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Zhang Q, Sun H, Xin Y, Li X, Shao X. Studies on Pain Associated with Anxiety or Depression in the Last 10 Years: A Bibliometric Analysis. J Pain Res 2024; 17:133-149. [PMID: 38196966 PMCID: PMC10775703 DOI: 10.2147/jpr.s436500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 12/21/2023] [Indexed: 01/11/2024] Open
Abstract
Background The prevalence of pain comorbid and anxiety/depression in clinical observations has been high, and the number of related publications has increased in recent years. Nevertheless, few studies have used bibliometric methods to analyze the scientific research on comorbid pain and depression/anxiety. The aim of this study was to systematically examine the trends in global scientific research on comorbid pain and depression/anxiety from 2012 to 2022. Methods Papers published between 2012 and 2022 were identified in the Web of Science database. Publications that examined comorbid pain and depression/anxiety were included. The language was limited to English. CiteSpace, Excel and VOSviewer were used to analyze the volume of publications, countries, institutions, authors, cocited authors, and keywords. Results A total of 30,290 papers met the inclusion criteria of the study. Using CiteSpace, VOSviewer and Excel, the results showed that the United States (10,614 publications), Harvard University (1195 publications), and Jensen, Mark P. (77 publications) were the most productive country, institution, and author, respectively. The hotspots and frontiers were "relationship between depression and pain", "gender differences in pain and depression/anxiety domains", "study of specific pain types with depression/anxiety", "treatment of pain combined with anxiety/depression", and "effects of COVID-19 on patients with pain combined with depression/anxiety". Conclusion These findings indicate a growing interest in the field of comorbid pain and depression/anxiety. The research has been broad and deep, but there is still much room for growth. Furthermore, there is a need for more mature global collaborative networks as well as more high-quality research results in the future.
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Affiliation(s)
- Qianyuan Zhang
- Key Laboratory of Acupuncture and Neurology of Zhejiang Province, Department of Neurobiology and Acupuncture Research, The Third Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, 310053, People’s Republic of China
| | - Haiju Sun
- Key Laboratory of Acupuncture and Neurology of Zhejiang Province, Department of Neurobiology and Acupuncture Research, The Third Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, 310053, People’s Republic of China
| | - Yinuo Xin
- Key Laboratory of Acupuncture and Neurology of Zhejiang Province, Department of Neurobiology and Acupuncture Research, The Third Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, 310053, People’s Republic of China
| | - Xiaoyu Li
- Key Laboratory of Acupuncture and Neurology of Zhejiang Province, Department of Neurobiology and Acupuncture Research, The Third Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, 310053, People’s Republic of China
| | - Xiaomei Shao
- Key Laboratory of Acupuncture and Neurology of Zhejiang Province, Department of Neurobiology and Acupuncture Research, The Third Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, 310053, People’s Republic of China
- Key Laboratory for Research of Acupuncture Treatment and Transformation of Emotional Diseases, The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, 310009, People’s Republic of China
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Pashak TJ, Bradley SM, Trierweiler EJ. Many Hands Make Light Work: Group Therapy on College Campuses Is Efficient, Effective, Enticing, and Essential. JOURNAL OF COLLEGE STUDENT PSYCHOTHERAPY 2022. [DOI: 10.1080/87568225.2022.2155600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Travis J. Pashak
- Department of Psychology, Saginaw Valley State University, University Center, Michigan, USA
| | | | - Emma J. Trierweiler
- The Virginia Consortium Program in Clinical Psychology, Norfolk, Virginia, USA
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Saucedo-Uribe E, Treviño-Lozano J, González-Mallozzi PJ, Enríquez-Navarro MK, de la Cruz-de la Cruz C, Rangel-Gómez AN, Carranza-Navarro F, Pardiñaz-García DD, Fuentes-Garza JM. Anxiety in Mexican adults throughout the COVID-19 pandemic: A cross sectional study. Arch Psychiatr Nurs 2022; 41:201-207. [PMID: 36428050 PMCID: PMC9422398 DOI: 10.1016/j.apnu.2022.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Revised: 08/11/2022] [Accepted: 08/21/2022] [Indexed: 12/14/2022]
Abstract
INTRODUCTION Perceived fear during a pandemic along with measures used to contain it can develop or intensify anxiety symptoms. In Mexico, information on the psychological impact of the COVID-19 pandemic in the general population is scarce. OBJECTIVE We examined the prevalence and factors associated with anxiety during the COVID-19 outbreak in a Mexican sample. METHOD We conducted a cross sectional study from June 15, 2020, to January 31, 2021, in a state in north-eastern Mexico, using an online survey. Beck Anxiety Inventory was used to determine the prevalence and severity of anxiety. RESULTS The overall prevalence of anxiety was 43.5 %. Categories with the highest anxiety prevalence within their groups were women (46.2 %), age group of 18-30 years (47.3 %), higher level of education (43 %), students (48.8 %) and people who weren't currently with a couple (47.3 %). Additionally, we found that people who reported clinically significant anxiety were more likely to be women, ages 18-30 years, not currently partnered and currently living with a psychiatric disorder. Moreover, patients with clinically significant anxiety were more likely to be diagnosed with a mood, anxiety, trauma and stress, or an eating disorder. We also observed that being a woman and having at least one psychiatric disorder were independent factors related to a positive anxiety screening. DISCUSSION AND CONCLUSION COVID-19 outbreak results in considerable increase in anxiety symptoms among the Mexican population. It is important to acknowledge the psychological impact of contingency situations to provide information that can allow establishing preventive and therapeutic strategies.
