title: Group metacognitive therapy for repetitive negative thinking in primary and non-primary generalized anxiety disorder: an effectiveness trial.
abstract: BACKGROUND
  Generalized anxiety disorder (GAD) is a common and highly comorbid anxiety disorder characterized by repetitive negative thinking (RNT). Treatment trials tend to exclude individuals with non-primary GAD, despite this being a common presentation in real world clinics. RNT is also associated with multiple emotional disorders, suggesting that it should be targeted regardless of the primary disorder. This study evaluated the acceptability and effectiveness of brief group metacognitive therapy (MCT) for primary or non-primary GAD within a community clinic.
  
  
  METHODS
  Patients referred to a specialist community clinic attended six, two-hour weekly sessions plus a one-month follow-up (N=52). Measures of metacognitive beliefs, RNT, symptoms, positive and negative affect, and quality of life were completed at the first, last, and follow-up sessions.
  
  
  RESULTS
  Attrition was low and large intent-to-treat effects were observed on most outcomes, particularly for negative metacognitive beliefs and RNT. Treatment gains increased further to follow-up. Benchmarking comparisons demonstrated that outcomes compared favorably to longer disorder-specific protocols for primary GAD.
  
  
  CONCLUSIONS
  No control group or independent assessment of protocol adherence.
  
  
  CONCLUSIONS
  Brief metacognitive therapy is an acceptable and powerful treatment for patients with primary or non-primary GAD.
authors.affiliation: Centre for Clinical Interventions, Perth, Australia; School of Psychology and Speech Pathology, Curtin University, GPO Box U1987, Perth, Western Australia 6845, Australia. Electronic address: peter.mcevoy@curtin.edu.au.
authors.forename: Peter M
authors.initials: PM
authors.lastname: McEvoy
authors.affiliation: Centre for Clinical Interventions, Perth, Australia; University of Western Australia, Perth, Australia.
authors.forename: David M
authors.initials: DM
authors.lastname: Erceg-Hurn
authors.affiliation: Centre for Clinical Interventions, Perth, Australia; School of Psychology and Speech Pathology, Curtin University, GPO Box U1987, Perth, Western Australia 6845, Australia.
authors.forename: Rebecca A
authors.initials: RA
authors.lastname: Anderson
authors.affiliation: Centre for Clinical Interventions, Perth, Australia.
authors.forename: Bruce N C
authors.initials: BN
authors.lastname: Campbell
authors.affiliation: Centre for Clinical Interventions, Perth, Australia.
authors.forename: Amanda
authors.initials: A
authors.lastname: Swan
authors.affiliation: Centre for Clinical Interventions, Perth, Australia.
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Saulsman
authors.affiliation: Centre for Clinical Interventions, Perth, Australia.
authors.forename: Mark
authors.initials: M
authors.lastname: Summers
authors.affiliation: Centre for Clinical Interventions, Perth, Australia; University of Western Australia, Perth, Australia.
authors.forename: Paula R
authors.initials: PR
authors.lastname: Nathan
mesh_terms: D000328:Adult; D000368:Aged; D001007:Anxiety / Q000523:psychology / Q000628:therapy; D001008:Anxiety Disorders / Q000523:psychology* / Q000628:therapy*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D004644:Emotions; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009341:Negativism; D010342:Patient Acceptance of Health Care / Q000523:psychology; D011615:Psychotherapy, Group / Q000379:methods*; D013313:Stress Disorders, Post-Traumatic / Q000523:psychology / Q000628:therapy; D013850:Thinking; D016896:Treatment Outcome
keywords: Effectiveness; Generalized anxiety disorder; Metacognitive therapy; Repetitive negative thinking; Worry