A meta-analysis of CBT for pathological worry among clients with GAD
Section snippets
A meta-analysis on CBT for pathological worry among GAD clients
Generalized Anxiety Disorder (GAD) is characterized by uncontrollable and excessive worry, a necessary feature for its diagnosis. Although other cognitive and/or physical symptoms, such as muscle tension and poor concentration, must be present for diagnosis, the fundamental component is pathological worry across multiple domains of life (e.g., work, health, relationships; American Psychiatric Association [APA], 2000). While everyone worries to some degree, pathological worry is distinguished
Method
A PSYCHINFO literature search (up to 2006) was conducted using a variety of keywords designed to find articles on the outcome literature for CBT with GAD. Also, studies listed in the reference lists of previously published meta-analytic articles were used to identify additional relevant publications. Unpublished manuscripts were not used in this manuscript because the quality of data used in any meta-analysis is extremely important, and therefore only peer-reviewed research was utilized. There
Between-groups analysis
As previously outlined, a control group was defined as any comparison group that provided a nonspecific treatment (e.g., supportive therapy) or individuals on a wait-list and currently not receiving any treatment. Unbiased effect sizes can be seen in Table 2 for each of the studies used in the between-groups analysis. When CBT was compared to a control group, the average ES was found to be quite large (−1.15). Tests of significance were performed using Fischer's Z-test, and yielded a
Discussion
Findings from the current meta-analysis show that CBT for GAD can be a highly effective treatment for reducing pathological worry. However, CBT's effectiveness appears to be moderated by the age of GAD patients being treated. Younger adults responded much more favourably to CBT at post-treatment relative to older adults. Nevertheless, when compared to control groups, the mean ES of CBT for geriatric patients was still impressive, both at post-treatment and follow-up. In fact, mean PSWQ scores
Acknowledgements
David J.A. Dozois was funded by the Ontario Mental Health Foundation (OMHF), Allison J. Ouimet was supported by a Fonds Québécois de la Recherche sur la Société et la Culture (FQRSC) fellowship, and Pamela M. Seeds was supported by the Social Sciences and Humanities Research Council (SSHRC) scholarship.
References (33)
- et al.
Generalized anxiety disorder: a preliminary test of a conceptual model
Behaviour Research and Therapy
(1998) - et al.
Cognitive-behavioral and pharmacological treatment of generalized anxiety disorder: a preliminary meta analysis
Behavior Therapy
(1997) - et al.
Treatment of generalized anxiety in older adults: a preliminary comparison of cognitive-behavioral approaches
Behavior Therapy
(1996) - et al.
Cognitive-behavior therapy for late-life generalized anxiety disorder in primary care
The American Journal of Geriatric Psychiatry
(2003) - et al.
Issues of measurement and mechanism in meta-analyses: comment on Westen and Morrison (2001)
Journal of Consulting and Clinical Psychology
(2001) - American Psychiatric Association (2000). Diagnostic and Statistical Manual of Mental Disorders (4th ed. Text Revision)....
Anxiety and its disorders: the nature and treatment of anxiety and panic
(2002)- et al.
Efficacy of applied relaxation and cognitive-behavioral therapy in the treatment of generalized anxiety disorder
Journal of Consulting and Clinical Psychology
(1993) - et al.
A component analysis of cognitive-behavioral therapy for generalized anxiety disorder and the role of interpersonal problems
Journal of Consulting and Clinical Psychology
(2002) - et al.
Worry: a cognitive phenomenon intimately linked to affective, physiological, and interpersonal behavioral processes
Cognitive Therapy and Research
(1998)
Psychotherapy for generalized anxiety disorder
Journal of Clinical Psychiatry
Generalized anxiety disorder
A meta-analysis of the efficacy of cognitive therapy for depression
Journal of Consulting and Clincial Psychology
Biased cognitive processing of uncertainty-inducing information in generalized anxiety disorder: implications for treatment
Targeting intolerance of uncertainty in two types of worry
Behavior Modification
Group cognitive-behavioral therapy for generalized anxiety disorder: treatment outcome and long-term follow-up
Journal of Consulting and Clinical Psychology
Cited by (177)
Symptom distress and psychosocial functioning improve bidirectionally during cognitive-behavioral therapy for anxiety disorders
2024, Journal of Anxiety DisordersDevelopment and validation of Ayurveda based assessment scale for anxiety
2023, Journal of Ayurveda and Integrative MedicineAvoidance of negative emotional contrast from worry and rumination: An application of the Contrast Avoidance Model
2022, Journal of Behavioral and Cognitive Therapy