title: Perceived social support mediates anxiety and depressive symptom changes following primary care intervention.
abstract: BACKGROUND
  The current study tested whether perceived social support serves as a mediator of anxiety and depressive symptom change following evidence-based anxiety treatment in the primary care setting. Gender, age, and race were tested as moderators.
  
  
  METHODS
  Data were obtained from 1004 adult patients (age M = 43, SD = 13; 71% female; 56% White, 20% Hispanic, 12% Black) who participated in a randomized effectiveness trial (coordinated anxiety learning and management [CALM] study) comparing evidence-based intervention (cognitive-behavioral therapy and/or psychopharmacology) to usual care in the primary care setting. Patients were assessed with a battery of questionnaires at baseline, as well as at 6, 12, and 18 months following baseline. Measures utilized in the mediation analyses included the Abbreviated Medical Outcomes (MOS) Social Support Survey, the Brief Symptom Index (BSI)-Somatic and Anxiety subscales, and the Patient Health Questionnaire (PHQ-9).
  
  
  RESULTS
  There was a mediating effect over time of perceived social support on symptom change following treatment, with stronger effects for 18-month depression than anxiety. None of the mediating pathways were moderated by gender, age, or race.
  
  
  CONCLUSIONS
  Perceived social support may be central to anxiety and depressive symptom changes over time with evidence-based intervention in the primary care setting. These findings possibly have important implications for development of anxiety interventions.
authors: Department of Psychology, University of California, Los Angeles, California.
authors: Halina J
authors: HJ
authors: Dour
authors: Joshua F
authors: JF
authors: Wiley
authors: Peter
authors: P
authors: Roy-Byrne
authors: Murray B
authors: MB
authors: Stein
authors: Greer
authors: G
authors: Sullivan
authors: Cathy D
authors: CD
authors: Sherbourne
authors: Alexander
authors: A
authors: Bystritsky
authors: Raphael D
authors: RD
authors: Rose
authors: Michelle G
authors: MG
authors: Craske
mesh_terms: D000328:Adult; D014151:Anti-Anxiety Agents / Q000008:administration & dosage*; D001008:Anxiety Disorders / Q000175:diagnosis / Q000523:psychology* / Q000628:therapy*; D015928:Cognitive Behavioral Therapy; D003131:Combined Modality Therapy; D003866:Depressive Disorder / Q000175:diagnosis / Q000523:psychology* / Q000628:therapy*; D019317:Evidence-Based Medicine; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016584:Panic Disorder / Q000175:diagnosis / Q000523:psychology / Q000628:therapy; D010698:Phobic Disorders / Q000175:diagnosis / Q000523:psychology / Q000628:therapy; D011320:Primary Health Care; D012938:Social Perception; D012944:Social Support; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000523:psychology / Q000628:therapy; D011795:Surveys and Questionnaires
chemical_list: D014151:Anti-Anxiety Agents
keywords: anxiety; depression; intervention studies; primary care; social support