Psychological interventions for generalized anxiety disorder: Effects and predictors in a naturalistic outpatient setting.
Journal
PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081
Informations de publication
Date de publication:
2023
2023
Historique:
received:
07
09
2022
accepted:
25
02
2023
entrez:
10
3
2023
pubmed:
11
3
2023
medline:
15
3
2023
Statut:
epublish
Résumé
Numerous randomized controlled trials (RCTs) demonstrate the efficacy of cognitive behavioral therapy (CBT), metacognitive therapy (MCT), and methods to reduce intolerance of uncertainty (IU-CBT) in the treatment of generalized anxiety disorder (GAD). However, few studies have investigated these treatments under conditions of routine clinical care. The main objective of this study was to investigate the effectiveness of psychotherapy for GAD in an outpatient setting and to identify factors influencing treatment outcome. Fifty-nine GAD patients received naturalistic CBT (including MCT and IU-CBT) in an outpatient clinic and postgraduate training center for psychotherapy. Patients completed self-report questionnaires at the beginning and end of therapy regarding the main outcome worry as well as metacognitions, intolerance of uncertainty, depression, and general psychopathology. Worry, negative metacognitions, intolerance of uncertainty, depression, and general psychopathology decreased significantly (p's < .001) with large effect sizes for all symptoms (d = 0.83-1.49). A reliable change in the main outcome worry was observed in 80% of patients, and recovery occurred in 23%. Higher worry scores at posttreatment were predicted by higher pretreatment scores, female sex, and less change in negative metacognitive beliefs during treatment. Naturalistic CBT for GAD appears to be effective in routine clinical care for worry as well as depressive symptoms, with particular benefits associated with altering negative metacognitions. However, a recovery rate of only 23% is lower than the rates reported in RCTs. Treatment needs to be improved, especially for patients with more severe GAD and for women.
Identifiants
pubmed: 36897860
doi: 10.1371/journal.pone.0282902
pii: PONE-D-22-24983
pmc: PMC10004605
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e0282902Informations de copyright
Copyright: © 2023 Krzikalla et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Déclaration de conflit d'intérêts
The authors have declared that no competing interests exist.
Références
Clin Psychol Rev. 2013 Dec;33(8):954-64
pubmed: 23988455
Braz J Psychiatry. 2013 Oct-Dec;35(4):416-31
pubmed: 24402217
Cogn Behav Ther. 2008;37(3):192-8
pubmed: 18608310
J Clin Psychiatry. 2002;63 Suppl 8:4-10
pubmed: 12044107
Behav Ther. 2010 Mar;41(1):46-58
pubmed: 20171327
Psychother Psychosom. 2009;78(2):106-15
pubmed: 19218829
Behav Modif. 2007 Jul;31(4):512-38
pubmed: 17548543
J Pers Assess. 2020 May-Jun;102(3):297-308
pubmed: 30657714
J Nerv Ment Dis. 2006 Feb;194(2):91-7
pubmed: 16477186
Cogn Behav Ther. 2020 Jan;49(1):1-21
pubmed: 30760112
Psychol Med. 2005 Dec;35(12):1747-59
pubmed: 16202187
Psychother Res. 2019 Feb;29(2):139-156
pubmed: 29096584
Depress Anxiety. 2012 Jul;29(7):614-20
pubmed: 22495990
Dialogues Clin Neurosci. 2015 Sep;17(3):337-46
pubmed: 26487814
J Clin Psychiatry. 2008 Oct;69(10):1606-16
pubmed: 19192444
Acta Psychiatr Scand. 2007 May;115(5):372-9
pubmed: 17430415
Behav Res Ther. 2004 Apr;42(4):385-96
pubmed: 14998733
J Consult Clin Psychol. 1991 Feb;59(1):12-9
pubmed: 2002127
Behav Res Ther. 1990;28(6):487-95
pubmed: 2076086
Behav Res Ther. 2017 Nov;98:4-18
pubmed: 27890222
Clin Psychol Rev. 2014 Mar;34(2):130-40
pubmed: 24487344
J Consult Clin Psychol. 2000 Dec;68(6):957-64
pubmed: 11142548
Int J Psychiatry Clin Pract. 2013 Jun;17(2):90-7
pubmed: 23485125
Front Psychol. 2018 Nov 14;9:2211
pubmed: 30487770
Arch Gen Psychiatry. 2005 Jun;62(6):617-27
pubmed: 15939839
Clin Psychol Rev. 2013 Feb;33(1):120-32
pubmed: 23168445
Eur Neuropsychopharmacol. 2005 Aug;15(4):445-52
pubmed: 15951160
Behav Res Ther. 2005 Oct;43(10):1243-61
pubmed: 16086979
Behav Ther. 2020 May;51(3):434-446
pubmed: 32402259
J Psychiatr Res. 2013 Dec;47(12):1876-85
pubmed: 24074517
Behav Res Ther. 2013 Feb;51(2):82-6
pubmed: 23262115
Front Psychiatry. 2019 Nov 04;10:796
pubmed: 31780964
Qual Life Res. 2000 Mar;9(2):185-93
pubmed: 10983482
J Consult Clin Psychol. 2006 Oct;74(5):908-19
pubmed: 17032095
World Psychiatry. 2016 Oct;15(3):245-258
pubmed: 27717254
J Consult Clin Psychol. 2003 Aug;71(4):821-5
pubmed: 12924687
Behav Res Ther. 2003 Jun;41(6):633-46
pubmed: 12732372
Behav Res Ther. 2012 Feb;50(2):100-9
pubmed: 22222208
J Anxiety Disord. 2008;22(1):108-16
pubmed: 17321717
Behav Ther. 2010 Mar;41(1):59-72
pubmed: 20171328
Psychol Med. 2014 Aug;44(11):2351-62
pubmed: 24384401
BMC Psychiatry. 2016 Jul 19;16:248
pubmed: 27431392
Behav Modif. 2000 Oct;24(5):635-57
pubmed: 11036732
Depress Anxiety. 2018 Jun;35(6):502-514
pubmed: 29451967
Behav Ther. 2010 Sep;41(3):296-305
pubmed: 20569779
Behav Ther. 2014 Jan;45(1):7-20
pubmed: 24411110
Expert Rev Neurother. 2012 Aug;12(8):937-47
pubmed: 23002938
Behav Res Ther. 2002 Mar;40(3):313-23
pubmed: 11863241
J Consult Clin Psychol. 2009 Aug;77(4):595-606
pubmed: 19634954
Behav Res Methods. 2021 Apr;53(2):669-685
pubmed: 32804343
Clin Psychol Rev. 2015 Jun;38:39-54
pubmed: 25795293