Treatment of generalized anxiety in older adults: A preliminary comparison of cognitive-behavioral and supportive approaches

Stanley, Melinda A.; Beck, J. Gayle; Glassco, Jill DeWitt

doi:10.1016/s0005-7894(96)80044-x

Cited by 170 publications

(183 citation statements)

References 35 publications

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“…In concordance with most other treatment studies in late-life anxiety, 9,10,12 effect sizes for CBT were substantially lower and attrition rates for both CBT and sertraline were considerably higher than those found in comparable treatment studies in mixed-age populations (mean attrition rate approximately 10%). 31 These findings imply that it is important that we find ways to increase treatment adherence in anxious older adults.…”

Section: Implications Of Our Findingssupporting

confidence: 85%

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A Randomized, Controlled Trial of the Effectiveness of Cognitive–Behavioral Therapy and Sertraline versus a Waitlist Control Group for Anxiety Disorders in Older Adults

Schuurmans

Comijs

Emmelkamp

et al. 2006

The American Journal of Geriatric Psychiatry

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Section: Implications Of Our Findingssupporting

confidence: 85%

“…Although treatment response rates were higher in the Barrowclough study (71% at 12-month follow up), effect sizes were also in the small to medium range at 0.34. Also, participants in other treatment studies 9,10,12 were mostly well educated, whereas in our study, 45% of CBT participants had only finished primary school.…”

Section: Implications Of Our Findingscontrasting

confidence: 65%

A Randomized, Controlled Trial of the Effectiveness of Cognitive–Behavioral Therapy and Sertraline versus a Waitlist Control Group for Anxiety Disorders in Older Adults

Schuurmans

Comijs

Emmelkamp

et al. 2006

The American Journal of Geriatric Psychiatry

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“…18,[36][37][38][39][56][57][58][59][60][61][62][63][64] The total sample for the meta-analysis was N = 985 with an average age of 68.16 years (SD = 2.52).…”

Section: Study Selectionmentioning

confidence: 99%

Efficacy of Cognitive Behavioral Therapy for Generalized Anxiety Disorder in Older Adults: Systematic Review, Meta-Analysis, and Meta-Regression

Hall

Kellett

Berrios

et al. 2016

The American Journal of Geriatric Psychiatry

122

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Article available under the terms of the CC-BY-NC-ND licence (https://creativecommons.org/licenses/by-nc-nd/4.0/) eprints@whiterose.ac.uk https://eprints.whiterose.ac.uk/ Reuse This article is distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs (CC BY-NC-ND) licence. This licence only allows you to download this work and share it with others as long as you credit the authors, but you can't change the article in any way or use it commercially. More information and the full terms of the licence here: https://creativecommons.org/licenses/ Takedown If you consider content in White Rose Research Online to be in breach of UK law, please notify us by emailing eprints@whiterose.ac.uk including the URL of the record and the reason for the withdrawal request. and six-month follow-up, significant treatment effects favoring CBT were found in comparison to a waitlist or treatment-as-usual. When CBT was compared with active controls, a small non-significant treatment advantage was found for CBT at the end of treatment, with equivalence of outcomes at follow-up. Treatment effect size of CBT for GAD was significantly associated with attrition rates and depression outcomes. Conclusions: CBT is more helpful than having no treatment for GAD in later life. However, whether CBT shows long-term durability, or is superior to other commonly available treatments (such as supportive psychotherapy), remains to be tested. The relationship between treatment effects for GAD and depression following CBT warrants further research. Efficacy of CBT for GAD in

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“…Stanley, Beck and DeWitt Glassco (1996) randomised patients to CBT or non-directive group supportive therapy and whilst both treatments significantly improved anxiety, no significant differences were evident between treatments. Wetherell, Gatz and Craske (2003) randomised patients to either CBT or discussion groups following a waitlist control period and again there were no significant differences between treatments.…”

mentioning

confidence: 97%

Group psychoeducative cognitive-behaviour therapy for mixed anxiety and depression with older adults

Bains

Scott

Kellett

et al. 2014

Aging & Mental Health

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Objectives. There is a dearth of older adult literature regarding group treatment for comorbid anxiety and depression. This research evaluated the effectiveness of a low intensity group psychoeducational approach. Method.Patients attended six sessions of a manualised cognitive-behavioural group programme. Validated measures of anxiety, depression and psychological well-being were taken at assessment, termination and short-term follow-up and staff rated patients regarding their functioning at the same time points. Patients rated the alliance and their anxiety and depression at each group session. Outcomes were categorised according to whether patients had recovered, improved, deteriorated or been harmed. Effect sizes were compared to extant group interventions for anxiety and depression.Results. Eight groups were completed with 34 patients, with a drop-out rate of 17%.Staff and patient rated outcome measures showed significant improvements in assessment to termination and assessment to follow-up comparisons. Over one quarter (26.47 %) of patients met the recovery criteria at follow-up and no patients were harmed. Outcomes for anxiety were better than for depression and the alliance was stable over time.Conclusion. The intervention evaluated shows some clinical and organisational promise. The group approach needs to be further explored and tested in research with greater methodological control.Keywords: older adult, CBT, group, co-morbid anxiety/depression. RUNNING HEAD: Group CBT for mixed anxiety and depression in older adults Depression and anxiety co-occur at high rates in older adult populations; Beekman et al., (2000) found that 47.5% of those with major depressive disorder had co-morbid anxiety disorders and 26.1% of people with anxiety disorders had co-morbid major depressive disorders. Katona, Manela and Livingstone (1997) found high rates of co-morbid generalised anxiety disorder (GAD) in older adults diagnosed with depression and Flint (1999) noted that late-life GAD was typically associated with depression. Co-morbidity in older adults is twice more likely in women than men, with more severely depressed individuals more likely to suffer with severe anxiety and vice versa (Schoevers, Beekman, Deeg, Jonker & van Tilburg, 2003).Despite this well evidenced overlap between anxiety and depression in older people, there is a relative lack of research regarding one-to-one and group psychotherapy interventions. Whilst group cognitive behaviour therapy (CBT) is recommended by NICE for working age adults with anxiety and depression for example (NICE Guideline 90, 2009), there are no specific guidelines in relation to older adults due to lack of evidence. Only one study has evaluated group CBT treatment of mixed anxiety and depression (Schimmel-Spreeuw, Linssen & Heeren, 2000) with outpatient elderly depressed women. Statistically significant reductions in depression, anxiety and neuroticism were observed from pre to post pre to follow-up comparisons.A recent review of older adult group CBT specifically ...

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Treatment of generalized anxiety in older adults: A preliminary comparison of cognitive-behavioral and supportive approaches

Cited by 170 publications

References 35 publications

A Randomized, Controlled Trial of the Effectiveness of Cognitive–Behavioral Therapy and Sertraline versus a Waitlist Control Group for Anxiety Disorders in Older Adults

A Randomized, Controlled Trial of the Effectiveness of Cognitive–Behavioral Therapy and Sertraline versus a Waitlist Control Group for Anxiety Disorders in Older Adults

Efficacy of Cognitive Behavioral Therapy for Generalized Anxiety Disorder in Older Adults: Systematic Review, Meta-Analysis, and Meta-Regression

Group psychoeducative cognitive-behaviour therapy for mixed anxiety and depression with older adults

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