title: Sudden gains in the treatment of generalized anxiety disorder.
abstract: The objective of this study was to investigate the prevalence and timing of sudden gains over the course of brief, psychodynamically oriented treatment for generalized anxiety disorder (GAD). Data were used from two studies of brief (i.e., 16-session) supportive-expressive psychotherapy for GAD. Anxiety symptoms were measured at every weekly treatment session. Sudden gains in anxiety symptoms were defined to parallel previous research on sudden gains in major depressive disorder (MDD). Overall, sudden gains were found for 11 of 68 participants (16.2%), with 4 (36.4%) of these patients experiencing reversals of these gains and losing over 50% of the sudden gain during subsequent treatment sessions. Applying a baseline severity cutoff and a duration criteria similar to those used in previous studies of sudden gains resulted in 10 of 29 (34.5%) patients showing sudden gains. Of these sudden gainers, 4 (40.0%) experienced a reversal and 7 (70%) experienced an upwards spike in symptoms during their psychotherapy course. When defined in a parallel fashion, rates of sudden gains in GAD are similar to those found in MDD, although anxiety symptoms are highly variable.
authors.affiliation: University of Pennsylvania, PA, USA.
authors.forename: Julie
authors.initials: J
authors.lastname: Present
authors.forename: Paul
authors.initials: P
authors.lastname: Crits-Christoph
authors.forename: Mary Beth
authors.initials: MB
authors.lastname: Connolly Gibbons
authors.forename: Bridget
authors.initials: B
authors.lastname: Hearon
authors.forename: Sarah
authors.initials: S
authors.lastname: Ring-Kurtz
authors.forename: Matthew
authors.initials: M
authors.lastname: Worley
authors.forename: Robert
authors.initials: R
authors.lastname: Gallop
mesh_terms: D001008:Anxiety Disorders / Q000523:psychology / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data; D011614:Psychotherapy, Brief / Q000706:statistics & numerical data; D014481:United States