Category: Adult Anxiety
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.
Methods: 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.
Results: 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.
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
Center for the Treatment and Study of Anxiety, University of Pennsylvania
Assistant Professor in Clinical Psychology
University of Pennsylvania School of Medicine and Center for the Treatment and Study of Anxiety