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Affiliation(s)
- Erasmo Saucedo-Uribe
- Department of Psychiatry, Hospital Universitario "Dr. José Eleuterio González", Av. Francisco I. Madero n/n. & Av. Gonzalitos, Mitras Centro P.C. 64460, Monterrey, Nuevo León, Mexico; Advanced Neuroscience Center UANL, Hospital Universitario "Dr. José Eleuterio González", Av. Francisco I. Madero n/n. & Av. Gonzalitos, Mitras Centro P.C. 64460, Monterrey, Nuevo León, Mexico.
| | - Jessica Treviño-Lozano
- Department of Psychiatry, Hospital Universitario "Dr. José Eleuterio González", Av. Francisco I. Madero n/n. & Av. Gonzalitos, Mitras Centro P.C. 64460, Monterrey, Nuevo León, Mexico
| | - Pedro Jehú González-Mallozzi
- Advanced Neuroscience Center UANL, Hospital Universitario "Dr. José Eleuterio González", Av. Francisco I. Madero n/n. & Av. Gonzalitos, Mitras Centro P.C. 64460, Monterrey, Nuevo León, Mexico
| | - Moisés Karika Enríquez-Navarro
- Advanced Neuroscience Center UANL, Hospital Universitario "Dr. José Eleuterio González", Av. Francisco I. Madero n/n. & Av. Gonzalitos, Mitras Centro P.C. 64460, Monterrey, Nuevo León, Mexico
| | - Carlos de la Cruz-de la Cruz
- Faculty of Medicine, Universidad Autónoma de Nuevo León, Madero y Dr. Aguirre Pequeño n/n, Mitras Centro P.C 64460, Monterrey, Nuevo León, Mexico
| | - Ada Nayeli Rangel-Gómez
- Advanced Neuroscience Center UANL, Hospital Universitario "Dr. José Eleuterio González", Av. Francisco I. Madero n/n. & Av. Gonzalitos, Mitras Centro P.C. 64460, Monterrey, Nuevo León, Mexico
| | - Farid Carranza-Navarro
- Advanced Neuroscience Center UANL, Hospital Universitario "Dr. José Eleuterio González", Av. Francisco I. Madero n/n. & Av. Gonzalitos, Mitras Centro P.C. 64460, Monterrey, Nuevo León, Mexico
| | - Dania Dalel Pardiñaz-García
- Faculty of Medicine, Universidad Autónoma de Nuevo León, Madero y Dr. Aguirre Pequeño n/n, Mitras Centro P.C 64460, Monterrey, Nuevo León, Mexico
| | - Juan Manuel Fuentes-Garza
- Faculty of Medicine, Universidad Autónoma de Nuevo León, Madero y Dr. Aguirre Pequeño n/n, Mitras Centro P.C 64460, Monterrey, Nuevo León, Mexico
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Strodl E, Yang J. Motivational Interviewing Enhances Group Cognitive Behavioral Therapy for Anxiety Disorders. J Cogn Psychother 2021; 35:JCPSY-D-20-00025. [PMID: 33833090 DOI: 10.1891/jcpsy-d-20-00025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
This pilot study tested whether the addition of motivational interviewing (MI) prior to group cognitive behavioral therapy (CBT) for anxiety may improve the effectiveness of the treatment. Prior to group CBT, 40 individuals with a principal diagnosis of an anxiety disorder (40% panic disorder, 25% generalized anxiety disorder, 22.5% social phobia, and 12.5% others) were randomly assigned to receive either three individual sessions of MI or were assigned to a control group that did not receive MI. The pretreatment MI group, compared to the control group, experienced significantly greater reduction in anxiety symptoms post-CBT. These results suggest that brief MI pretreatment enhances the efficacy of CBT on anxiety. A combination of MI and CBT may be particularly promising for the treatment of anxiety, with MI directed at increasing motivation and commitment to change, and CBT directed at helping the client achieve the desired changes.
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Affiliation(s)
- Esben Strodl
- School of Psychology and Counselling, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Joel Yang
- School of Psychology and Counselling, Queensland University of Technology, Brisbane, Queensland, Australia
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Roberge P, Provencher MD, Gaboury I, Gosselin P, Vasiliadis HM, Benoît A, Carrier N, Antony MM, Chaillet N, Houle J, Hudon C, Norton PJ. Group transdiagnostic cognitive-behavior therapy for anxiety disorders: a pragmatic randomized clinical trial. Psychol Med 2020; 52:1-11. [PMID: 33261700 PMCID: PMC9647541 DOI: 10.1017/s0033291720004316] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 10/03/2020] [Accepted: 10/26/2020] [Indexed: 12/30/2022]
Abstract
BACKGROUND Transdiagnostic group cognitive-behavioral therapy (tCBT) is a delivery model that could help overcome barriers to large-scale implementation of evidence-based psychotherapy for anxiety disorders. The aim of this study was to assess the effectiveness of combining group tCBT with treatment-as-usual (TAU), compared to TAU, for the treatment of anxiety disorders in community-based mental health care. METHODS In a multicenter single-blind, two-arm pragmatic superiority randomized trial, we recruited participants aged 18-65 who met DSM-5 criteria for principal diagnoses of generalized anxiety disorder, social anxiety disorder, panic disorder, or agoraphobia. Group tCBT consisted of 12 weekly 2 h sessions. There were no restrictions for TAU. The primary outcome measures were the Beck Anxiety Inventory (BAI) and clinician severity rating from the Anxiety and Related Disorders Interview Schedule for DSM-5 (ADIS-5) for the principal anxiety disorder at post-treatment, with intention-to-treat analysis. RESULTS A total of 231 participants were randomized to either tCBT + TAU (117) or TAU (114), with outcome data available for, respectively, 95 and 106. Results of the mixed-effects regression models showed superior improvement at post-treatment for participants in tCBT + TAU, compared to TAU, for BAI [p < 0.001; unadjusted post-treatment mean (s.d.): 13.20 (9.13) v. 20.85 (10.96), Cohen's d = 0.76] and ADIS-5 [p < 0.001; 3.27 (2.19) v. 4.93 (2.00), Cohen's d = 0.79]. CONCLUSIONS Our findings suggest that the addition of group tCBT into usual care can reduce symptom severity in patients with anxiety disorders, and support tCBT dissemination in routine community-based care.
