Transdiagnostic versus disorder-specific and clinician-guided versus self-guided internet-delivered treatment for generalized anxiety disorder and comorbid disorders: A randomized controlled trial

B F Dear; L G Staples; M D Terides; E Karin; J Zou; L Johnston; M Gandy; V J Fogliati; B M Wootton; P M McEvoy; N Titov

doi:10.1016/j.janxdis.2015.09.003

Transdiagnostic versus disorder-specific and clinician-guided versus self-guided internet-delivered treatment for generalized anxiety disorder and comorbid disorders: A randomized controlled trial

J Anxiety Disord. 2015 Dec:36:63-77. doi: 10.1016/j.janxdis.2015.09.003. Epub 2015 Sep 11.

Authors

B F Dear¹, L G Staples², M D Terides², E Karin², J Zou², L Johnston², M Gandy², V J Fogliati², B M Wootton³, P M McEvoy⁴, N Titov²

Affiliations

¹ eCentreClinic, Department of Psychology, Macquarie University, Sydney, Australia. Electronic address: blake.dear@mq.edu.au.
² eCentreClinic, Department of Psychology, Macquarie University, Sydney, Australia.
³ eCentreClinic, Department of Psychology, Macquarie University, Sydney, Australia; School of Medicine (Psychology), University of Tasmania, Tasmania, Australia.
⁴ School of Psychology and Speech Pathology, Curtin University, Western Australia, Australia.

PMID: 26460536
DOI: 10.1016/j.janxdis.2015.09.003

Abstract

Generalized anxiety disorder (GAD) can be treated effectively with either disorder-specific cognitive behavior therapy (DS-CBT) or transdiagnostic CBT (TD-CBT). The relative benefits of DS-CBT and TD-CBT for GAD and the relative benefits of delivering treatment in clinician guided (CG-CBT) and self-guided (SG-CBT) formats have not been examined. Participants with GAD (n=338) were randomly allocated to receive an internet-delivered TD-CBT or DS-CBT intervention delivered in either CG-CBT or SG-CBT formats. Large reductions in symptoms of GAD (Cohen's d ≥ 1.48; avg. reduction ≥ 50%) and comorbid major depressive disorder (Cohen's d ≥ 1.64; avg. reduction ≥ 45%), social anxiety disorder (Cohen's d ≥ 0.80; avg. reduction ≥ 29%) and panic disorder (Cohen's d ≥ 0.55; avg. reduction ≥ 33%) were found across the conditions. No substantive differences were observed between DS-CBT and TD-CBT or CG-CBT and SG-CBT, highlighting the public health potential of carefully developed TD-CBT and SG-CBT.

Keywords: 24-Month follow-up; Anxiety disorders; Clinician-guided; Disorder-specific; Generalized anxiety disorder; Internet; Randomized controlled trial; Self-guided; Transdiagnostic; Treatment.

Publication types

Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Adult
Anxiety Disorders / psychology
Anxiety Disorders / therapy*
Cognitive Behavioral Therapy / methods*
Comorbidity
Depressive Disorder, Major / therapy
Female
Humans
Internet*
Male
Middle Aged
Panic Disorder / therapy
Phobic Disorders / therapy
Self Care / methods
Stress Disorders, Traumatic, Acute / therapy
Treatment Outcome
Young Adult