Approaching Cognitive Behavior Therapy For Generalized Anxiety Disorder From A Cognitive Process Perspective.
attention bias
attention control
cognitive behavior therapy
generalized anxiety disorder
interpretation bias
verbal worry
Journal
Frontiers in psychiatry
ISSN: 1664-0640
Titre abrégé: Front Psychiatry
Pays: Switzerland
ID NLM: 101545006
Informations de publication
Date de publication:
2019
2019
Historique:
received:
01
08
2019
accepted:
07
10
2019
entrez:
30
11
2019
pubmed:
30
11
2019
medline:
30
11
2019
Statut:
epublish
Résumé
Generalized anxiety disorder (GAD), with uncontrollable worry at its core, is a common psychological disorder with considerable individual and societal costs. Cognitive behavior therapy (CBT) is recommended as the first-line treatment for GAD; however, further investigation into its effectiveness in routine clinical care is indicated and improvement is required in treatment outcomes for worry. Improvements to CBT need to be guided by experimental research that identifies key mechanisms maintaining core aspects of the disorder. This paper summarizes how theory-driven experimental research guided selection and refinements of CBT techniques originally developed by Borkovec and Costello, to target key cognitive processes that maintain worry in GAD. Hirsch and Mathews' model specifies three key research-supported processes that maintain uncontrollable worry in GAD: implicit cognitive biases such as negative interpretation bias and attention bias, generalized verbal thinking style, and impaired ability to re-direct attentional control away from worry. Specific CBT techniques outlined in this paper aim to target these key processes. Clinical data from clients treated using our refined CBT protocol for GAD in a routine clinical care service with a special interest in anxiety disorders were collected as part of service procedures. Large pre-to-posttreatment effect sizes were obtained for anxiety (GAD-7), depression (PHQ-9), and worry (PSWQ) (
Identifiants
pubmed: 31780964
doi: 10.3389/fpsyt.2019.00796
pmc: PMC6852150
doi:
Types de publication
Journal Article
Langues
eng
Pagination
796Informations de copyright
Copyright © 2019 Hirsch, Beale, Grey and Liness.
Références
Anxiety Stress Coping. 2013;26(3):293-313
pubmed: 22762442
Acta Psychiatr Scand Suppl. 2004;(420):21-7
pubmed: 15128384
J Abnorm Psychol. 1991 May;100(2):144-50
pubmed: 2040764
J Consult Clin Psychol. 2020 Mar;88(3):226-239
pubmed: 32068424
Psychol Methods. 2002 Mar;7(1):105-25
pubmed: 11928886
Clin Psychol Sci. 2015 Sep 1;3(5):758-771
pubmed: 26504675
J Affect Disord. 2012 Oct;140(2):103-12
pubmed: 22154706
Behav Res Ther. 2009 Nov;47(11):902-9
pubmed: 19664756
Behav Res Ther. 2012 Oct;50(10):636-46
pubmed: 22863541
J Abnorm Psychol. 1989 Feb;98(1):31-4
pubmed: 2708637
Behav Res Ther. 2011 Feb;49(2):99-105
pubmed: 21159327
Behav Res Ther. 2010 Mar;48(3):171-8
pubmed: 19857859
Arch Intern Med. 2006 May 22;166(10):1092-7
pubmed: 16717171
J Abnorm Psychol. 2014 May;123(2):330-335
pubmed: 24886007
J Consult Clin Psychol. 2003 Apr;71(2):309-19
pubmed: 12699025
Iran J Psychiatry. 2014 Apr;9(2):69-75
