Anticipatory fear, worry and generalised anxiety.
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Qurʾān
القرآن6 shownVerses named for this subject by hand come first. The rest are found by the subject’s own Arabic and English senses and are shown as lexical matches, not as anchors anyone has confirmed.
Qur'ān 16:112English sense: fear | Arabic sense: الخوف, خوف
وَضَرَبَ ٱللَّهُ مَثَلࣰ ا قَرۡيَةࣰ كَانَتۡ ءَامِنَةࣰ مُّطۡمَئِنَّةࣰ يَأۡتِيهَا رِزۡقُهَا رَغَدࣰ ا مِّن كُلِّ مَكَانࣲ فَكَفَرَتۡ بِأَنۡعُمِ ٱللَّهِ فَأَذَٰقَهَا ٱللَّهُ لِبَاسَ ٱلۡجُوعِ وَٱلۡخَوۡفِ بِمَا كَانُواْ يَصۡنَعُونَ
God presents the example of a town that was secure and at ease, with provisions coming to it abundantly from all places. Then it became ungrateful for God’s blessings, so God afflicted it with the garment of famine and fear, for what its people had done
Qur'ān 2:155English sense: fear | Arabic sense: الخوف, خوف
وَلَنَبۡلُوَنَّكُم بِشَيۡءࣲ مِّنَ ٱلۡخَوۡفِ وَٱلۡجُوعِ وَنَقۡصࣲ مِّنَ ٱلۡأَمۡوَٰلِ وَٱلۡأَنفُسِ وَٱلثَّمَرَٰتِۗ وَبَشِّرِ ٱلصَّٰبِرِينَ
We shall certainly test you with fear and hunger, and loss of property, lives, and crops. But [Prophet], give good news to those who are steadfast
Qur'ān 21:103English sense: fear | Arabic sense: الفزع, فزع
لَا يَحۡزُنُهُمُ ٱلۡفَزَعُ ٱلۡأَكۡبَرُ وَتَتَلَقَّىٰهُمُ ٱلۡمَلَٰٓئِكَةُ هَٰذَا يَوۡمُكُمُ ٱلَّذِي كُنتُمۡ تُوعَدُونَ
They will have no fear of the great Terror: the angels will receive them with the words, ‘This is the Day you were promised!’
Qur'ān 33:19English sense: fear | Arabic sense: الخوف, خوف
أَشِحَّةً عَلَيۡكُمۡۖ فَإِذَا جَآءَ ٱلۡخَوۡفُ رَأَيۡتَهُمۡ يَنظُرُونَ إِلَيۡكَ تَدُورُ أَعۡيُنُهُمۡ كَٱلَّذِي يُغۡشَىٰ عَلَيۡهِ مِنَ ٱلۡمَوۡتِۖ فَإِذَا ذَهَبَ ٱلۡخَوۡفُ سَلَقُوكُم بِأَلۡسِنَةٍ حِدَادٍ أَشِحَّةً عَلَى ٱلۡخَيۡرِۚ أُوْلَٰٓئِكَ لَمۡ يُؤۡمِنُواْ فَأَحۡبَطَ ٱللَّهُ أَعۡمَٰلَهُمۡۚ وَكَانَ ذَٰلِكَ عَلَى ٱللَّهِ يَسِيرࣰ ا
who begrudge you [believers] any help. When fear comes, you [Prophet] see them looking at you with eyes rolling like someone in their death throes; when fear has passed, they attack you with sharp tongues and begrudge you any good. Such men do not believe, and God brings their deeds to nothing- that is all too easy for God
Qur'ān 4:83Arabic sense: الخوف, خوف
وَإِذَا جَآءَهُمۡ أَمۡرࣱ مِّنَ ٱلۡأَمۡنِ أَوِ ٱلۡخَوۡفِ أَذَاعُواْ بِهِۦۖ وَلَوۡ رَدُّوهُ إِلَى ٱلرَّسُولِ وَإِلَىٰٓ أُوْلِي ٱلۡأَمۡرِ مِنۡهُمۡ لَعَلِمَهُ ٱلَّذِينَ يَسۡتَنۢبِطُونَهُۥ مِنۡهُمۡۗ وَلَوۡلَا فَضۡلُ ٱللَّهِ عَلَيۡكُمۡ وَرَحۡمَتُهُۥ لَٱتَّبَعۡتُمُ ٱلشَّيۡطَٰنَ إِلَّا قَلِيلࣰ ا
Whenever news of any matter comes to them, whether concerning peace or war, they spread it about; if they referred it to the Messenger and those in authority among them, those seeking its meaning would have found it out from them. If it were not for God’s bounty and mercy towards you, you would almost all have followed Satan
Qur'ān 41:30English sense: fear | Arabic sense: تحزنوا
إِنَّ ٱلَّذِينَ قَالُواْ رَبُّنَا ٱللَّهُ ثُمَّ ٱسۡتَقَٰمُواْ تَتَنَزَّلُ عَلَيۡهِمُ ٱلۡمَلَٰٓئِكَةُ أَلَّا تَخَافُواْ وَلَا تَحۡزَنُواْ وَأَبۡشِرُواْ بِٱلۡجَنَّةِ ٱلَّتِي كُنتُمۡ تُوعَدُونَ
As for those who say, ‘Our Lord is God,’ and take the straight path towards Him, the angels come down to them and say, ‘Have no fear or grief, but rejoice in the good news of Paradise, which you have been promised
Tafsīr
التفسير6 shownCommentary on the verses above, at most two editions per verse.
