Elsevier

Behavior Therapy

Volume 43, Issue 3, September 2012, Pages 506-517
Behavior Therapy

A Randomized Clinical Trial of Transdiagnostic Cognitve-Behavioral Treatments for Anxiety Disorder by Comparison to Relaxation Training

https://doi.org/10.1016/j.beth.2010.08.011Get rights and content

Abstract

Transdiagnostic cognitive-behavioral treatments (CBT) for anxiety disorders have been gaining increased attention and empirical study in recent years. Despite this, all of the research on transdiagnostic anxiety treatments to date have either not used a control condition, or have relied on no-treatment or delayed-treatment controls, thus limiting inferences about comparative efficacy. The current study was a randomized clinical trial examining the efficacy of a 12-week transdiagnostic cognitive-behavioral group treatment in comparison to a 12-week comprehensive relaxation training program. Results from 87 treatment initiators suggested significant and statistically equivalent/noninferior outcomes across conditions, although relaxation was associated with a greater rate of dropout despite no differences in treatment credibility. No evidence was found for any differential effects of transdiagnostic CBT for any primary or comorbid diagnoses.

Highlights

► Randomized clinical trial comparing the efficacy of transdiagnostic CBGT to relaxation training ► Data from 87 clients suggested significant and statistically equivalent/noninferior outcomes across conditions ► Relaxation was associated with a greater rate of dropout despite no differences in treatment credibility ► No evidence for any differential effects of transdiagnostic CBT for any primary or comorbid diagnoses

Section snippets

Participants

Participants were drawn from 154 individuals contacting the University of Houston Anxiety Disorder Clinic between October 2006 and April 2009 for possible treatment services. Participants were recruited for participation via advertisements and articles in local and neighborhood newspapers, referrals from health and mental health professions, and public service media announcements. The following criteria were established for inclusion in the study: (a) age 18 or older; (b) principal DSM-IV

Preliminary Analyses

Of the randomization sample, 37 received a primary diagnosis of social anxiety disorder, 31 panic disorder with or without agoraphobia, 15 GAD, 2 anxiety disorder not otherwise specified (NOS), and one each of OCD and specific phobia. Over half (60.7%) of the sample were given one or more additional diagnoses, based on lower CSR scores, including major depressive disorder, dysthymia, or other depressive mood disorder (n = 28), GAD (n = 18), social anxiety disorder (n = 11), specific phobia (n = 8),

Discussion

Transdiagnostic models and treatments appear to be gaining interest for anxiety disorders (Erickson et al., 2007, Norton, 2008, Schmidt et al., 2012), eating disorders (Fairburn, Cooper, & Shafran, 2003), and, more generally, negative affective syndromes (Barlow et al., 2004, McEvoy and Nathan, 2007). Data published thus far suggests considerable improvement among those receiving transdiagnostic CBT for anxiety, and comparisons of effect sizes to those obtained from other treatment trials

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    This research was supported by an NIMH Mentored Research Scientist Development Award (1K01MH073920).

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