Treatment of Gad

This study evaluates the efficacy of a cognitive-behavioral treatment for generalized anxiety disorder (GAD) that addresses two types of worries: (a) those about situations that are amenable to problem solving, and (b) those about situations that are not. The treatment’s goal is to help patients become more tolerant of uncertainty by discriminating between both types ofworry and applying the correct strategy to each type.Amultiple baseline designwas used and subjects were 4 adults with a primary diagnosis of GAD. Treatment outcome was assessed with daily self-monitoring, self-report questionnaires, and standardized clinician ratings. At posttest and 6-month follow-up, 3 of 4 subjects no longer met diagnostic criteria for GAD and had attained high end-state functioning. At 12-month follow-up, none of the subjects met GAD diagnostic criteria but end-state functioningwas variable. The results also showthat treatment outcomewas highly related to change in intolerance of uncertainty.

[1]  N. Jacobson,et al.  Psychotherapy outcome research: Methods for reporting variability and evaluating clinical significance , 1984 .

[2]  Michael W. Eysenck,et al.  Worry: Mechanisms and Modulating Influences , 1994, Behavioural and Cognitive Psychotherapy.

[3]  N. Jacobson,et al.  Clinical significance: a statistical approach to defining meaningful change in psychotherapy research. , 1991, Journal of consulting and clinical psychology.

[4]  T J Meyer,et al.  Development and validation of the Penn State Worry Questionnaire. , 1990, Behaviour research and therapy.

[5]  Nicole Thibodeau,et al.  Specificity of generalized anxiety disorder symptoms and processes , 1999 .

[6]  M. Freeston,et al.  Generalized anxiety disorder: a preliminary test of a conceptual model. , 1998, Behaviour research and therapy.

[7]  M. Fennell,et al.  Comparison of behavior therapy and cognitive behavior therapy in the treatment of generalized anxiety disorder. , 1991, Journal of consulting and clinical psychology.

[8]  W. Coryell,et al.  The Clinical management of anxiety disorders , 1991 .

[9]  R. Ladouceur,et al.  Behavioral Expressions of Intolerance of Uncertainty in Worry , 1997, Behavior modification.

[10]  David H. Barlow,et al.  Anxiety and its disorders : the nature and treatment of anxiety and panic , 1988 .

[11]  T. Pruzinsky,et al.  Preliminary exploration of worry: some characteristics and processes. , 1983, Behaviour research and therapy.

[12]  A. Beck,et al.  An inventory for measuring clinical anxiety: psychometric properties. , 1988, Journal of consulting and clinical psychology.

[13]  H. Kraemer,et al.  Coming to terms with the terms of risk. , 1997, Archives of general psychiatry.

[14]  D. Barlow,et al.  Single Case Experimental Designs: Strategies for Studying Behavior Change , 1976 .

[15]  M. Borkovec,et al.  A self-report diagnostic measure of generalized anxiety disorder. , 1995, Journal of behavior therapy and experimental psychiatry.

[16]  P. Salkovskis,et al.  A Comparison of Cognitive Therapy, Applied Relaxation and Imipramine in the Treatment of Panic Disorder , 1994, British Journal of Psychiatry.

[17]  T. Borkovec,et al.  The nature of worry in generalized anxiety disorder: a predominance of thought activity. , 1990, Behaviour research and therapy.

[18]  Wolfgang Ellermeier,et al.  On the “absoluteness” of category and magnitude scales of pain , 1991, Perception & psychophysics.

[19]  T. Borkovec,et al.  Efficacy of applied relaxation and cognitive-behavioral therapy in the treatment of generalized anxiety disorder. , 1993, Journal of consulting and clinical psychology.

[20]  R. Rapee,et al.  Behavioral treatment of generalized anxiety disorder , 1992 .

[21]  S. Hu,et al.  The effect of worry on cardiovascular response to phobic imagery. , 1990, Behaviour research and therapy.

[22]  Neil S. Jacobson,et al.  Toward a standard definition of clinically significant change , 1986 .

[23]  J. Hampton,et al.  Some characteristics of worrying: Evidence for worrying and anxiety as separate constructs , 1992 .

[24]  Gwilym M. Jenkins,et al.  Time series analysis, forecasting and control , 1972 .

[25]  Robert Ladouceur,et al.  Why do people worry , 1994 .

[26]  M. Freeston,et al.  Problem solving and problem orientation in generalized anxiety disorder. , 1998, Journal of anxiety disorders.

[27]  T. Borkovec.  Worry: a potentially valuable concept. , 1985, Behaviour research and therapy.

[28]  A. Mathews.  Why worry? The cognitive function of anxiety. , 1990, Behaviour research and therapy.

[29]  D. Chambless,et al.  Cognitive therapy of anxiety disorders. , 1993 .

[30]  A. Wells,et al.  Differential Effects of Worry and Imagery After Exposure to a Stressful Stimulus: A Pilot Study , 1995, Behavioural and Cognitive Psychotherapy.