TY - JOUR
T1 - Early response to psychotherapy and long-term change in worry symptoms in older adults with generalized anxiety disorder
AU - Bradford, Andrea
AU - Cully, Jeffrey
AU - Rhoades, Howard
AU - Kunik, Mark
AU - Kraus-Schuman, Cynthia
AU - Wilson, Nancy
AU - Stanley, Melinda
N1 - Funding Information:
This research was supported by a grant from the National Institute of Mental Health (NIMH) (R01- MH53932) for $1,826,539 from 2003 to 2008 (to MS) and supported in part by the Houston Center for Quality of Care & Utilization Studies, Health Services Research and Development Service, Office of Research and Development, Department of Veterans Affairs (HFP90–020).
PY - 2011/4
Y1 - 2011/4
N2 - 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-month intervals through 15 months (1-year follow-up). The authors used binary logistic regression analysis to determine the association between early (1 month) response and treatment responder status (reduction of more than 8.5 points on the PSWQ) at 3 and 15 months. The authors also used hierarchical linear modeling to determine the relationship of early response to the trajectory of score change after posttreatment. Results: Reduction in PSWQ scores after the first month predicted treatment response at posttreatment and follow-up, controlling for treatment arm and baseline PSWQ score. The magnitude of early reduction also predicted the slope of score change from posttreatment through the 15-month assessment. Conclusion: Early symptom reduction is associated with long-term outcomes after psychotherapy in older adults with GAD.
AB - 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-month intervals through 15 months (1-year follow-up). The authors used binary logistic regression analysis to determine the association between early (1 month) response and treatment responder status (reduction of more than 8.5 points on the PSWQ) at 3 and 15 months. The authors also used hierarchical linear modeling to determine the relationship of early response to the trajectory of score change after posttreatment. Results: Reduction in PSWQ scores after the first month predicted treatment response at posttreatment and follow-up, controlling for treatment arm and baseline PSWQ score. The magnitude of early reduction also predicted the slope of score change from posttreatment through the 15-month assessment. Conclusion: Early symptom reduction is associated with long-term outcomes after psychotherapy in older adults with GAD.
KW - Psychotherapy
KW - generalized anxiety disorder
KW - older adults
UR - http://www.scopus.com/inward/record.url?scp=79953751207&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=79953751207&partnerID=8YFLogxK
U2 - 10.1097/JGP.0b013e3181f18061
DO - 10.1097/JGP.0b013e3181f18061
M3 - Article
C2 - 21427643
AN - SCOPUS:79953751207
SN - 1064-7481
VL - 19
SP - 347
EP - 356
JO - American Journal of Geriatric Psychiatry
JF - American Journal of Geriatric Psychiatry
IS - 4
ER -