A Fresh Look at Potential Mechanisms of Change in Applied Relaxation for Generalized Anxiety Disorder: A Case Series (Hayes-Skelton et al.)

2012 ◽  
Vol 19 (3) ◽  
pp. 497-498
2012 ◽  
Vol 19 (3) ◽  
pp. 451-462 ◽  
Author(s):  
Sarah A. Hayes-Skelton ◽  
Aisha Usmani ◽  
Jonathan K. Lee ◽  
Lizabeth Roemer ◽  
Susan M. Orsillo

2010 ◽  
Vol 1 (1) ◽  
pp. jep.007910 ◽  
Author(s):  
Adrian Wells

The metacognitive model of pathological worry and Generalized Anxiety Disorder (GAD) makes a crucial distinction between two types of worry and explains the persistence and uncontrollability of negative thinking as an effect of specific metacognitions. The negative appraisal of worry (meta-worry) and negative beliefs about worry are central to the development of GAD. Furthermore, GAD is associated with paradoxes in mental control such as the use of extended thinking to reduce thinking. Evidence is reviewed that supports major tenets of the model. A specific treatment, metacognitive therapy is described that focuses on modifying metacognitive beliefs and reducing the use of worry to cope with thoughts. The empirical status of the model is reviewed and evidence from recent trials of this treatment is summarized. The treatment appears to be effective and initial trials suggest it is associated with greater levels of recovery than approaches comprised of applied relaxation or cognitive-behavioural treatment focused on intolerance of uncertainty.


2021 ◽  
Author(s):  
Kathleen Tallon

Cognitive-Behavioural Therapy (CBT) is an evidence-based treatment for Generalized Anxiety Disorder (GAD). Worry postponement (WP), in which a client is asked to postpone worry until a 30-minute “worry time,” is a common component of CBT for GAD; however, the efficacy of WP has never been tested in people with GAD. Further, the mechanisms of change of WP are not known; nor are its effects on cognitive processes and symptoms related to GAD. A better understanding of the efficacy and mechanisms of change of WP could help to optimize CBT for GAD. The goals of the present study were to examine, in a sample of people with GAD, the effects of WP on worry and GAD symptoms, and cognitive processes and symptoms related to GAD. The study also examined the effects of WP on two proposed mediators: stimulus control and metacognitive beliefs. Sixty-seven adults were randomized to one of three conditions: 2- week worry postponement intervention (WP), 2-week worry monitoring intervention (MON), or an assessment only control. Participants completed outcome measures before and after the 2- week intervention period and at a 2-week follow-up. In the WP and MON conditions, participants completed daily worry monitoring using a phone-based application. All participants showed a significant decrease in past-week worry over the course of the study, with no significant differences between the conditions. There were no significant changes in GAD symptoms across conditions. There was no evidence that WP had superior effects to control groups on cognitive processes or symptoms related to GAD. There was no evidence that stimulus control or metacognitive beliefs mediated the reduction in past week worry in WP. This is the first known study to examine the effects of WP in people with GAD. Whereas worry did decrease on some indices over the course of the study, there were no significant differences between WP and two control conditions. Further this study found no evidence that WP has specific effects on two processes that are thought to be mechanisms of action. The findings of this study demonstrate the need to establish the efficacy of the treatment components used in CBT.


Author(s):  
Priscilla T. Cheung ◽  
Laura C. Curren ◽  
Lisa W. Coyne ◽  
Donna B. Pincus ◽  
Martha C. Tompson

2022 ◽  
Vol 15 ◽  
Author(s):  
Craig Chigwedere ◽  
Judy Moran

Abstract Intolerance of uncertainty (IoU) is important in the development and maintenance of worry and generalized anxiety disorder (GAD; Dugas et al., 1997). However, it remains unclear why some people respond so negatively to uncertainty and have poor clinical outcomes. We adapted the IoU model to include the influence of developmental and/or attachment factors, and their possible importance to intolerability of uncertainty and associated hypothetical worries. Seven consecutive GAD referrals for CBT were naturalistically treated with the novel approach. All participants completed the 7-item Generalized Anxiety Disorder Scale (GAD-7; Spitzer et al., 2006), the Penn State Worry Questionnaire (PSWQ; Meyer et al., 1990), as well as a novel 10-item Premonition Bias Questionnaire (PBQ; C. Chigwedere et al., unpublished). From pre- to post-treatment, results for both GAD (p=.001) and worry (p=.005) improved significantly. Clinically significant change or a post-treatment score within the normal population range were observed for both the GAD-7 and PSWQ. The change in believability of worry, measured on the PBQ was also significant from pre- to post-treatment (p=.008). Overall, the novel approach may be an alternative approach to treating GAD, with some potential, both as an adjunctive or standalone treatment. However, this is a small case series and the presented novel approach requires empirical support and evaluation in larger experimental studies.


Author(s):  
Jessica R. Morgan ◽  
Marlysa Sullivan ◽  
Akihiko Masuda ◽  
Erin Tully ◽  
Lindsey L. Cohen ◽  
...  

Sign in / Sign up

Export Citation Format

Share Document