A component analysis of cognitive-behavioral therapy for generalized anxiety disorder and the role of interpersonal problems.

TLDR

Clients with generalized anxiety disorder were randomized to applied relaxation and self‑control desensitization, cognitive therapy, or a combined treatment. All three conditions produced significant, durable reductions in anxiety and depression, with most participants no longer meeting diagnostic criteria after two years, no differential effects among conditions, and residual interpersonal problems predicting poorer outcomes and indicating that adding interpersonal treatment could enhance effectiveness.

Abstract

Clients with generalized anxiety disorder (GAD) received either (a) applied relaxation and self-control desensitization, (b) cognitive therapy, or (c) a combination of these methods. Treatment resulted in significant improvement in anxiety and depression that was maintained for 2 years. The large majority no longer met diagnostic criteria; a minority sought further treatment during follow-up. No differences in outcome were found between conditions; review of the GAD therapy literature suggested that this may have been due to strong effects generated by each component condition. Finally, interpersonal difficulties remaining at posttherapy, measured by the Inventory of Interpersonal Problems Circumplex Scales (L. E. Alden, J. S. Wiggins, & A. L. Pincus, 1990) in a subset of clients, were negatively associated with posttherapy and follow-up improvement, suggesting the possible utility of adding interpersonal treatment to cognitive-behavioral therapy to increase therapeutic effectiveness.