Worry themes in primary GAD, secondary GAD, and other anxiety disorders

Psychometric properties and factor structure of the Worry Domains Questionnaire

The Worry Domains Questionnaire (WDQ) is a content-based measure of nonpathological worry. The current study investigates an adapted WDQ for clinical assessment. The WDQ was completed by 570 participants (286 clinical, 284 nonclinical). Internal consistency of the WDQ domains was found to be adequate. Clinical participants obtained significantly higher WDQ scores than control participants. WDQ scores were moderately correlated with several clinical self-report measures. A seven-factor structure and a higher order worry factor model were separately subjected to structural equation modeling in the clinical sample. The factor groupings originally outlined by the scale's authors (with minor revisions) provided the best description of the clinical data set. Evidence of differences in the worry factor structures of clinical and control samples did emerge. This study provides initial support of the psychometric suitability of the adapted WDQ for use in clinical populations.

Efficacy of a cognitive-behavioral treatment for generalized anxiety disorder: evaluation in a controlled clinical trial

Recent advances in the understanding of worry have led to the development of treatments for generalized anxiety disorder (GAD). The present study tested a GAD treatment that targeted intolerance of uncertainty, erroneous beliefs about worry, poor problem orientation, and cognitive avoidance. Twenty-six primary GAD patients were randomly allocated to a treatment condition (n = 14) or a delayed treatment control condition (n = 12). Self-report, clinician, and significant other ratings assessed GAD and associated symptoms. The results show that the treatment led to statistically and clinically significant change at posttest and that gains were maintained at 6- and 12-month follow-ups. Furthermore, 20 of 26 participants (77%) no longer met GAD diagnostic criteria following treatment. With regard to the treatment's underlying model, the results show that intolerance of uncertainty significantly decreased over treatment and that gains were maintained at both follow-ups. Although nonspecific factors were not significant predictors of treatment outcome, their role in the treatment of GAD requires further investigation.