en-asbab-al-nuzul-by-al-wahidi on 2:155en-asbab-al-nuzul-by-al-wahidicommentary on an ayah this subject surfaced
And We will indeed try you with something of fear and hunger, and decrease of wealth, souls, and fruits; and give good news to the patient. The custom of the Lord is that whenever He threatens the servant and shows harshness in a verse, then, right after that or before it, He caresses the servant and gives him hope. Thus in this verse He breaks the servant by mentioning those harsh things and varieties of trial. Then He gives good news, He caresses, and He says, “and give good news to the patient.” And, at the beginning of these verses He says, “Surely God is with the patient” [2:153]. Glory be to Him! How gentle and how merciful He is to His servants! And We will indeed try you. He says, “We will test you, sometimes with fear, sometimes with dread, sometimes with poverty, sometimes with hunger, sometimes with outward affliction, sometimes with inward sorrow.” The outward trial and evide
en-asbab-al-nuzul-by-al-wahidi on 21:103en-asbab-al-nuzul-by-al-wahidicommentary on an ayah this subject surfaced
The greatest terror shall not make them sorrow, and the angels will receive them: “This is the day that you were promised.” On the Day of Resurrection in the greatest gathering place and most tremendous courtyard, they will not hear from the angels the call “no good news” [25:22], nor the address, “Stand apart today, O offenders!” [36:59], nor the harsh call, “Slink into it, and do not talk to Me!” [23:108]. They will not hear the call of separation's pain, nor will they despair of mercy. Rather the angels will keep on coming, company after company, and they will give the good news: “This is the day that you were promised,” that is, “This is the day in which you have the promised reward.” Among them are those who will be received by the angels, and among them are those who will be addressed and made known by the King. God will say, “My servants, have you been yearning for Me?” He will sa
en-al-jalalayn on 16:112en-al-jalalayncommentary on an ayah this subject surfaced
And God strikes a similitude mathalan is substituted by the following qaryatan a town Mecca — meaning its inhabitants — secure from any raids never becoming agitated and peaceful without anyone ever needing to emigrate from it on account of anxiety or fear its provision coming to it plenteously abundantly from every place. But it rejected God’s graces by denying the Prophet s so God made it taste the garb of hunger and so they suffered seven years of drought and fear as a result of the raiding parties of the Prophet s all because of what they used to do.
en-al-jalalayn on 2:155en-al-jalalayncommentary on an ayah this subject surfaced
Surely We will try you with something of fear of an enemy and hunger by way of drought and diminution of goods as a result of destruction and lives as a result of slaughter death and disease and fruits by way of crop damage that is to say We will try you to see if you practise patience or not; yet give good tidings of Paradise to the patient during calamities;
en-al-jalalayn on 21:103en-al-jalalayncommentary on an ayah this subject surfaced
The Supreme Terror — which is that a servant be ordered off to the Fire shall not grieve them and the angels shall receive them upon their exiting from their graves saying to them ‘This is your day the one which you were promised’ during the life of the world.
