Open Access
Subscription Access
A 30-month follow-up of generalized anxiety disorder: Status after metacognitive therapy and intolerance of uncertainty-therapy
Abstract
Objectives: Although metacognitive therapy and intolerance-of-uncertainty therapy are considered efficacious treatments for generalized anxiety disorder, little is known about the long-term course in patients who engaged in treatment studies.
Method: We conducted a continuation study of patients with GAD who had participated in a randomized, delayed treatment controlled trial in which the relative efficacy of MCT and IUT were compared.
Results: Of the original 85 patients who completed the study, 34 were available for assessment of worry severity at 30-month follow-up. Both treatment groups showed maintenance of treatment gains from 6-month to 30-month follow-up assesment. However, MCT produced better results at long-term follow-up, which was reflected in statistically and clinically significant differences, and in terms of sustained efficacy (i.e., the degree in which patients who improved with treatment remained improved).
Conclusion: Both MCT and IUT may be associated with long-term benefits for patients diagnosed with GAD, with MCT performing significantly better than IUT, and showing greater sustained efficacy.
References
American Psychiatric Association (APA). Diagnostic and Statistical Manual of Mental Disorders, 5th edition. (DSM-5). Washington: APA, 2013.
Yonkers KA, Warshaw MG, Massion AO, Keller MB. Phenomenology and course of generalized anxiety disorder. Br J Psychiatry 1996;168: 308-13.
Fisher PL. The efficacy of psychological treatments for generalised anxiety disorder? In: Davey GCL, Wells A (eds). Worry and its psychological disorders: Theory, Assessment and Treatment (pp.359-378). Chichester: Wiley, 2006.
Wells A. Metacognition and worry: A cognitive model of generalized anxiety disorder. Behav Cogn Psychother 1995:23:301-20.
Dugas MJ, Ladouceur R. Treatment of generalised anxiety disorder: Targeting intolerance of uncertainty in two types of worry. Behav Modif 2000;24:635-58.
Van der Heiden C, Muris P, van der Molen HT. Effectiveness of cognitive therapy for generalized anxiety disorder: A randomized controlled trial comparing metacognitive therapy and intolerance-of-uncertainty therapy. Behav Res Ther 2012;50:100-9.
Dugas MJ, Ladouceur R, Léger E, Freeston MH, Langlois F, Provencher MD, Boisvert J-M. Group cognitive-behavioral therapy for generalized anxiety disorder: treatment outcome and long-term follow-up. J Consult Clin Psychol 2003;71:821-5.
Ladouceur R, Dugas MJ, Freeston MH, Léger E, Gagnon F, Thibodeau N. Efficacy of a cognitive-behavioral treatment for generalized anxiety disorder: evaluation in a controlled clinical trial. J Consult Clin Psychol 2000;68:957-64.
Van der Heiden C, Melchior K, de Stigter E. The effectiveness of group metacognitive therapy for generalised anxiety disorder: A pilot study. J Contemp Psychotherapy 2013;43:151-7.
Wells A, King P. Metacognitive therapy for generalized anxiety disorder: An open trial. J Behav Ther Exp Psychiatry 2006;37:206-12.
Wells A, Welford M, King P, Wisely J, Mendel E. A pilot randomized trial of metacognitive therapy versus applied relaxation in the treatment of adults with generalized anxiety disorder. Behav Res Ther 2010;48:429-34.
Westen D, Morrison K. A multidimensional meta-analysis of treatments for depression, panic, and generalized anxiety disorder: An empirical examination of the status of empirically supported therapies. J Consult Clin Psychol 2001;69: 875-99.
Meyer TJ, Miller ML, Metzger RL, Borkovec TD. Development and validation of the Penn State Worry Questionnaire. Behav Res Ther 1990;28:487-95.
Van Rijsoort S, Vervaeke G, Emmelkamp P. De Penn State Worry Questionnaire en de Worry Domains Questionnaire: Eerste resultaten bij een normale Nederlandse populatie. [The Penn State Worry Questionnaire and the Worry Domains Questionnaire: First results in a normal Dutch population.] Gedragstherapie 1997;30:121-8.
Clark DM, Ehlers A, McManus F, Hackmann A, Fennell M, Campbell M, Louis B. Cognitive therapy versus fluoxetine in generalized social phobia: A randomized placebo-controlled trial. J Consult Clin Psychol 2003;74:1058-67.
Willutzki U, Teismann T, Schulte D. Psychotherapy for social anxiety disorder: Long-term effectiveness of resource-oriented cognitive-behavioral therapy and cognitive therapy in social anxiety disorder. J Clin Psychol 2012;68:581-91.
Cohen J. A power primer. Psychol Bull 1992;112:155-9.
Jacobson NS, Truax P. Clinical significance: A statistical approach to defining meaningful change in psychotherapy research. J Consult Clin Psychol 1991;59:12-9.
DOI: http://dx.doi.org/10.5750/ejpch.v2i4.812
Refbacks
- There are currently no refbacks.