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Affiliation(s)
- Pasquale Roberge
- Department of Family Medicine and Emergency Medicine, Université de Sherbrooke, Sherbrooke (Québec), Canada
- Centre de recherche du Centre hospitalier universitaire de Sherbrooke (CRCHUS), Sherbrooke (Québec), Canada
| | | | - Isabelle Gaboury
- Department of Family Medicine and Emergency Medicine, Université de Sherbrooke, Sherbrooke (Québec), Canada
- Centre de recherche du Centre hospitalier universitaire de Sherbrooke (CRCHUS), Sherbrooke (Québec), Canada
| | - Patrick Gosselin
- Department of Psychology, Université de Sherbrooke, Sherbrooke (Québec), Canada
| | - Helen-Maria Vasiliadis
- Department of Community Health Sciences, Université de Sherbrooke, Québec (Québec), Canada
| | - Annie Benoît
- Department of Family Medicine and Emergency Medicine, Université de Sherbrooke, Sherbrooke (Québec), Canada
- Centre de recherche du Centre hospitalier universitaire de Sherbrooke (CRCHUS), Sherbrooke (Québec), Canada
| | - Nathalie Carrier
- Department of Family Medicine and Emergency Medicine, Université de Sherbrooke, Sherbrooke (Québec), Canada
- Centre de recherche du Centre hospitalier universitaire de Sherbrooke (CRCHUS), Sherbrooke (Québec), Canada
| | - Martin M. Antony
- Department of Psychology, Ryerson University, Toronto (Ontario), Canada
| | - Nils Chaillet
- Department of Obstetrics, Gynecology, and Reproduction, Université Laval, Québec (Québec), Canada
| | - Janie Houle
- Department of Psychology, Université du Québec à Montréal, Montréal (Québec), Canada
| | - Catherine Hudon
- Department of Family Medicine and Emergency Medicine, Université de Sherbrooke, Sherbrooke (Québec), Canada
- Centre de recherche du Centre hospitalier universitaire de Sherbrooke (CRCHUS), Sherbrooke (Québec), Canada
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de Almeida Sampaio TP, Jorge RC, Martins DS, Gandarela LM, Hayes-Skelton S, Bernik MA, Lotufo-Neto F. Efficacy of an acceptance-based group behavioral therapy for generalized anxiety disorder. Depress Anxiety 2020; 37:1179-1193. [PMID: 32333486 DOI: 10.1002/da.23021] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2019] [Revised: 03/17/2020] [Accepted: 03/27/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Generalized anxiety disorder (GAD) shows the weakest treatment response among anxiety disorders. This study aimed at examining whether an acceptance-based group behavioral therapy (ABBT) for patients in a Brazilian anxiety disorders program, combining mindfulness and exposure strategies, can improve clinical outcome when compared with a standard nondirective supportive group therapy (NDST). METHODS Ninety-two individuals diagnosed with GAD were randomized to receive 10 sessions of either ABBT or NDST. Assessments at pretreatment, midtreatment, posttreatment, and 3-month follow-up comprised the following outcome measures: Hamilton Anxiety Rating Scale (HAM-A), Penn State Worry Questionnaire (PSWQ), Depression Anxiety and Stress Scale (DASS), and the Clinical Global Impressions (CGI). The World Health Organization Quality of Life (WHOQOL) was administered at pretreatment and posttreatment. RESULTS The mixed-effects regression models for DASS-stress, Hamilton Anxiety Interview, and CGI showed a significant effect for Time and the Time × Treatment effect, but not for the Treatment main effect. Similarly, there was a significant Time × Treatment effect for the PSWQ, but not main effects of Time or Treatment. Altogether, these data indicate that symptoms decreased in both conditions across treatment and follow-up, and that the rate of change was more rapid for those participants in the ABBT condition. We found no differences between groups from pretreatment to posttreatment in DASS-anxiety or any secondary outcome measure, but for the physical health domain of WHOQOL, which was faster in ABBT. CONCLUSIONS Both groups showed good clinical outcomes, but in general, participants of the ABBT group improved faster than those in the NDST group.
