title: Physiological and behavioral indices of emotion dysregulation as predictors of outcome from cognitive behavioral therapy and acceptance and commitment therapy for anxiety.
abstract: OBJECTIVE
  Identifying for whom and under what conditions a treatment is most effective is an essential step toward personalized medicine. The current study examined pre-treatment physiological and behavioral variables as predictors and moderators of outcome in a randomized clinical trial comparing cognitive behavioral therapy (CBT) and acceptance and commitment therapy (ACT) for anxiety disorders.
  
  
  METHODS
  Sixty individuals with a DSM-IV defined principal anxiety disorder completed 12 sessions of either CBT or ACT. Baseline physiological and behavioral variables were measured prior to entering treatment. Self-reported anxiety symptoms were assessed at pre-treatment, post-treatment, and 6- and 12-month follow-up from baseline.
  
  
  RESULTS
  Higher pre-treatment heart rate variability was associated with worse outcome across ACT and CBT. ACT outperformed CBT for individuals with high behavioral avoidance. Subjective anxiety levels during laboratory tasks did not predict or moderate treatment outcome.
  
  
  CONCLUSIONS
  Due to small sample sizes of each disorder, disorder-specific predictors were not tested. Future research should examine these predictors in larger samples and across other outcome variables.
  
  
  CONCLUSIONS
  Lower heart rate variability was identified as a prognostic indicator of overall outcome, whereas high behavioral avoidance was identified as a prescriptive indicator of superior outcome from ACT versus CBT. Investigation of pre-treatment physiological and behavioral variables as predictors and moderators of outcome may help guide future treatment-matching efforts.
authors.affiliation: Department of Psychology, University of California, Los Angeles (UCLA), Los Angeles, CA, USA. Electronic address: cdavies@psych.ucla.edu.
authors.forename: Carolyn D
authors.initials: CD
authors.lastname: Davies
authors.affiliation: Department of Psychology, University of California, Los Angeles (UCLA), Los Angeles, CA, USA.
authors.forename: Andrea N
authors.initials: AN
authors.lastname: Niles
authors.affiliation: Department of Psychology, University of Mannheim, Mannheim, Germany.
authors.forename: Andre
authors.initials: A
authors.lastname: Pittig
authors.affiliation: Department of Psychology and Neuroscience, University of Colorado, Boulder, Boulder, CO, USA.
authors.forename: Joanna J
authors.initials: JJ
authors.lastname: Arch
authors.affiliation: Department of Psychology, University of California, Los Angeles (UCLA), Los Angeles, CA, USA. Electronic address: craske@psych.ucla.edu.
authors.forename: Michelle G
authors.initials: MG
authors.lastname: Craske
mesh_terms: D064869:Acceptance and Commitment Therapy; D000328:Adult; D000704:Analysis of Variance; D001007:Anxiety / Q000523:psychology* / Q000534:rehabilitation*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D004562:Electrocardiography; D005260:Female; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D006985:Hyperventilation / Q000209:etiology; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011237:Predictive Value of Tests; D012063:Relaxation; D057566:Self Report; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Acceptance and commitment therapy; Behavioral avoidance; Cognitive behavioral therapy; Heart rate variability; Treatment outcome