en-tafisr-ibn-kathir on 16:112en-tafisr-ibn-kathircommentary on an ayah this subject surfaced
And Allah gives the example of a township (Makkah), it was secure and peaceful: its provision coming to it in abundance from every place, but it (its people) denied the favors of Allah. So Allah made it taste extreme hunger (famine) and fear, because of what they did (112)There has come to them a Messenger from among themselves, but they denied him, so the torment seized them while they were wrongdoers (113)
The Example of Makkah
This example refers to the people of Makkah, which had been secure, peaceful and stable, a secure sanctuary while men were being snatched away from everywhere outside of it. Whoever entered Makkah, he was safe, and he had no need to fear, as Allah said:
وَقَالُوا إِن نَّتَّبِعِ الْهُدَىٰ مَعَكَ نُتَخَطَّفْ مِنْ أَرْضِنَا ۚ أَوَلَمْ نُمَكِّن لَّهُمْ حَرَمًا آمِنًا يُجْبَىٰ إِلَيْهِ ثَمَرَاتُ كُلِّ شَيْءٍ رِّزْقًا مِّن لَّدُنَّا
(And they say: "If we follow th
Research library, full list
251 to 275 of 4,916The effect of mindfulness-based therapy on anxiety and depression: A meta-analytic review.
Objective: Although mindfulness-based therapy has become a popular treatment, little is known about its efficacy. Therefore, our objective was to conduct an effect size analysis of this popular intervention for anxiety and mood symptoms in clinical samples.
Method: We conducted a literature search using PubMed, PsycINFO, the Cochrane Library, and manual searches. Our meta-analysis was based on 39 studies totaling 1,140 participants receiving mindfulness-based therapy for a range of conditions, including cancer, generalized anxiety disorder, depression, and other psychiatric or medical conditions.
Results: Effect size estimates suggest that mindfulness-based therapy was moderately effective for improving anxiety (Hedges's g = 0.63) and mood symptoms (Hedges's g = 0.59) from pre- to posttreatment in the overall sample. In patients with anxiety and mood disorders, this intervention was asso…
matched on Anxiety Disorders (mesh), generalized anxiety (text)
Computer therapy for the anxiety and depressive disorders is effective, acceptable and practical health care: a meta-analysis.
Background: Depression and anxiety disorders are common and treatable with cognitive behavior therapy (CBT), but access to this therapy is limited.
Objective: Review evidence that computerized CBT for the anxiety and depressive disorders is acceptable to patients and effective in the short and longer term.
Method: Systematic reviews and data bases were searched for randomized controlled trials of computerized cognitive behavior therapy versus a treatment or control condition in people who met diagnostic criteria for major depression, panic disorder, social phobia or generalized anxiety disorder. Number randomized, superiority of treatment versus control (Hedges g) on primary outcome measure, risk of bias, length of follow up, patient adherence and satisfaction were extracted.
Principal findings: 22 studies of comparisons with a control group were identified. The mean effect size superior…
matched on Anxiety (mesh), generalized anxiety (text)
Second-generation antipsychotics for anxiety disorders.
Background: Anxiety disorders are common and disabling conditions, with a lifetime prevalence of 17% in the general population. Due to high rates of treatment resistance, there is interest in new pharmacological treatment options such as second-generation antipsychotics.
Objectives: To evaluate the efficacy and tolerability of second-generation antipsychotics as monotherapy or adjunctive treatment for people with anxiety disorders.
Search strategy: The Cochrane Depression, Anxiety and Neurosis Group's controlled trial registers (CCDANCTR-Studies and CCDANCTR-References) were searched up to 21 July 2010. The author team ran complementary searches on ClinicalTrials.gov.
Selection criteria: We included all randomised trials (RCTs) comparing second-generation antipsychotic drugs with placebo, benzodiazepines, pregabalin or antidepressants. Participants were people with generalised anxiety di…
matched on Anxiety Disorders (mesh), generalised anxiety (text)
Hydroxyzine for generalised anxiety disorder.
Background: Generalised anxiety disorder (GAD) is a common chronic long-term psychiatric disorder, particularly frequent in primary care. There are several treatment options available, both non-pharmacological (i.e. cognitive behavioral therapy) and pharmacological. Among the pharmacological interventions, antidepressants, buspirone and benzodiazepines (BDZs) have been studied in GAD. Hydroxyzine is an anti-histamine medication which has been used in the treatment of anxiety.