pubmed: 25632283
Annu Rev Clin Psychol. 2016;12:281-305
pubmed: 27019398
Br J Psychiatry. 2002 May;180:461-4
pubmed: 11983645
Clin Psychol Rev. 2007 Jun;27(5):572-81
pubmed: 17343963
J Nerv Ment Dis. 2013 May;201(5):414-20
pubmed: 23588228
Behav Res Ther. 1990;28(6):487-95
pubmed: 2076086
Clin Psychol Rev. 2014 Mar;34(2):130-40
pubmed: 24487344
J Abnorm Psychol. 1986 Feb;95(1):15-20
pubmed: 3700842
Cogn Behav Ther. 2008;37(3):192-8
pubmed: 18608310
BMC Psychiatry. 2012 Jun 25;12:66
pubmed: 22731889
J Abnorm Psychol. 2009 Feb;118(1):44-54
pubmed: 19222313
Clin Psychol Rev. 2013 Feb;33(1):120-32
pubmed: 23168445
Eur Neuropsychopharmacol. 2005 Aug;15(4):445-52
pubmed: 15951160
Cogn Psychol. 2000 Aug;41(1):49-100
pubmed: 10945922
J Clin Psychiatry. 2013 Jun;74(6):595-602
pubmed: 23842011
Depress Anxiety. 2003;17(3):173-9
pubmed: 12768651
Behav Res Ther. 1989;27(4):317-23
pubmed: 2775141
Psychol Med. 2018 Sep;48(12):2045-2053
pubmed: 29224581
J Consult Clin Psychol. 1993 Aug;61(4):611-9
pubmed: 8370856
J Consult Clin Psychol. 2002 Apr;70(2):288-98
pubmed: 11952187
Behav Res Ther. 2013 Feb;51(2):82-6
pubmed: 23262115
Med Care. 2004 Dec;42(12):1194-201
pubmed: 15550799
J Abnorm Psychol. 2008 Aug;117(3):712-7
pubmed: 18729625
J Consult Clin Psychol. 2018 Dec;86(12):1017-1030
pubmed: 30507227
J Anxiety Disord. 2012 Dec;26(8):823-32
pubmed: 23023161
Am J Geriatr Psychiatry. 2009 Jun;17(6):473-82
pubmed: 19472438
Behav Res Ther. 2009 Feb;47(2):119-27
pubmed: 19036354
J Abnorm Psychol. 2009 Feb;118(1):28-33
pubmed: 19222311
Behav Res Ther. 2003 Jun;41(6):633-46
pubmed: 12732372
Clin Psychol Sci. 2015 Jul;3(4):637-647
pubmed: 27110477
J Behav Ther Exp Psychiatry. 2014 Mar;45(1):8-14
pubmed: 23906509
Cognit Ther Res. 2012 Oct 1;36(5):427-440
pubmed: 23459093
Behav Res Ther. 2000 Apr;38(4):319-45
pubmed: 10761279
J Anxiety Disord. 2008;22(1):108-16
pubmed: 17321717
Annu Rev Clin Psychol. 2018 May 7;14:159-183
pubmed: 29350997
J Nerv Ment Dis. 2007 Jun;195(6):521-31
pubmed: 17568301
Psychopharmacology (Berl). 2004 Nov;176(3-4):466-70
pubmed: 15549278
Psychol Med. 2005 Dec;35(12):1747-59
pubmed: 16202187
Depress Anxiety. 2005;21(4):178-84
pubmed: 16075454
Biol Psychol. 2016 Dec;121(Pt B):203-212
pubmed: 26407521
Psychother Psychosom. 2005;74(1):36-42
pubmed: 15627855
J Clin Psychiatry. 2001;62 Suppl 11:37-42; discussion 43-5
pubmed: 11414549
Neuropsychiatr Dis Treat. 2013;9:73-80
pubmed: 23326197
J Gen Intern Med. 2001 Sep;16(9):606-13
pubmed: 11556941
Br J Clin Psychol. 1999 Sep;38(3):267-78
pubmed: 10532148
J Abnorm Psychol. 2014 Aug;123(3):557-65
pubmed: 24933276
J Consult Clin Psychol. 2009 Aug;77(4):595-606
pubmed: 19634954
BMC Psychiatry. 2014;14 Suppl 1:S1
pubmed: 25081580
J Abnorm Psychol. 2010 Feb;119(1):235-40
pubmed: 20141260
J Clin Psychiatry. 1996;57 Suppl 7:86-91
pubmed: 8690701
Compr Psychiatry. 2005 May-Jun;46(3):223-8
pubmed: 16021593
J Abnorm Psychol. 2012 Feb;121(1):238-43
pubmed: 21842960
Clinicoecon Outcomes Res. 2014 Apr 02;6:151-63
pubmed: 24729720
Behav Res Ther. 2010 May;48(5):418-23
pubmed: 20381014
Behav Res Ther. 1990;28(2):153-8
pubmed: 2183759