scholarly journals Negative Life Events and Avoidant Coping are Associated with Poorer Long-Term Outcome in Older Adults Treated for Generalized Anxiety Disorder

2010 ◽  
Vol 1 (1) ◽  
pp. jep.003110 ◽  
Author(s):  
Catherine R. Ayers ◽  
Andrew Petkus ◽  
Lin Liu ◽  
Thomas L. Patterson ◽  
Julie Loebach Wetherell
Keyword(s):  
Older Adults ◽  
Anxiety Disorder ◽  
Life Events ◽  
Generalized Anxiety Disorder ◽  
Negative Life Events ◽  
Avoidant Coping ◽  
Generalized Anxiety ◽  
Term Outcome ◽  
Long Term Outcome

The objective of this investigation was to explore predictors of long-term outcome following treatment of generalized anxiety disorder (GAD) in older adults. A small sample of older adults (N = 27) were randomized into a modular cognitive behavioral therapy protocol or enhanced community treatment for 12 weeks and followed for one year. Results from random effects regression models indicated that baseline levels of anxiety symptoms, avoidant coping, and negative life events are significantly associated with anxiety across follow-up. These preliminary data suggest that negative life events and avoidant coping may merit further investigation as predictors of long-term treatment outcome in geriatric GAD.

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.

The Nottingham Study of Neurotic Disorder: predictors of 12-year outcome of dysthymic, panic and generalized anxiety disorder

2004 ◽  
Vol 34 (8) ◽  
pp. 1385-1394 ◽  
Author(s):  
PETER TYRER ◽  
HELEN SEIVEWRIGHT ◽  
TONY JOHNSON
Keyword(s):  
Anxiety Disorder ◽  
Personality Disorder ◽  
Generalized Anxiety Disorder ◽  
Depressive Disorders ◽  
Favourable Outcome ◽  
Dysthymic Disorder ◽  
Generalized Anxiety ◽  
Neurotic Disorder ◽  
Term Outcome ◽  
Long Term Outcome

Background. Controlled prospective studies of the simultaneous long-term outcome of several mental disorders are rare. This study sought to determine if there were important differences between the outcome of anxiety and depressive disorders after 12 years and to examine their main predictors.Method. A cohort of 210 people seen in general practice psychiatric clinics with a DSM-III diagnosis of generalized anxiety disorder (71), panic disorder (74), or dysthymic disorder (65), including combined anxiety-depressive disorder (cothymia) (67) was followed up after 12 years. Interview assessments of symptoms, social functioning and outcome were made, the latter using a new scale, the Neurotic Disorder Outcome Scale. Seventeen baseline predictors were also examined.Results. Data were obtained from 201 (96%) patients, 17 of whom had died. Only 73 (36%) had no DSM diagnosis at the time of follow-up. Using univariate and stepwise multiple linear regression those with cothymia, personality disorder, recurrent episodes and greater baseline self-rated anxiety and depression ratings had a worse outcome than others; initial diagnosis did not contribute significantly to outcome and instability of diagnosis over time was much more common than consistency.Conclusion. Only two out of five people with the common neurotic disorders have a good outcome despite alleged advances in treatment. Those with greater mood symptoms and pre-morbid personality disorder have the least favourable outcome. It is suggested that greater attention be paid to the concurrent treatment of personality disorder and environmental factors rather than symptoms as these may be the real cause of apparent treatment resistance.

scholarly journals Early Response to Psychotherapy and Long-Term Change in Worry Symptoms in Older Adults With Generalized Anxiety Disorder

2011 ◽  
Vol 19 (4) ◽  
pp. 347-356 ◽  
Author(s):  
Andrea Bradford ◽  
Jeffrey Cully ◽  
Howard Rhoades ◽  
Mark Kunik ◽  
Cynthia Kraus-Schuman ◽  
...  
Keyword(s):  
Older Adults ◽  
Anxiety Disorder ◽  
Generalized Anxiety Disorder ◽  
Early Response ◽  
Generalized Anxiety ◽  
Term Change

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.

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
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