Objectives: 1. To determine the efficacy of hydroxyzine in comparison with placebo or any other active agent in alleviating the acute symptoms of GAD. 2. To review acceptability of treatment with hydroxyzine in comparison with placebo or any other active agent. 3. To investigate the adverse effects of hydroxyzine in comparison with other active agents.
Search strategy: The Cochrane Depression, Anxiety and Neurosis G…
matched on Anxiety Disorders (mesh), generalised anxiety (text)
Siev J, Chambless DL (2007)meta-analysisMEDLINE-indexed journal, not yet read by usJournal of consulting and clinical psychology69 citations Specificity of treatment effects: cognitive therapy and relaxation for generalized anxiety and panic disorders.
The aim of this study was to address claims that among bona fide treatments no one is more efficacious than another by comparing the relative efficacy of cognitive therapy (CT) and relaxation therapy (RT) in the treatment of generalized anxiety disorder (GAD) and panic disorder without agoraphobia (PD). Two fixed-effects meta-analyses were conducted, for GAD and PD separately, to review the treatment outcome literature directly comparing CT with RT in the treatment of those disorders. For GAD, CT and RT were equivalent. For PD, CT, which included interoceptive exposure, outperformed RT on all panic-related measures, as well as on indices of clinically significant change. There is ample evidence that both CT and RT qualify as bona fide treatments for GAD and PD, for which they are efficacious and intended to be so. Therefore, the finding that CT and RT do not differ in the treatment of GA…
matched on Anxiety Disorders (mesh), generalized anxiety (text)
An evaluation of the cardiovascular safety profile of duloxetine: findings from 42 placebo-controlled studies.
Background and objective: In recent years, new classes of medication, such as the serotonin-noradrenaline reuptake inhibitors (SNRIs), have been developed for use in the treatment of major depressive disorder (MDD). For many years, treatment options were largely limited to the use of monoamine oxidase inhibitors (MAOIs), tricyclic antidepressants (TCAs) and selective serotonin reuptake inhibitors (SSRIs). However, there have been published reports of orthostatic hypotension, arrhythmias and corrected QT (QTc) interval changes in patients treated with TCAs. As new medications become available, it is important to understand how their cardiovascular safety profile compares with that of more established agents to aid clinicians and patients in choosing the best treatment options. This study was designed to evaluate the cardiovascular safety profile of the SNRI duloxetine through evaluation o…
matched on Anxiety Disorders (mesh), generalised anxiety (text)
Cognitive behavioural therapy for depression, panic disorder and generalized anxiety disorder: a meta-regression of factors that may predict outcome.
Objective: To determine which factors impact on the efficacy of cognitive behavioural therapy (CBT) for depression and anxiety. Factors considered include those related to clinical practice: disorder, treatment type, duration and intensity of treatment, mode of therapy, type and training of therapist and severity of patients. Factors related to the conduct of the trial were also considered, including: year of study, country of study, type of control group, language, number of patients and percentage of dropouts from the trial.
Method: We used the technique of meta-analysis to determine an overall effect size (standardized mean difference calculated using Hedges' g) and meta-regression to determine the factors that impact on this effect size. We included randomized controlled trials with a wait list, pill placebo or attention/psychological placebo control group. Study participants had to …
matched on Anxiety Disorders (mesh), generalized anxiety (text)
Specific anxiety and depression symptoms are risk factors for the onset of suicidal ideation and suicide attempts in youth.
Background: Suicidality research has typically focused on affective disorders to identify at-risk youth. Investigating the predictive role of individual symptoms, particularly anxiety symptoms, may allow for preventative targeting of additional risk factors for suicidal ideation and attempts.
Methods: This analysis used the Sources of Strength Australia project dataset, a cluster randomised controlled trial which assessed the impact of a schools-based intervention for youth help-seeking over 18 months (Calear et al., 2022). Symptoms of anxiety, depression and distress at baseline were used to predict the onset of suicidal ideation, planning for suicide and suicide attempts at 18 months.
Results: Worry, lack of sleep and anxiety interfering with everyday activities at baseline predicted new onset of suicidal ideation 18 months later. Worry about the future and past, reduced appetite and a…
matched on Anxiety (mesh), anxiety symptoms (text), worry (text)
Internet-delivered interpretation training reduces worry and anxiety in individuals with generalized anxiety disorder: A randomized controlled experiment.