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Affiliation(s)
- Thiago Pacheco de Almeida Sampaio
- Department of Clinical Psychology, Institute of Psychology, University of São Paulo, São Paulo, Brazil.,Department of Psychiatry, Anxiety Disorders Program, Institute of Psychiatry, University of São Paulo, São Paulo, Brazil
| | - Renê Cabral Jorge
- Department of Psychiatry, Anxiety Disorders Program, Institute of Psychiatry, University of São Paulo, São Paulo, Brazil
| | - Daniel Santos Martins
- Department of Clinical Psychology, Institute of Psychology, University of São Paulo, São Paulo, Brazil.,Department of Psychiatry, Anxiety Disorders Program, Institute of Psychiatry, University of São Paulo, São Paulo, Brazil
| | - Lucas Marques Gandarela
- Department of Psychiatry, Anxiety Disorders Program, Institute of Psychiatry, University of São Paulo, São Paulo, Brazil
| | - Sarah Hayes-Skelton
- Department of Psychology, University of Massachusetts Boston, Boston, Massachusetts
| | - Márcio Antonini Bernik
- Department of Psychiatry, Anxiety Disorders Program, Institute of Psychiatry, University of São Paulo, São Paulo, Brazil
| | - Francisco Lotufo-Neto
- Department of Clinical Psychology, Institute of Psychology, University of São Paulo, São Paulo, Brazil.,Department of Psychiatry, Anxiety Disorders Program, Institute of Psychiatry, University of São Paulo, São Paulo, Brazil
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What are the recovery and attrition outcomes for group CBT and individual CBT for generalised anxiety disorder in an IAPT service? An exploratory study. COGNITIVE BEHAVIOUR THERAPIST 2020. [DOI: 10.1017/s1754470x20000045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Abstract
Group cognitive behavioural therapy (gCBT) is commonly used in Increasing Access to Psychological Therapies (IAPT) services. However, there is limited knowledge of the efficacy of gCBT as a delivery format for generalised anxiety disorder (GAD). To address gaps in literature, this study aims to explore the efficacy and attrition of individual and group CBT interventions, respectively, at Step 3 for GAD using data from a routine IAPT service over a 24-month period. Data were retrospectively derived from a routine serviceʼs IAPTus database, separating those eligible for comparison into group (n = 44) and individual (n = 55) CBT for GAD. Outcomes were differences in pre–post self-reported anxiety (GAD-7) and depression (PHQ-9) scores, clinical recovery and attrition for gCBT and individual CBT. Both gCBT and individual CBT yielded significant reductions in self-reported anxiety and depression scores over time. Results indicate that 53% of patients attending individual CBT achieved clinical recovery, with similar but less competitive rates of 41% in gCBT. Attrition rates were similar between gCBT (29.5%) and individual CBT (27.3%), respectively. Preliminary results suggest that both individual and gCBT are effective interventions for GAD patients in IAPT, offering symptom alleviation and comparable recovery and attrition rates post-intervention. This observational design offers credibility and insight into a pragmatic evaluative and explorative comparison. gCBT may offer an acceptable and potentially economical alternative.
Key learning aims
(1)
To explore whether gCBT and individual CBT yield significant symptom reduction in self-reported anxiety and depression in GAD patients from a routine IAPT service.
(2)
To explore gCBT and individual CBT clinical recovery rates in non-optimum routine conditions.
(3)
To explore whether gCBT for GAD produces unacceptable attrition rates and if this differs from attrition rates in individual CBT for GAD in a routine IAPT service.
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Resende CMBMD, Rocha LGDDS, Paiva RPD, Cavalcanti CDS, Almeida EOD, Roncalli AG, Barbosa GAS. Relationship between anxiety, quality of life, and sociodemographic characteristics and temporomandibular disorder. Oral Surg Oral Med Oral Pathol Oral Radiol 2020; 129:125-132. [DOI: 10.1016/j.oooo.2019.10.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Revised: 10/06/2019] [Accepted: 10/09/2019] [Indexed: 11/29/2022]
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Effectiveness of cognitive behavioural group therapy for social anxiety disorder: long-term benefits and aftercare. Behav Cogn Psychother 2019; 47:501-513. [PMID: 30919793 DOI: 10.1017/s1352465819000079] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND Empirical research demonstrates the short- to medium-term efficacy and effectiveness of cognitive behavioural group therapy (CBGT) for social anxiety disorder (SAD). Little is known about the durability of gains beyond 1 year following treatment in real-life clinical settings. Literature regarding the impact of aftercare programs as an adjunct to CBGT treatment on SAD is scarce. AIMS To evaluate the long-term effectiveness of CBGT for SAD in a community sample and to explore the relationship between long-term treatment outcomes and aftercare support group attendance. METHOD A longitudinal cohort design evaluated changes in standardized psychological measures assessing aspects of SAD, anxiety and depression. Questionnaires were completed before the program (time 1, N = 457), after the program (time 2, n = 369) and at an average of 4.6 years follow-up (time 3, n = 138). RESULTS Large treatment effect sizes at post-intervention were maintained at long-term follow-up on measures of SAD, anxiety and depression. There was no statistically significant relationship between frequency of attendance at an aftercare support group and degree of improvement from post-treatment severity on any measure. CONCLUSIONS CBGT is an effective intervention in the long-term in a routine clinical setting and should be considered a viable treatment option for SAD. Recommendations for future research, treatment implications and study limitations are considered.
