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Applied relaxation, CBT benefit different GAD patient populations

PHILADELPHIA — Pure applied relaxation for generalized anxiety disorder was more effective for individuals with a longer duration of illness, while cognitive behavioral therapy was more effective for individuals with comorbid depression, according to data presented here.

“Treatment nonresponse rates tend to be around 50% in most treatments for generalized anxiety disorder. There have been many efforts and attempts to improve that response rate,” Ki Eun Shin, BA, a graduate student at Pennsylvania State University, told Healio.com/Psychiatry. “So what I'm trying to do here is look at individual patient characteristics that predict response to different types of treatments available for [generalized anxiety disorder (GAD)]. If we can identify factors that predict differential response rates between these treatments, then maybe we can tailor treatment for individual clients.”

Shin and colleagues analyzed data from a randomized controlled trial comparing nondirective therapy (n = 18), applied relaxation (n = 18) and CBT (n = 19) for GAD. Study participants received 14 sessions over 9 weeks and rated anxiety three times daily throughout the treatment period and 2-week post-treatment period.

Applied relaxation and CBT had greater significant effects on anxiety than nondirective therapy from the third week of treatment to post-treatment.

Applied relaxation and CBT did not significantly differ from one another, though duration of illness significantly moderated treatment effect from week 6 to post-treatment.

Longer illness duration predicted greater reductions in anxiety following applied relaxation compared with nondirective therapy. This association was not present for CBT.

From week 2 to study end, higher depressive symptoms predicted greater anxiety symptom reduction in CBT compared with nondirective therapy; however, the same was not true for applied relaxation.

“The idea is that with individuals who have had GAD for a longer time might need to practice a focused skill repeatedly to benefit from treatment because their problems are so entrenched, rather than be exposed to a different toolbox of skills,” Shin said. “Individuals with comorbid depressive symptoms needed that toolbox of CBT rather than focusing on a specific skill, as CBT includes skills that can generalize to depression, compared with applied relaxation.” – by Amanda Oldt

Reference:

Shin K and Newman M. Time-varying processes in a randomized trial of applied relaxation and CBT for generalized anxiety disorder. Presented at: Anxiety and Depression Association of America Conference; March 31-April 3, 2016; Philadelphia.

Disclosure: Shin reports no relevant financial disclosures.