utilizing a randomized waiting-list controlled design. The active intervention consists of six weekly modules of online CBT. Participants are assigned a supporter who provides weekly post-session feedback on progress and exercises. Participants will complete the GAD-7 as the primary outcome measure. Secondary outcomes include pathological worry, depression and measures of well-being. At three-months follow-up data will be collected using the GAD-7, BDI-II, PSWQ, ED-Q5 and WSAS. Post-session data will be collected on significant in-session events in treatment (HAT). A satisfaction with treatment measure will be administered post-treatment (SAT).DiscussionThe study will be a contribution to the potential for a low-intensity internet-delivered program implemented in a service-based setting; implemented as one step in a stepped-care model. The study will be a contribution to the already established work in online treatments for anxiety worldwide. The study will assess the utility of an innovative digital health solution (SilverCloud) to deliver such interventions.Trial registrationCurrent Controlled Trials ISRCTN16303842.

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Generalized anxiety disorder: A comparison of symptom change in adults receiving cognitive-behavioral therapy or applied relaxation.

Cited by 41 publications

References 20 publications

Repetitive negative thinking predicts depression and anxiety symptom improvement during brief cognitive behavioral therapy

Repetitive negative thinking predicts depression and anxiety symptom improvement during brief cognitive behavioral therapy

Intolerance of uncertainty as a mediator of reductions in worry in a cognitive behavioral treatment program for generalized anxiety disorder

Low-intensity internet-delivered treatment for generalized anxiety symptoms in routine care: protocol for a randomized controlled trial

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