Objective: Generalized anxiety disorder (GAD) is a debilitating condition, characterized by negative interpretations about ambiguous situations. This study tested whether entirely internet-delivered interpretation training [cognitive bias modification (CBM)] versus control promotes positive interpretations and reduces worry and anxiety in individuals with GAD, with or without depression. Method: A two-arm (CBM; control) parallel-group randomized controlled experiment. Assessments were preintervention (T0), postintervention (T1), 1-month (T2) postintervention, and 3-month (T3) postintervention. Participants with GAD (with or without comorbid depression) were randomly allocated to either CBM (n = 115) or control (n = 115). Participants, but not researchers, were blind to allocated condition. Participants completed up to 10 online CBM or control sessions across 1 month. Interpretation bias …
matched on Anxiety Disorders (mesh), generalized anxiety (text), worry (text)
Brief Online Cognitive Behavioural Intervention for Dysfunctional Worry Related to the COVID-19 Pandemic: A Randomised Controlled Trial.
Introduction: Worries about the immediate and long-term consequences of the COVID-19 pandemic may for some individuals develop into pervasive worry that is disproportionate in its intensity or duration and significantly interferes with everyday life.
Objective: The aim of this study was to investigate if a brief self-guided, online psychological intervention can reduce the degree of dysfunctional worry related to the COVID-19 pandemic and associated symptoms.
Methods: 670 adults from the Swedish general population reporting daily uncontrollable worry about CO-VID-19 and its possible consequences (e.g., illness, death, the economy, one's family) were randomised (1:1 ratio) to a 3-week self-guided, online cognitive behavioural intervention targeting dysfunctional COVID-19 worry and associated symptoms, or a waiting list of equal duration. The primary outcome measure was a COVID-19 adapted …
matched on Anxiety (mesh), generalised anxiety (text), worry (text)
Augmenting the unified protocol for transdiagnostic treatment of emotional disorders with transcranial direct current stimulation in individuals with generalized anxiety disorder and comorbid depression: A randomized controlled trial.
Background: The aim of the current study was to compare the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP) with and without transcranial direct current stimulation (tDCS) in individuals suffering from generalized anxiety disorder (GAD) and comorbid depression.
Methods: A total of 43 individuals diagnosed with GAD and comorbid depression enrolled in a randomized controlled trial (IRCT20140929019334N1). Participants were randomly assigned to three groups including UP with tDCS (UP+tDCS; n = 15), UP alone (UP; n = 13) or wait-list control (n = 15). GAD and depression symptoms, worry severity, anxiety sensitivity, and intolerance of uncertainty were assessed at baseline, post-treatment and 3-month follow-up.
Results: Treatment with both UP+tDCS and UP alone resulted in significant lower ratings across all measures relative to wait-list controls at post-treatment a…
matched on Anxiety Disorders (mesh), generalized anxiety (text), worry (text)
Zainal NH, Newman MG (2018)randomised controlled trialMEDLINE-indexed journal, not yet read by usJournal of affective disorders33 citations Worry amplifies theory-of-mind reasoning for negatively valenced social stimuli in generalized anxiety disorder.
Background: Theory-of-mind (ToM) is the ability to accurately infer others' thoughts and feelings. In generalized anxiety disorder (GAD), cognitive and emotion regulation theories allude to the plausibility that ToM is conditional on the degree of individuals' state worry, a hallmark symptom. GAD and state worry may interact to predict ToM constructs. However, no experiments have directly tested such interactional hypotheses, and used ToM as a framework to advance understanding of social cognition in GAD. This study therefore aimed to address this gap.
Methods: 171 participants (69 GAD, 102 Controls) were randomly assigned to either a Worry or Relaxation induction and completed well-validated ToM decoding (Reading the Mind in the Eyes Test) and reasoning (Movie for the Assessment of Social Cognition) tasks.
Results: GAD status significantly interacted with state worry to predict accuracy…
matched on Anxiety Disorders (mesh), generalized anxiety (text), worry (text)
The effects of adaptive working memory training and mindfulness meditation training on processing efficiency and worry in high worriers.