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Roberge P, Provencher MD, Gosselin P, Vasiliadis HM, Gaboury I, Benoit A, Antony MM, Chaillet N, Houle J, Hudon C, Norton PJ. A pragmatic randomized controlled trial of group transdiagnostic cognitive-behaviour therapy for anxiety disorders in primary care: study protocol. BMC Psychiatry 2018; 18:320. [PMID: 30285672 PMCID: PMC6169021 DOI: 10.1186/s12888-018-1898-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Accepted: 09/18/2018] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Anxiety disorders are the most common mental disorders in community settings, and they are associated with significant psychological distress, functional and social impairment. While cognitive behaviour therapy (CBT) is the most consistently efficacious psychological treatment for anxiety disorders, barriers preclude widespread implementation of CBT in primary care. Transdiagnostic group CBT (tCBT) focuses on cognitive and behavioural processes and intervention strategies common to different anxiety disorders, and could be a promising alternative to conventional CBT. This study aims to examine the effectiveness of a transdiagnostic group CBT for anxiety disorders program as a complement to treatment-as-usual (TAU) in primary mental health care. METHODS/DESIGN The trial is a multicentre pragmatic randomized controlled trial with a pre-treatment, post-treatment, and follow-up at 4, 8 and 12-months design. Treatment and control groups. a) tCBT (12 weekly 2-h group sessions following a manualized treatment protocol); b) TAU for anxiety disorders. Inclusion criteria comprise meeting DSM-5 criteria for primary Panic Disorder, Agoraphobia, Social Anxiety Disorder and/or Generalized Anxiety Disorder. Patients are recruited in three regions in the province of Quebec, Canada. The primary outcome measures are the self-reported Beck Anxiety Inventory and the clinician-administered Anxiety and Related Disorders Interview Schedule for DSM-5 (ADIS-5); secondary outcome measures include treatment responder status based on the ADIS-5, and self-reported instruments for specific anxiety and depression symptoms, quality of life, functioning, and service utilisation. STATISTICAL ANALYSIS Intention-to-treat analysis. A mixed effects regression model will be used to account for between- and within-subject variations in the analysis of the longitudinal effects of the intervention. DISCUSSION This rigorous evaluation of tCBT in the real world will provide invaluable information to decision makers, health care managers, clinicians and patients regarding the effectiveness of the intervention. Widespread implementation of tCBT protocols in primary care could lead to better effectiveness, efficiency, access and equity for the large number of patients suffering from anxiety disorders that are currently not obtaining evidence-based psychotherapy. TRIAL REGISTRATION ClinicalTrials.gov: NCT02811458 .
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Affiliation(s)
- Pasquale Roberge
- Centre de recherche du Centre hospitalier universitaire de Sherbrooke (CRCHUS), Department of Family Medicine and Emergency Medicine, Faculty of Medicine and Health Sciences, Université de Sherbrooke, 3001, 12th Avenue North, Sherbrooke, QC J1H 5N4 Canada
| | - Martin D Provencher
- École de psychologie, Pavillon Félix-Antoine-Savard, 2325, rue des Bibliothèques, Université Laval, Québec, QC G1V 0A6 Canada
| | - Patrick Gosselin
- Institut universitaire de première ligne en santé et services sociaux (CIUSSS de l’Estrie- CHUS), Department of Psychology, Université de Sherbrooke, 2500, boulevard de l’Université, Sherbrooke, QC J1K 2R1 Canada
| | - Helen-Maria Vasiliadis
- Department of Community Health Sciences, Université de Sherbrooke, Centre de recherche Hôpital Charles LeMoyne, 3120, boul. Taschereau, Greenfield Park, QC J4V 2H1 Canada
| | - Isabelle Gaboury
- Centre de recherche du Centre hospitalier universitaire de Sherbrooke (CRCHUS), Department of Family Medicine and Emergency Medicine, Faculty of Medicine and Health Sciences, Université de Sherbrooke, 3001, 12th Avenue North, Sherbrooke, QC J1H 5N4 Canada
| | - Annie Benoit
- Centre de recherche du Centre hospitalier universitaire de Sherbrooke (CRCHUS), Department of Family Medicine and Emergency Medicine, Faculty of Medicine and Health Sciences, Université de Sherbrooke, 3001, 12th Avenue North, Sherbrooke, QC J1H 5N4 Canada
| | - Martin M Antony
- Department of Psychology, Ryerson University, 350 Victoria Street, Toronto, ON M5B 2K3 Canada
| | - Nils Chaillet
- Department of Obstetrics, Gynecology, and Reproduction, Université Laval, 2705, boulevard Laurier, Québec, QC G1V 4G2 Canada
| | - Janie Houle
- Department of Psychology, Université du Québec à Montréal, C.P. 8888, succ. Centre-ville, Montréal, QC H3C 3P8 Canada
| | - Catherine Hudon
- Centre de recherche du Centre hospitalier universitaire de Sherbrooke (CRCHUS), Department of Family Medicine and Emergency Medicine, Faculty of Medicine and Health Sciences, Université de Sherbrooke, 3001, 12th Avenue North, Sherbrooke, QC J1H 5N4 Canada
| | - Peter J Norton
- Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Monash University, 18 Innovation Walk, Clayton Campus, Clayton, VIC 3800 Australia
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Abstract
Transdiagnostic cognitive-behavioral (CBT) therapy is a modified form of CBT designed to be applicable with patients across the range of anxiety and related emotional disorders. Based on emerging genetic, neurologic, developmental, cognitive, and behavioral science, transdiagnostic CBT may alleviate barriers to dissemination and accessibility by providing a single treatment approach across diagnoses. Data from clinical trials and metaanalyses suggest treatment efficacy that is comparable with traditional CBT approaches, with possibly superior efficacy among patients with multiple comorbid anxiety and emotional diagnoses. Limitations in the evidence base and remaining areas for future research are discussed.
