Category: Adult Anxiety

PS2- #A28 - Changes in Functional Impairment in Anxiety Disorders Following Eight Weeks of CBT

Friday, Nov 17
9:45 AM – 10:45 AM
Location: Indigo Ballroom CDGH, Level 2, Indigo Level

Keywords: Adult Anxiety | CBT

Background:  Research has demonstrated that: 1) Anxiety disorders  interfere with a person’s daily functioning and quality of life; 2) the levels of impairment the various domains vary across anxiety disorders;  and 3) treatment improves quality of life and reduces impairments in functioning across anxiety disorders.

Aims: This study sought to investigate how functional impairment, as measured by the Sheehan Disability Scale (SDS), changes over the course of 8 weeks of cognitive behavioral therapy in a range of anxiety disorders.

229 patients seeking treatment at a fee-for-service anxiety disorders clinic presented for treatment. At the intake assessment, patients completed self-report questionnaires assessing for a variety of symptoms: 47.5% (n=109) were given a primary diagnosis of obsessive-compulsive disorder (OCD), 20.1% (n=46) with generalized anxiety disorder (GAD), 17.4% (n=40) with post-traumatic stress disorder (PTSD), and 14.8% (n=34) with social anxiety disorder (SAD). Patients completed identical self-report questionnaires following 8 weeks of disorder-specific, protocol-based cognitive-behavioral therapy.

A one-way analysis of variance (ANOVA) was conducted to compare the effect of diagnostic group on the change in functioning (SDSChange) after 8 weeks of CBT. There was a significant effect of diagnostic group on degree of improvement in functioning, F(3,89) = 3.818, p = .013. Specifically, post hoc LSD tests showed that patients with primary SAD had significantly smaller improvement in functioning (SDSChange = 1.41) compared to those with primary OCD (SDSChange = 7.13, mean difference = 5.71, p = .007) and PTSD (SDSChange = 9.57, mean difference = 8.15, SD = 2.81, p = .002). SAD did not significantly differ from GAD (SDSChange = 5.82, mean difference = 4.409, SD = 2.58, p = .056), although there was a trend in the same direction as seen with PTSD/OCD. Improvement in functioning did not differ significantly across patients with OCD, PTSD, and GAD.

Similar to findings of previous research, in this naturalistic setting of patients, anxiety disorder diagnosis was associated with improvement in functioning after 8 weeks of CBT. However, these results demonstrate that the degree of improvement in functionality may vary across anxiety disorders in this naturalistic setting. SAD was associated with less improvement in functioning after a brief course of CBT compared to OCD and PTSD, and marginally as compared to GAD.

Julie Petersen

Research Assistant
Center for the Treatment and Study of Anxiety, University of Pennsylvania
Philadelphia, Pennsylvania

Anu Asnaani

Assistant Professor in Clinical Psychology
University of Pennsylvania School of Medicine and Center for the Treatment and Study of Anxiety
Philadelphia, Pennsylvania

Edna Foa

Professor and Director
University of Pennsylvania. Center for the Treatment and Study of Anxiety
Philadelphia, Pennsylvania