Worry is the principle characteristic of generalised anxiety disorder, and has been linked to deficient attentional control, a main function of working memory (WM). Adaptive WM training and mindfulness meditation practice (MMP) have both shown potential to increase attentional control. The present study hence investigates the individual and combined effects of MMP and a dual adaptive n-back task on a non-clinical, randomised sample of high worriers. 60 participants were tested before and after seven days of training. Assessment included self-report questionnaires, as well as performance tasks measuring attentional control and working memory capacity. Combined training resulted in continued reduction in worry in the week after training, highlighting the potential of utilising n-back training as an adjunct to established clinical treatment. Engagement with WM training correlated with immed…
matched on Anxiety (mesh), generalised anxiety (text), worry (text)
A BRIEF ECOLOGICAL MOMENTARY INTERVENTION FOR GENERALIZED ANXIETY DISORDER: A RANDOMIZED CONTROLLED TRIAL OF THE WORRY OUTCOME JOURNAL.
Background: The efficacy of many cognitive behavioral component interventions has not been examined, with worry outcome monitoring among them.
Methods: To address this issue, 51 participants with clinical levels of generalized anxiety disorder were randomly assigned to a treatment or control condition for 10 days. The treatment condition consisted of a brief ecological momentary intervention termed the Worry Outcome Journal (WOJ). WOJ participants recorded worries and tracked their outcomes, rating worry distress, interference, and expected outcome probabilities. Thought log (TL) control participants completed a record of their everyday thoughts and rated associated distress. All participants made four entries on paper each day when randomly prompted by text message. They then entered their paper contents online each night. After 30 days they reviewed their contents electronically and co…
matched on Anxiety Disorders (mesh), generalized anxiety (text), worry (text)
Repetitive transcranial magnetic stimulation for generalised anxiety disorder: a pilot randomised, double-blind, sham-controlled trial.
Background: Repetitive transcranial magnetic stimulation (rTMS) holds promise for treating generalised anxiety disorder (GAD) but has only been studied in uncontrolled research.
Aims: This is the first randomised controlled trial (clinicaltrials.gov: NCT01659736) to investigate the efficacy and neural correlates of rTMS in GAD.
Method: Twenty five participants (active n = 13; sham, n = 12) enrolled. rTMS was targeted at the right dorsolateral prefrontal cortex (DLPFC, 1 Hz, 90% resting motor threshold).
Results: Response and remission rates were higher in the active v. sham groups and there were significant group × time interactions for anxiety, worry and depressive symptoms, favouring active v. sham. In addition, right DLPFC activation during a decision-making gambling task increased at post-treatment for active rTMS only, and changes in neuroactivation correlated significantly with cha…
matched on Anxiety Disorders (mesh), generalised anxiety (text), worry (text)
Reductions in experiential avoidance as a mediator of change in symptom outcome and quality of life in acceptance-based behavior therapy and applied relaxation for generalized anxiety disorder.
As a field, we lack information about specific mechanisms that are responsible for changes that occur over the course of treatments for anxiety disorders (Kazdin, 2007). Identifying these mechanisms would help streamline evidence-based approaches, increase treatment response rates, and aid in the dissemination and implementation of evidence-based approaches in diverse contexts. The current study examined reductions in experiential avoidance (EA; Hayes, Wilson, Gifford, Follette, & Strosahl, 1996), attempts to control or eliminate distressing internal experiences, regardless of behavioral consequences, as a potential mechanism of change in participants with a principal diagnosis of generalized anxiety disorder (GAD) receiving either acceptance-based behavior therapy (ABBT) or applied relaxation (AR). Participants' EA scores across treatment on the Acceptance and Action Questionnaire (AAQ)…
matched on Anxiety Disorders (mesh), generalized anxiety (text), worry (text)
Adult attachment as a moderator of treatment outcome for generalized anxiety disorder: Comparison between cognitive-behavioral therapy (CBT) plus supportive listening and CBT plus interpersonal and emotional processing therapy.
Objective: To determine whether baseline dimensions of adult insecure attachment (avoidant and anxious) moderated outcome in a secondary analysis of a randomized controlled trial comparing cognitive-behavioral therapy (CBT) plus supportive listening (CBT + SL) versus CBT plus interpersonal and emotional processing therapy (CBT + I/EP).
