Does intolerance of uncertainty mediate improvement in anger during group CBT for GAD? A preliminary investigation

2019 ◽  
Vol 47 (5) ◽  
pp. 585-593
Author(s):  
Judith M. Laposa ◽  
Katie Fracalanza

AbstractBackground:Individuals with generalized anxiety disorder (GAD) have elevated intolerance of uncertainty (IU) and anger, and IU mediates the relationship between GAD symptoms and anger.Aims:The current pilot study examined whether group cognitive behavioural therapy (CBT) improves anger in people with GAD, and the degree to which change in IU mediates improved anger.Method:Individuals diagnosed with GAD completed measures of worry, IU, and facets of anger, before and at the end of group CBT for GAD.Results:Worry, IU, and internally felt and outwardly expressed anger, reduced significantly over treatment, but anger control (inwardly and outwardly) did not. CBT for GAD led to improvement in both internally felt and outwardly expressed anger, even though anger is not directly targeted in this treatment. Improvement in IU significantly mediated improvement in internally felt and outwardly expressed anger.Conclusions:This preliminary study contributes to the literature on the importance of IU in understanding worry and other symptoms such as elevated anger, experienced by people with excessive worry.

1999 ◽  
Vol 33 (1) ◽  
pp. 70-76 ◽  
Author(s):  
Tian P. S. Oei ◽  
Alice E. O. Yeoh

Objective: This study aimed to investigate the impact of pre-existing medication on the outcome of group cognitive-behavioural therapy (CBT) in the treatment of patients with depression. Method: Of the 71 patients diagnosed with major depression who participated in group CBT, 25 were on medication (CBT-M) and 46 were unmedicated (CBT). The patients received 12 sessions of group CBT over a 3-month period. The dependent measures used were the Beck Depression Inventory, Zung Self-Rating Depression Scale, Automatic Thoughts Questionnaire, Hopelessness Scale, Dysfunctional Attitude Scale, Daily Activity Rating Scale and Daily Mood Rating Scale. Results: Both the CBT and CBT-M groups showed statistically significant improvement in depression scores and cognitive process measures. However, the rate of improvement for both groups on these measures did not differ. Conclusion: The study indicated that pre-existing antidepressant medication did not enhance or detract from the positive treatment outcome of depressed patients receiving a group CBT treatment.


2003 ◽  
Vol 182 (6) ◽  
pp. 498-504 ◽  
Author(s):  
Richard C. Oude Voshaar ◽  
Wim J. M. J. Gorgels ◽  
Audrey J. J. Mol ◽  
Anton J. L. M. Van Balkom ◽  
Eloy H. Van De Lisdonk ◽  
...  

BackgroundBenzodiazepine withdrawal programmes have never been experimentally compared with a nonintervention control condition.AimsTo evaluate the efficacy and feasibility of tapering off long-term benzodiazepine use in general practice, and to evaluate the value of additional group cognitive–behavioural therapy (CBT).MethodA 3-month randomised, controlled trial was conducted in which 180 people attempting to discontinue long-term benzodiazepine use were assigned to tapering off plus group CBT, tapering off alone or usual care.ResultsTapering off led to a significantly higher proportion of successful discontinuations than usual care (62% v. 21%). Adding group CBT did not increase the success rate (58% v. 62%). Neither successful discontinuation nor intervention type affected psychological functioning. Both tapering strategies showed good feasibility in general practice.ConclusionsTapering off is a feasible and effective way of discontinuing long-term benzodiazepine use in general practice. The addition of group CBT is of limited value.


2002 ◽  
Vol 30 (3) ◽  
pp. 351-360 ◽  
Author(s):  
Michele Furlong ◽  
Tian P. S. Oei

The present study sought to clarify the role of cognitive change in Cognitive Behavioural Therapy (CBT) by examining the relationship between depression outcome and changes to automatic thoughts and dysfunctional attitudes at different points of therapy. Thirty patients suffering from Major Depression (MDD) or Dysthymia attended the 12 sessions of a group CBT program. Multiple regressions found total scores on the Automatic Thoughts Questionnaire (ATQ) and cumulative change scores on the Dysfunctional Attitudes Scale (DAS) to predict scores on the Beck Depression Inventory (BDI) at later stages of therapy, though neither form of cognition was predictive from earlier stages of therapy. Only scores on the ATQ were significantly related to both cognitive and somatic subscales of the BDI, indicating that automatic thoughts are more directly related to cognitive change than dysfunctional attitudes. Overall findings suggest that significant reductions in both automatic thoughts and dysfunctional attitudes are related to non-clinical levels of depressive symptoms at the end of the treatment.


