Baseline Client Interpersonal Agency Moderates the Indirect Effect of Treatment on Long-term Worry in Variants of CBT for Generalized Anxiety Disorder

2019 ◽  
Vol 50 (6) ◽  
pp. 1063-1074
Author(s):  
Juan Martín Gómez Penedo ◽  
Michael J. Constantino ◽  
Alice E. Coyne ◽  
Felicia M. Romano ◽  
Henny A. Westra ◽  
...  
Keyword(s):  
Anxiety Disorder ◽  
Generalized Anxiety Disorder ◽  
Indirect Effect ◽  
Generalized Anxiety ◽  
Effect Of Treatment

Comparative effects of pregabalin on anxiety and sleep disturbance: Results of a path analysis

2011 ◽  
Vol 26 (S2) ◽  
pp. 184-184
Author(s):  
H.-U. Wittchen ◽  
R. Prieto ◽  
B. Emir ◽  
S. Donevan
Keyword(s):  
Anxiety Disorder ◽  
Sleep Disturbance ◽  
Path Analysis ◽  
Generalized Anxiety Disorder ◽  
Direct Effect ◽  
Indirect Effect ◽  
Rating Scale ◽  
Generalized Anxiety ◽  
Effect Of Treatment ◽  
Sleep Factor

IntroductionSleep disturbance is one of the key DSM-IV criteria for generalized anxiety disorder (GAD), and represents the chief complaint in approximately one-third of patients presenting in the primary care setting.Objectives/aimsTo evaluate the extent to which improvement in anxiety is a direct effect of treatment with pregabalin, or is an indirect effect mediated by improvement in sleep disturbance, and vice-versa.MethodsData were pooled from 4 double-blind, placebo-controlled (n = 406) short-term trials of pregabalin (all doses combined; n = 853) in the treatment of generalized anxiety disorder (GAD). The effect of treatment on anxiety was measured using the Hamilton Anxiety Rating Scale (HAM-A), effect of treatment on sleep disturbance was measured using the 3-item Hamilton Depression Rating Scale (HAM-D) sleep factor. Path analyses, using a set of multivariate regression models, were used to evaluate the reciprocal effects of pregabalin on improvement in anxiety in the presence of improvement in sleep disturbance, and vice-versa.ResultsSleep disturbance was common in this GAD sample, with 51.2% (placebo) and 52.2% (pregabalin) of patients, respectively, reporting moderate-to-severe insomnia (HAM-D sleep factor score ≥3). The results of the path analysis indicated that 91.7% (P < 0.0001) of improvement in anxiety was a direct effect of treatment with pregabalin, while 8.3% of improvement in anxiety was an indirect effect, mediated by improvement in sleep disturbance.ConclusionsIn this pooled 4-study data set, the anxiolytic efficacy of pregabalin appears to be primarily a direct effect, with only a small (8.3%) indirect effect, mediated by improvement in sleep disturbance.

Positive Emotion in Generalized Anxiety Disorder

2019 ◽  
pp. 297-311
Author(s):  
Ilana Seager ◽  
Douglas S. Mennin ◽  
Amelia Aldao
Keyword(s):  
Anxiety Disorder ◽  
Positive Affect ◽  
Generalized Anxiety Disorder ◽  
Positive Emotion ◽  
Behavioral Therapy ◽  
Generalized Anxiety ◽  
Emotional Dysfunction ◽  
Wide Range ◽  
Future Work

Generalized anxiety disorder (GAD) is a debilitating condition characterized by excessive, pervasive, uncontrollable, and paralyzing worries about a wide range of future situations. Individuals with this condition frequently find themselves stuck in worry and tension cycles in futile attempts at reducing uncertainty and increasing control. GAD has been associated with substantial impairments in functioning and reduced quality of life. GAD remains poorly understood, and the long-term efficacy and end-state functioning resulting from treatment are weaker compared to other anxiety disorders. Some treatments (e.g., emotion regulation therapy, acceptance-based behavioral therapy) have improved efficacy, partly by targeting emotional dysfunction. Basic psychopathology research has focused on identifying the role of negative affect in GAD, so little is known about how positive affect is experienced and regulated in this disorder. This is particularly important in light of the overlap of this condition with major depressive disorder, which is characterized by low or suppressed positive emotion. Developing such an understanding is essential to further improve the efficacy of emotion-based treatments. This chapter reviews current and future directions in the study of positive affect in GAD. The chapter reviews the nascent research on positive affect and GAD, then illustrates dimensions of future work.

scholarly journals Does cognitive-behavioural therapy influence the long-term outcome of generalized anxiety disorder? An 8–14 year follow-up of two clinical trials

2003 ◽  
Vol 33 (3) ◽  
pp. 499-509 ◽  
Author(s):  
R. C. DURHAM ◽  
J. A. CHAMBERS ◽  
R. R. MACDONALD ◽  
K. G. POWER ◽  
K. MAJOR
Keyword(s):  
Anxiety Disorder ◽  
Generalized Anxiety Disorder ◽  
Secondary Care ◽  
Generalized Anxiety ◽  
Behaviour Therapy ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Cognitive Behaviour

Background. Generalized anxiety disorder is a common condition of excessive worry and tension which tends to run a chronic course associated with significant psychiatric and medical problems. Cognitive behaviour therapy (CBT) has been shown to be of clinical value in about 50% of cases with treatment gains maintained over follow-up periods ranging from 6 to 12 months. The potential value of CBT over the longer term has not been subject to rigorous investigation.Method. Results are reported of 8–14 year follow-up of two randomized controlled trials of cognitive-behaviour therapy for generalized anxiety disorder employing structured interview with an assessor blind to initial treatment condition. Comparison groups included medication and placebo in one study based in primary care, and analytical psychotherapy in the other based in secondary care. Follow-up samples (30% and 55% of trial entrants) were broadly representative of the original cohorts.Results. Overall, 50% of participants were markedly improved of whom 30–40% were recovered (i.e. free of symptoms). Outcome was significantly worse for the study based in secondary care in which the clinical presentation of participants was more complex and severe. For a minority (30–40%), mainly from the secondary care study, outcome was poor. Treatment with CBT was associated with significantly lower overall severity of symptomatology and less interim treatment, in comparison with non-CBT conditions, but there was no evidence that CBT influenced diagnostic status, probability of recovery or patient perceptions of overall improvement.Conclusions. Both CBT and the complexity and severity of presenting problems appear to influence the long-term outcome of GAD.

Can Long-Term Pharmacotherapy Prevent Relapses in Generalized Anxiety Disorder? A Systematic Review

2017 ◽  
Vol 37 (8) ◽  
pp. 737-743 ◽  
Author(s):  
Marina Dyskant Mochcovitch ◽  
Rafael Christophe da Rocha Freire ◽  
Rafael Ferreira Garcia ◽  
Antonio Egidio Nardi
Keyword(s):  
Systematic Review ◽  
Anxiety Disorder ◽  
Generalized Anxiety Disorder ◽  
Generalized Anxiety

Efficacy and Tolerability of Paroxetine for the Long-Term Treatment of Generalized Anxiety Disorder

2003 ◽  
Vol 64 (3) ◽  
pp. 250-258 ◽  
Author(s):  
Fabrizio Stocchi ◽  
Giampetro Nordera ◽  
Riitta H. Jokinen ◽  
Ulla M. Lepola ◽  
Karen Hewett ◽  
...  
Keyword(s):  
Anxiety Disorder ◽  
Generalized Anxiety Disorder ◽  
Term Treatment ◽  
Generalized Anxiety ◽  
Long Term Treatment
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