Method: Eighty-three participants diagnosed with generalized anxiety disorder (GAD) were recruited from the community and assigned randomly to CBT + SL (n = 40) or to CBT + I/EP (n = 43) within a study using an additive design. PhD-level psychologists treated participants. Blind assessors evaluated participants at pretreatment, posttreatment, 6-month, 12-month, and 2-year follow-up with a composite of self-report and assessor-rated GAD symptom measures (Penn State Worry Questionnaire, Hamilton Anxiety Rating Scale, Clinician's Severity Rating). Avoidant an…
matched on Anxiety Disorders (mesh), generalized anxiety (text), worry (text)
A randomized controlled trial of telephone-delivered cognitive-behavioral therapy for late-life anxiety disorders.
Objectives: Older adults face a number of barriers to receiving psychotherapy, such as a lack of transportation and access to providers. One way to overcome such barriers is to provide treatment by telephone. The purpose of this study was to examine the effects of cognitive behavioral therapy delivered by telephone (CBT-T) to older adults diagnosed with an anxiety disorder.
Design: Randomized controlled trial.
Setting: Participants' homes.
Participants: Sixty participants age 60 and older with a diagnosis of generalized anxiety disorder, panic disorder, or anxiety disorder not otherwise specified.
Intervention: CBT-T versus information-only comparison.
Measurements: Coprimary outcomes included worry (Penn State Worry Questionnaire) and general anxiety (State Trait Anxiety Inventory). Secondary outcomes included clinician-rated anxiety (Hamilton Anxiety Rating Scale), anxiety sensitivity …
matched on Anxiety Disorders (mesh), generalized anxiety (text), worry (text)
The Pittsburgh Sleep Quality Index in older primary care patients with generalized anxiety disorder: psychometrics and outcomes following cognitive behavioral therapy.
The Pittsburgh Sleep Quality Index (PSQI) is a widely used, comprehensive self-report measure of sleep quality and impairment, which has demonstrated good psychometric properties within various populations, including older adults. However, the psychometric properties of the PSQI and its component scores have not been evaluated for older adults with generalized anxiety disorder (GAD). Additionally, changes in PSQI global or component scores have not been reported following cognitive-behavioral treatment (CBT) of late-life GAD. This study examined (1) the psychometric properties of the PSQI within a sample of 216 elderly primary care patients age 60 or older with GAD who were referred for treatment of worry and/or anxiety; as well as (2) response to CBT, relative to usual care, for 134 patients with principal or coprincipal GAD. The PSQI demonstrated good internal consistency reliability a…
matched on Anxiety Disorders (mesh), generalized anxiety (text), worry (text)
Aldao A, Mennin DS (2012)randomised controlled trialMEDLINE-indexed journal, not yet read by usBehaviour research and therapy50 citations Paradoxical cardiovascular effects of implementing adaptive emotion regulation strategies in generalized anxiety disorder.
Recent models of generalized anxiety disorder (GAD) have expanded on Borkovec's avoidance theory by delineating emotion regulation deficits associated with the excessive worry characteristic of this disorder (see Behar, DiMarco, Hekler, Mohlman, & Staples, 2009). However, it has been difficult to determine whether emotion regulation is simply a useful heuristic for the avoidant properties of worry or an important extension to conceptualizations of GAD. Some of this difficulty may arise from a focus on purported maladaptive regulation strategies, which may be confounded with symptomatic distress components of the disorder (such as worry). We examined the implementation of adaptive regulation strategies by participants with and without a diagnosis of GAD while watching emotion-eliciting film clips. In a between-subjects design, participants were randomly assigned to accept, reappraise, or …
matched on Anxiety Disorders (mesh), generalized anxiety (text), worry (text)
Wetherell JL, Afari N, Ayers CR, Stoddard JA, Ruberg J, Sorrell JT, Liu L, Petkus AJ, Thorp SR, Kraft A, Patterson TL (2011)randomised controlled trialMEDLINE-indexed journal, not yet read by usBehavior therapy72 citations Acceptance and Commitment Therapy for generalized anxiety disorder in older adults: a preliminary report.