2021 ◽  
pp. 070674372110273
Author(s):  
Irena Milosevic ◽  
Duncan H. Cameron ◽  
Melissa Milanovic ◽  
Randi E. McCabe ◽  
Karen Rowa

Objective: Telehealth is being increasingly incorporated into the delivery of mental health care and has received widespread attention during the COVID-19 pandemic for its ability to facilitate care during physical distancing restrictions. Videoconferencing is a common telehealth modality for delivering psychotherapy and has demonstrated similar outcomes to those of face-to-face therapy. Cognitive behavioural therapy (CBT) is the most common psychotherapy evaluated across various telehealth modalities; however, studies on CBT delivered via videoconference, particularly in a group therapy format, are lacking. Further, little research exists on videoconference group CBT for anxiety disorders. Accordingly, the present study compared the outcomes of group CBT for anxiety and related disorders delivered via videoconference versus face-to-face. Method: Using a non-randomized design, data on attendance, dropout, clinical outcomes, and functional impairment were collected from 413 adult outpatients of a tertiary care anxiety disorders clinic who attended a CBT group for panic disorder/agoraphobia, social anxiety disorder, generalized anxiety disorder (GAD), or obsessive-compulsive disorder delivered either face-to-face (pre-COVID-19 pandemic) or via videoconference (since the onset of COVID-19 pandemic). Outcomes were assessed using well-validated self-report measures. Data were collected pre-treatment, across 12 weekly sessions, and post-treatment. Intent-to-treat analyses were applied to symptom outcome measures. Results: Face-to-face CBT conferred only a slight benefit over videoconference CBT for symptom outcomes across all groups, but when assessed individually, only the GAD group showed greater symptom improvement in the face-to-face format. Effect sizes for significant differences between the delivery formats were small. Participants in videoconference groups tended to have slightly higher attendance rates in some instances, whereas functional improvement and treatment dropout were comparable across the delivery formats. Conclusions: Results provide preliminary evidence that videoconference group CBT for anxiety and related disorders may be a promising and effective alternative to face-to-face CBT. Additional research is needed to establish equivalence between these delivery formats.


2021 ◽  
Author(s):  
Alissa Pencer ◽  
Victoria C. Patterson ◽  
Meghan A. Rossi ◽  
Lori Wozney

BACKGROUND Internet-based cognitive-behavioural therapy (iCBT) is a necessary step towards increasing the accessibility of mental health services. Yet, few iCBT programs have been evaluated for their fidelity to therapeutic principles of CBT or usability standards. Additionally, many existing iCBT programs do not include treatments targeting both anxiety and depression – commonly co-occurring conditions. OBJECTIVE Evaluate the usability and fidelity of Tranquility, a novel iCBT program for anxiety, to CBT principles, and engage in a co-design process to adapt Tranquility to include treatment elements for depression. METHODS CBT experts (n = 6) and mental health informed peers (n = 6) reviewed the iCBT program Tranquility. CBT experts assessed Tranquility’s fidelity to CBT principles and were asked to identify necessary interventions for depression using two simulated client case examples. Mental health informed peers engaged in two co-design focus groups to discuss adaptations to the existing anxiety program and the integration of interventions for depression. Both groups completed online surveys assessing Tranquility’s usability and the likelihood that they would recommend the program. RESULTS CBT experts’ mean rating of Tranquility’s fidelity to CBT was 91%, indicating a high fidelity to CBT. Five out of six CBT experts and all mental health informed peers (88% of participants) rated Tranquility as satisfactory, indicating that they may recommend Tranquility to others, and they rated its usability highly (M = 76.56, SD = 14.07). Mental health informed peers provided suggestions about how to leverage engagement with Tranquility (e.g., add incentives, notification control). CONCLUSIONS This preliminary study demonstrated Tranquility’s strong fidelity to CBT and usability standards. Results highlight the importance of involving stakeholders in the co-design process and future opportunities to increase engagement.


2019 ◽  
pp. 204946371989580
Author(s):  
Dianne Wilson ◽  
Shylie Mackintosh ◽  
Michael K Nicholas ◽  
G Lorimer Moseley ◽  
Daniel S J Costa ◽  
...  

This study explored whether the psychological composition of a group, with respect to mood, catastrophising, fear of movement and pain self-efficacy characteristics at baseline, is associated with individuals’ treatment outcomes following group cognitive behavioural therapy (CBT)-based programmes for chronic pain. Retrospective analyses of outcomes from two independently run CBT-based pain management programmes (Programme A: N = 317 and Programme B: N = 693) were conducted. Mixed modelling analyses did not consistently support the presence of associations between group median scores of depression, catastrophising or fear avoidance with outcomes for individuals in either programme. These results suggest that the psychological profiles of groups are not robust predictors of individual outcomes in CBT groups for chronic pain. By implication, efforts made to consider group composition with respect to psychological attributes may be unnecessary.


2006 ◽  
Vol 189 (6) ◽  
pp. 527-532 ◽  
Author(s):  
Christine Barrowclough ◽  
Gillian Haddock ◽  
Fiona Lobban ◽  
Steve Jones ◽  
Ron Siddle ◽  
...  

BackgroundThe efficacy of cognitive–behavioural therapy for schizophrenia is established, but there is less evidence for a group format.AimsTo evaluate the effectiveness of group cognitive – behavioural therapy for schizophrenia.MethodIn all, 113 people with persistent positive symptoms of schizophrenia were assigned to receive group cognitive – behavioural therapy or treatment as usual. The primary outcome was positive symptom improvement on the Positive and Negative Syndrome Scales. Secondary outcome measures included symptoms, functioning, relapses, hopelessness and self-esteem.ResultsThere were no significant differences between the cognitive-behavioural therapy and treatment as usual on measures of symptoms or functioning or relapse, but group cognitive – behavioural therapy treatment resulted in reductions in feelings of hopelessness and in low self-esteem.ConclusionsAlthough group cognitive – behavioural therapy may not be the optimum treatment method for reducing hallucinations and delusions, it may have important benefits, including feeling less negative about oneself and less hopeless for the future.


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