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12
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Norton PJ, Paulus DJ. Transdiagnostic models of anxiety disorder: Theoretical and empirical underpinnings. Clin Psychol Rev 2017; 56:122-137. [DOI: 10.1016/j.cpr.2017.03.004] [Citation(s) in RCA: 69] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2016] [Revised: 02/07/2017] [Accepted: 03/21/2017] [Indexed: 01/18/2023]
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Norton PJ, Paulus DJ. Toward a Unified Treatment for Emotional Disorders: Update on the Science and Practice. Behav Ther 2016; 47:854-868. [PMID: 27993337 DOI: 10.1016/j.beth.2015.07.002] [Citation(s) in RCA: 101] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2015] [Revised: 06/25/2015] [Accepted: 07/07/2015] [Indexed: 12/21/2022]
Abstract
Mental health professionals have long been concerned with describing and proscribing a structure around the myriad variations of psychological and emotional distress that are deemed to be disordered. This has frequently been characterized as a conflict between so-called "lumpers" and "splitters"-those who advocate broad categorizations based on overarching commonalities versus those who endeavor toward a highly refined structure emphasizing unique characteristics. Many would argue that with the era of the modern Diagnostic and Statistical Manual of Mental Disorders (DSM-III to DSM-5), a splitting ideology has been dominant despite re-emerging concerns that some groups of diagnoses, particularly disorders of anxiety and other emotions, may be more similar than different. As a result of such concerns, transdiagnostic or unified models of psychopathology have burgeoned. In this review, we describe the work of Barlow, Allen, and Choate (2004), whose invited paper "Toward a Unified Treatment for Emotional Disorders" reignited transdiagnostic perspectives of emotional disorders. We provide an update on the scientific models and evidence-based treatments that have followed in the wake of this 2004 publication, including key areas for future study in the advancement of transdiagnostic and unified treatment of emotional disorders.
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Holas P, Suszek H. Group Process and Therapeutic Protocol of Intensive Transdiagnostic Group Cognitive-Behavioral Therapy for Anxiety and Personality Disorders in a Day Clinic. Int J Group Psychother 2016; 66:422-430. [PMID: 38449128 DOI: 10.1080/00207284.2016.1156405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
This brief report presents group processes and the treatment protocol of intensive, transdiagnostic group cognitive-behavior therapy for anxiety with comorbid personality disorders in a day clinic. It describes the history of and rationale for the development of this 3-month, 15-hour a week group treatment and the utilization of group processes during this therapy. The authors argue that the group format presented here allows the treatment of personality disorders that are frequently comorbid with anxiety disorders.
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Daltry RM. A Case Study: An ACT Stress Management Group in a University Counseling Center. JOURNAL OF COLLEGE STUDENT PSYCHOTHERAPY 2015. [DOI: 10.1080/87568225.2015.976076] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Changes in quality of life following group CBT for anxiety and depression in a psychiatric outpatient clinic. Psychiatry Res 2014; 220:1012-8. [PMID: 25256885 DOI: 10.1016/j.psychres.2014.08.036] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2013] [Revised: 08/11/2014] [Accepted: 08/13/2014] [Indexed: 11/23/2022]
Abstract
The present study examined the relationship between quality of life and symptom change following group CBT treatment for anxiety or depression in a psychiatric hospital outpatient setting. One hundred seventy seven outpatients undergoing eight sessions of group CBT for anxiety (n=124) or mood disorders (n=53) participated. The Beck Anxiety Inventory (BAI), Zung Self-Rating Depression Scale (Zung-SRDS), Quality of Life Inventory (QOLI), and Satisfaction with Life Scale (SWLS) were administered at baseline and post-treatment. Additionally, the QOLI and SWLS scores of those who achieved reliable improvement or clinically significant symptom change were compared to those who experienced no reliable symptom improvement. There were significant changes across the QOLI, SWLS, BAI and Zung-SRDS outcome measures between baseline and post-treatment, with moderate to very large effect sizes observed. Patients with reliable or clinically significant change in their symptoms experienced significant increases in QOLI and SWLS scores when compared to those whose symptoms did not change reliably. Overall, in a psychiatric hospital outpatient setting, group CBT appeared to be successful in increasing quality of life and satisfaction with life in addition to reducing anxiety and depression symptoms.
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Oei TPS, McAlinden NM, Cruwys T. Exploring mechanisms of change: the relationships between cognitions, symptoms, and quality of life over the course of group cognitive-behaviour therapy. J Affect Disord 2014; 168:72-7. [PMID: 25038294 DOI: 10.1016/j.jad.2014.06.040] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2013] [Revised: 06/19/2014] [Accepted: 06/25/2014] [Indexed: 11/28/2022]
Abstract
BACKGROUND This study aimed to explain how quality of life changes during psychotherapy, using a cognitive-behavioural theoretical framework, and examined whether changes in symptoms or changes in cognitions were more influential with regard to quality of life change. Three different hypotheses were tested that might explain the mechanisms by which quality of life changes during group cognitive-behaviour therapy (CBT) for anxiety and depression. METHODS 127 outpatients with anxiety and/or depression enrolled in a four-week group CBT programme participated. Measures of anxiety and depression symptoms, cognitive change, and quality of life were administered at baseline and post-treatment. Baseline to post-treatment change scores were calculated and entered into multiple regression analyses. RESULTS Reductions in anxiety and depression symptoms were related to increases in quality of life, whereas cognitive changes were not consistently related to changes in quality of life. LIMITATIONS The main limitation was that the study׳s design was not able to assess whether changes in cognitions or symptoms preceded changes in quality of life, as all variables were measured at the same two points in time. CONCLUSIONS These results provided evidence that quality of life changes as a result of or, simultaneously with, symptom change. It appears that group CBT does not improve quality of life through strategies designed to change patients׳ cognitions.