Some evidence suggests that acceptance-based approaches such as Acceptance and Commitment Therapy (ACT) may be well-suited to geriatric generalized anxiety disorder (GAD). The primary goal of this project was to determine whether ACT was feasible for this population. Seven older primary-care patients with GAD received 12 individual sessions of ACT; another 9 were treated with cognitive-behavioral therapy. No patients dropped out of ACT, and worry and depression improved. Findings suggest that ACT may warrant a large-scale investigation with anxious older adults.
matched on Anxiety Disorders (mesh), generalized anxiety (text), worry (text)
Early response to psychotherapy and long-term change in worry symptoms in older adults with generalized anxiety disorder.
Objectives: To determine the association of early and long-term reductions in worry symptoms after cognitive behavior therapy (CBT) for generalized anxiety disorder (GAD) in older adults.
Design: Substudy of larger randomized controlled trial.
Setting: Family medicine clinic and large multispecialty health organization in Houston, TX, between March 2004 and August 2006.
Participants: Patients (N = 76) aged 60 years or older with a principal or coprincipal diagnosis of GAD, excluding those with significant cognitive impairment, bipolar disorder, psychosis, or active substance abuse.
Intervention: CBT, up to 10 sessions for 12 weeks, or enhanced usual care (regular, brief telephone calls, and referrals to primary care provider as needed).
Measurements: Penn State Worry Questionnaire (PSWQ) administered by telephone at baseline, 1 month (mid treatment), 3 months (posttreatment), and at 3-mo…
matched on Anxiety Disorders (mesh), generalized anxiety (text), worry (text)
A randomized controlled trial of cognitive-behavioral therapy for generalized anxiety disorder with integrated techniques from emotion-focused and interpersonal therapies.
Objective: Recent models suggest that generalized anxiety disorder (GAD) symptoms may be maintained by emotional processing avoidance and interpersonal problems.
Method: This is the first randomized controlled trial to test directly whether cognitive-behavioral therapy (CBT) could be augmented with the addition of a module targeting interpersonal problems and emotional processing. Eighty-three primarily White participants (mean age = 37) with a principle diagnosis of GAD were recruited from the community. Participants were assigned randomly to CBT plus supportive listening (n = 40) or to CBT plus interpersonal and emotional processing therapy (n = 43) within a study using an additive design. Doctoral-level psychologists with full-time private practices treated participants in an outpatient clinic. Using blind assessors, participants were assessed at pretreatment, posttreatment, 6-month, …
matched on Anxiety Disorders (mesh), generalized anxiety (text), worry (text)
Evaluating the cognitive avoidance model of generalised anxiety disorder: impact of worry on threat appraisal, perceived control and anxious arousal.
Generalised anxiety disorder (GAD) is characterised by persistent and uncontrollable worry. According to the cognitive avoidance theory of GAD, worry may function as an affective dampening strategy motivated by intolerance of negative emotional states. By facilitating avoidance of more distressing cognitions and associated affect, worry is said to preclude modification of the fear representation in memory, maintaining threat associations and perpetuating further anxiety and worry. The present study evaluated these assumptions in a treatment-seeking GAD sample. Sixty-one participants were randomly allocated to conditions in which they were instructed to worry, imaginally process or relax in response to an anxiety trigger. Results supported the detrimental impact of worry, showing maintained threat expectancies and decreased control perceptions compared to other modes of processing. Howeve…
matched on Anxiety Disorders (mesh), generalised anxiety (text), worry (text)
A pilot randomized trial of metacognitive therapy vs applied relaxation in the treatment of adults with generalized anxiety disorder.
Metacognitive Therapy (MCT) and Applied Relaxation (AR) were compared in a pilot treatment trial of generalized anxiety disorder (GAD). Twenty outpatients meeting criteria for DSM-IV-TR GAD were assessed before treatment, after treatment and at 6 m and 12 m follow-up. The patients were randomized and treated individually for 8-12 weekly sessions. There was no drop-out from MCT and 10% at 6 m follow-up from AR. At post-treatment and at both follow-up points MCT was superior to AR. Standardized recovery rates for MCT at post-treatment were 80% on measures of worry and trait-anxiety compared with 10% following AR. At 6 m follow-up recovery rates for MCT were 70% on both measures compared with 10% and 20% for AR. At 12 m follow-up recovery rates for MCT were 80% (worry) and 60% (trait-anxiety) compared with 10% and 20% following AR. The recovery rates for MCT are similar to those obtained in…
matched on Anxiety Disorders (mesh), generalized anxiety (text), worry (text)