Cargando…
Psychological interventions for generalized anxiety disorder: Effects and predictors in a naturalistic outpatient setting
OBJECTIVE: 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 investigate...
Autores principales: | , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2023
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10004605/ https://www.ncbi.nlm.nih.gov/pubmed/36897860 http://dx.doi.org/10.1371/journal.pone.0282902 |
_version_ | 1784904875013832704 |
---|---|
author | Krzikalla, Clara Morina, Nexhmedin Andor, Tanja Nohr, Laura Buhlmann, Ulrike |
author_facet | Krzikalla, Clara Morina, Nexhmedin Andor, Tanja Nohr, Laura Buhlmann, Ulrike |
author_sort | Krzikalla, Clara |
collection | PubMed |
description | OBJECTIVE: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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. |
format | Online Article Text |
id | pubmed-10004605 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-100046052023-03-11 Psychological interventions for generalized anxiety disorder: Effects and predictors in a naturalistic outpatient setting Krzikalla, Clara Morina, Nexhmedin Andor, Tanja Nohr, Laura Buhlmann, Ulrike PLoS One Research Article OBJECTIVE: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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. Public Library of Science 2023-03-10 /pmc/articles/PMC10004605/ /pubmed/36897860 http://dx.doi.org/10.1371/journal.pone.0282902 Text en © 2023 Krzikalla et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Krzikalla, Clara Morina, Nexhmedin Andor, Tanja Nohr, Laura Buhlmann, Ulrike Psychological interventions for generalized anxiety disorder: Effects and predictors in a naturalistic outpatient setting |
title | Psychological interventions for generalized anxiety disorder: Effects and predictors in a naturalistic outpatient setting |
title_full | Psychological interventions for generalized anxiety disorder: Effects and predictors in a naturalistic outpatient setting |
title_fullStr | Psychological interventions for generalized anxiety disorder: Effects and predictors in a naturalistic outpatient setting |
title_full_unstemmed | Psychological interventions for generalized anxiety disorder: Effects and predictors in a naturalistic outpatient setting |
title_short | Psychological interventions for generalized anxiety disorder: Effects and predictors in a naturalistic outpatient setting |
title_sort | psychological interventions for generalized anxiety disorder: effects and predictors in a naturalistic outpatient setting |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10004605/ https://www.ncbi.nlm.nih.gov/pubmed/36897860 http://dx.doi.org/10.1371/journal.pone.0282902 |
work_keys_str_mv | AT krzikallaclara psychologicalinterventionsforgeneralizedanxietydisordereffectsandpredictorsinanaturalisticoutpatientsetting AT morinanexhmedin psychologicalinterventionsforgeneralizedanxietydisordereffectsandpredictorsinanaturalisticoutpatientsetting AT andortanja psychologicalinterventionsforgeneralizedanxietydisordereffectsandpredictorsinanaturalisticoutpatientsetting AT nohrlaura psychologicalinterventionsforgeneralizedanxietydisordereffectsandpredictorsinanaturalisticoutpatientsetting AT buhlmannulrike psychologicalinterventionsforgeneralizedanxietydisordereffectsandpredictorsinanaturalisticoutpatientsetting |