Symptom severity in daily life, early response and posttreatment changes in anxiety and depressive symptoms in generalized anxiety disorder

IF 3.2 3区心理学 Q1 PSYCHOLOGY, CLINICAL

Clinical psychology & psychotherapy Pub Date : 2023-03-03 DOI:10.1002/cpp.2847

Andreea Vîslă, Greta Helene Probst, Christoph Flückiger

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Abstract

Background

Meta-analytic research shows early response to psychotherapy to predict depression and anxiety outcomes posttreatment. However, little is known about which variables explain differences in early response. Moreover, for patients with generalized anxiety disorder (GAD), there is limited research on whether early response predicts longer-term changes in symptoms. In this study, we used anxiety and controllability beliefs assessed in daily life at intake to predict early response to treatment (until session 5), and we further examined if early response predicts longer-term changes in symptoms (until posttreatment, when adjusting for intake symptom severity) in patients with GAD.

Methods

Forty-nine individuals with GAD reported their anxiety and controllability beliefs using event-based (participant-initiated) ecological momentary assessment (EMA) for 7 days at intake. Symptoms were measured at pretreatment, session 5, session 10, and posttreatment.

Results

Results show anxiety levels reported during EMA to be associated with a higher reduction in both anxiety and depressive symptoms early in treatment. Moreover, higher controllability beliefs during EMA were associated with less early response. When predicting change in symptoms until posttreatment, results showed an early change to significantly predict change in symptoms until posttreatment.

Conclusions

Given that we found early response to psychotherapy in patients with GAD to be a prognostic factor for long-term response, it is recommended to monitor response early in treatment and pay special attention to those patients showing less early response.

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广泛性焦虑障碍患者日常生活症状严重程度、早期反应及治疗后焦虑抑郁症状的变化

荟萃分析研究表明，心理治疗的早期反应可以预测治疗后的抑郁和焦虑结果。然而，对于哪些变量解释了早期反应的差异，人们知之甚少。此外，对于广泛性焦虑障碍(GAD)患者，关于早期反应能否预测症状的长期变化的研究有限。在这项研究中，我们使用日常生活中摄入时评估的焦虑和可控性信念来预测GAD患者对治疗的早期反应(直到第5期)，我们进一步研究了早期反应是否能预测GAD患者症状的长期变化(直到治疗后，当调整摄入症状严重程度时)。方法采用基于事件的(参与者发起的)生态瞬间评估(EMA)方法报告49例GAD患者在摄入后7天的焦虑和可控性信念。在治疗前、第5期、第10期和治疗后测量症状。结果显示，EMA期间报告的焦虑水平与治疗早期焦虑和抑郁症状的较高减少有关。此外，EMA期间较高的可控性信念与较少的早期反应相关。当预测治疗后症状的变化时，结果显示早期变化可以显著预测治疗后症状的变化。结论:鉴于我们发现GAD患者对心理治疗的早期反应是长期反应的预后因素，建议在治疗早期监测反应，并特别注意那些早期反应较差的患者。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical psychology & psychotherapy PSYCHOLOGY, CLINICAL-

CiteScore

6.30

自引率

5.60%

发文量

106

期刊介绍： Clinical Psychology & Psychotherapy aims to keep clinical psychologists and psychotherapists up to date with new developments in their fields. The Journal will provide an integrative impetus both between theory and practice and between different orientations within clinical psychology and psychotherapy. Clinical Psychology & Psychotherapy will be a forum in which practitioners can present their wealth of expertise and innovations in order to make these available to a wider audience. Equally, the Journal will contain reports from researchers who want to address a larger clinical audience with clinically relevant issues and clinically valid research.