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Affiliation(s)
- Tian Po S Oei
- School of Psychology, The University of Queensland, Brisbane, Queensland, Australia; CBT Unit, Toowong Private Hospital, PO Box 882, Toowong, Brisbane, Queensland, Australia.
| | - Niamh M McAlinden
- School of Psychology, The University of Queensland, Brisbane, Queensland, Australia
| | - Tegan Cruwys
- School of Psychology, The University of Queensland, Brisbane, Queensland, Australia
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Cruwys T, Alexander Haslam S, Dingle GA, Jetten J, Hornsey MJ, Desdemona Chong EM, Oei TPS. Feeling connected again: interventions that increase social identification reduce depression symptoms in community and clinical settings. J Affect Disord 2014; 159:139-46. [PMID: 24679402 DOI: 10.1016/j.jad.2014.02.019] [Citation(s) in RCA: 129] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2013] [Revised: 02/07/2014] [Accepted: 02/07/2014] [Indexed: 11/25/2022]
Abstract
BACKGROUND Clinical depression is often preceded by social withdrawal, however, limited research has examined whether depressive symptoms are alleviated by interventions that increase social contact. In particular, no research has investigated whether social identification (the sense of being part of a group) moderates the impact of social interventions. METHOD We test this in two longitudinal intervention studies. In Study 1 (N=52), participants at risk of depression joined a community recreation group; in Study 2 (N=92) adults with diagnosed depression joined a clinical psychotherapy group. RESULTS In both the studies, social identification predicted recovery from depression after controlling for initial depression severity, frequency of attendance, and group type. In Study 2, benefits of social identification were larger for depression symptoms than for anxiety symptoms or quality of life. LIMITATION Social identification is subjective and psychological, and therefore participants could not be randomly assigned to high and low social identification conditions. CONCLUSIONS Findings have implications for health practitioners in clinical and community settings, suggesting that facilitating social participation is effective and cost-effective in treating depression.
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Affiliation(s)
- Tegan Cruwys
- School of Psychology, University of Queensland, St Lucia, QLD 4072, Australia.
| | - S Alexander Haslam
- School of Psychology, University of Queensland, St Lucia, QLD 4072, Australia
| | - Genevieve A Dingle
- School of Psychology, University of Queensland, St Lucia, QLD 4072, Australia
| | - Jolanda Jetten
- School of Psychology, University of Queensland, St Lucia, QLD 4072, Australia
| | - Matthew J Hornsey
- School of Psychology, University of Queensland, St Lucia, QLD 4072, Australia
| | - E M Desdemona Chong
- School of Psychology, University of Queensland, St Lucia, QLD 4072, Australia
| | - Tian P S Oei
- School of Psychology, University of Queensland, St Lucia, QLD 4072, Australia; CBT Unit, Toowong Private Hospital, Queensland, Australia
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Heatherington L, Harrington NT, Harrington J, Niemeyer KF, Weinberg SC, Friedlander ML. Applying Group Cognitive Behavioral Therapy for Anxiety Disorders in Community Settings: Retention, Outcome, and Clinical Considerations. J Cogn Psychother 2014; 28:117-133. [DOI: 10.1891/0889-8391.28.2.117] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The efficacy, and to a lesser extent, effectiveness, of individual cognitive behavioral therapy (CBT) for anxiety disorders has been demonstrated, but whether manualized treatments work in a group format in community settings is less established. We investigated the predictors of retention and outcome in 26 groups (11 Generalized Anxiety Disorder, 11 Panic, 4 Social Phobia groups), conducted for more than 10 years in a semirural community mental health center by 19 therapists. Members of the Anxiety Disorders Treatment Team delivered manualized group CBT treatments. Analysis of standard symptom measures at pre- and posttreatment and archival data revealed significant pre–post decreases in anxiety, retention rates comparable to past findings on group retention, and several significant predictors of retention and outcome. Manualized group CBT for anxiety appears to be a viable treatment in community settings. Limitations of the study as well as related practice–research implications of the findings are discussed.
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Garvik M, Idsoe T, Bru E. Effectiveness study of a CBT-based adolescent coping with depression course. EMOTIONAL AND BEHAVIOURAL DIFFICULTIES 2013. [DOI: 10.1080/13632752.2013.840959] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Effectiveness of a cognitive behavioural group therapy (CBGT) for social anxiety disorder: immediate and long-term benefits. COGNITIVE BEHAVIOUR THERAPIST 2013. [DOI: 10.1017/s1754470x13000111] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractThis study examines the effectiveness of a group CBT (CBGT) intervention in reducing a variety of symptoms and problem areas associated with social anxiety disorder. A longitudinal cohort design assessed changes in standardized psychological scales assessing general mood and specific aspects of social anxiety. Questionnaires were completed pre-programme (time 1, n = 252), post-programme (time 2, n = 202), and at 12 months follow-up (time 3, n = 93). A consistent significant pattern was found for all variables: pre-intervention scores were significantly higher than both post-intervention scores and 12-month follow-up scores. Large effect sizes were found and rates of clinical significant changes varied, with over half of the participants recording clinically significant changes in general mood. Individual CBT can be translated successfully into a group format for social anxiety. Given the high completion rate, the intervention is acceptable to participants, feasible, and effective in a routine clinical service.
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Oei TPS, Strodl E, Pang J, Cui L. Denial Predicts Outcome in Anxiety Following Group Cognitive Behavioral Therapy. J Cogn Psychother 2013; 27:370-383. [DOI: 10.1891/0889-8391.27.4.370] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
This study aimed to explore whether participants’ pretherapy coping strategies predicted the outcome of group cognitive behavioral therapy (CBT) for anxiety and depression. It was hypothesized that adaptive coping strategies such as the use of active planning and acceptance would be associated with higher reductions, whereas maladaptive coping strategies such as denial and disengagement would be associated with lower reductions in anxious and depressed symptoms following psychotherapy. There were 144 participants who completed group CBT for anxiety and depression. Measures of coping strategies were administered prior to therapy, whereas measures of depression and anxiety were completed both prior to and following therapy. The results showed that higher levels of denial were associated with a poorer outcome, in terms of change in anxiety but not depression, following therapy. These findings suggest the usefulness of using the Denial subscale from the revised Coping Orientation to Problems Experienced (COPE) as a predictor of outcome in group CBT for anxiety.
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Cognitive-Behavioral Group Therapy for Heterogeneous Anxiety and Mood Disorders in a Psychiatric Hospital Outpatient Clinic. J Cogn Psychother 2013; 27:138-154. [DOI: 10.1891/0889-8391.27.2.138] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Recent literature has shown that group cognitive-behavioral therapy (CBT) is effective for individuals with heterogeneous anxiety disorders. However, these studies have used a narrow range of outcome measures, and have not included global measures such as quality of life. In addition, heterogeneous mood disorders have not been well researched. The aim of this study was to replicate and extend on previous studies by assessing the effectiveness of group CBT treatment programs designed for use with heterogeneous anxiety or depressive disorders. Global outcome measures of quality of life and social functioning were assessed in addition to outcome measures of anxiety and mood symptoms. There were 173 patients who completed either group CBT for anxiety disorders or for depressive disorders. Symptom measures and quality of life measures were used to determine treatment effectiveness. Results demonstrated that the treatments were effective in reducing overall symptom severity and improving quality of life. Treatment gains were maintained to 12 month follow-up. However, the degree of change was considerably lower than that found in comparable trials with diagnostically homogenous samples. Overall, group CBT for heterogeneous diagnostic populations was effective but requires further investigation and refinement.
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The Factor Structure of the COPE Questionnaire in a Sample of Clinically Depressed and Anxious Adults. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2012. [DOI: 10.1007/s10862-012-9328-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Exploring the Effectiveness of a Mixed-Diagnosis Group Cognitive Behavioral Therapy Intervention Across Diverse Populations. COGNITIVE AND BEHAVIORAL PRACTICE 2012. [DOI: 10.1016/j.cbpra.2011.12.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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Billingham DD, Kelly PJ, Deane FP, Crowe TP, Buckingham MS, Craig FL. Clinically Significant Change to Establish Benchmarks in Residential Drug and Alcohol Treatment Services. Int J Ment Health Addict 2012. [DOI: 10.1007/s11469-012-9384-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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Khoo A, Dent MT, Oei TPS. Group cognitive behaviour therapy for military service-related post-traumatic stress disorder: effectiveness, sustainability and repeatability. Aust N Z J Psychiatry 2011; 45:663-72. [PMID: 21870924 DOI: 10.3109/00048674.2011.590464] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE The aim of this study was to assess 12 month outcomes of Australian combat veterans with post-traumatic stress disorder (PTSD) who participated in a 6 week group-based CBT programme at the Toowong Private Hospital. The study population included 496 consecutive admissions to the programme between 1999 and 2008. METHOD Self-report measures of PTSD, depression, anxiety, anger, alcohol use, relationship satisfaction and quality of life parameters were collected at intake and 3, 6 and 12 months post intake. RESULTS Statistically significant and sustained improvements were noted in 12 month outcome measures for PTSD, depression, anxiety, alcohol use, anger, and quality of life. PTSD symptom reduction occurred consistently each year for 9 years and exhibited an aggregated effect size of 0.68. CONCLUSIONS This naturalistic research demonstrates that treatment administered under clinical conditions produces equivocal magnitudes of positive change in terms of PTSD symptoms when compared with existing efficacy data in individual and group treatments. Further, these symptomatic gains are sustainable and consistently reproducible. The benefits noted from group therapy were seen as independent of whether or not individual treatment was in place.
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Affiliation(s)
- Andrew Khoo
- Group Therapy Day Programs, Toowong Private Hospital, Toowong, Queensland 4066, Australia.
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Monteiro DR, Zuim PRJ, Pesqueira AA, Ribeiro PDP, Garcia AR. Relationship between anxiety and chronic orofacial pain of temporomandibular disorder in a group of university students. J Prosthodont Res 2011; 55:154-8. [DOI: 10.1016/j.jpor.2010.11.001] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2010] [Revised: 10/05/2010] [Accepted: 11/04/2010] [Indexed: 10/18/2022]
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Sardinha A, Araújo CGS, Soares-Filho GLF, Nardi AE. Anxiety, panic disorder and coronary artery disease: issues concerning physical exercise and cognitive behavioral therapy. Expert Rev Cardiovasc Ther 2011; 9:165-75. [PMID: 21453213 DOI: 10.1586/erc.10.170] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Psychological factors such as stress and depression have already been established as primary and secondary cardiovascular risk factors. More recently, the role of anxiety in increasing cardiac risk has also been studied. The underlying mechanisms of increased cardiac risk in panic disorder patients seem to reflect the direct and indirect effects of autonomic dysfunction, as well as behavioral risk factors associated with an unhealthy lifestyle. Implications of the comorbidity between panic and cardiovascular disease include higher morbidity, functional deficits, increased cardiovascular risk, and poor adherence to cardiac rehabilitation or exercise programs. This article probes the most recent evidence on the association between coronary artery disease, anxiety and panic disorder, and discusses the potential role of incorporating regular physical exercise and cognitive behavioral therapy in the treatment of this condition.
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Affiliation(s)
- Aline Sardinha
- Laboratory of Panic and Respiration, Psychiatry Institute, Federal University of Rio de Janeiro (IPUB/UFRJ), National Institute for Translational Medicine (INCT-TM, CNPq), Rio de Janeiro, Brazil.
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Disorder specific and trans-diagnostic case conceptualisation. Clin Psychol Rev 2011; 31:213-24. [DOI: 10.1016/j.cpr.2010.07.005] [Citation(s) in RCA: 67] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2010] [Revised: 07/05/2010] [Accepted: 07/22/2010] [Indexed: 11/22/2022]
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