title: Transdiagnostic versus disorder-specific and clinician-guided versus self-guided internet-delivered treatment for generalized anxiety disorder and comorbid disorders: A randomized controlled trial.
abstract: Generalized anxiety disorder (GAD) can be treated effectively with either disorder-specific cognitive behavior therapy (DS-CBT) or transdiagnostic CBT (TD-CBT). The relative benefits of DS-CBT and TD-CBT for GAD and the relative benefits of delivering treatment in clinician guided (CG-CBT) and self-guided (SG-CBT) formats have not been examined. Participants with GAD (n=338) were randomly allocated to receive an internet-delivered TD-CBT or DS-CBT intervention delivered in either CG-CBT or SG-CBT formats. Large reductions in symptoms of GAD (Cohen's d ≥ 1.48; avg. reduction ≥ 50%) and comorbid major depressive disorder (Cohen's d ≥ 1.64; avg. reduction ≥ 45%), social anxiety disorder (Cohen's d ≥ 0.80; avg. reduction ≥ 29%) and panic disorder (Cohen's d ≥ 0.55; avg. reduction ≥ 33%) were found across the conditions. No substantive differences were observed between DS-CBT and TD-CBT or CG-CBT and SG-CBT, highlighting the public health potential of carefully developed TD-CBT and SG-CBT.
authors.affiliation: eCentreClinic, Department of Psychology, Macquarie University, Sydney, Australia. Electronic address: blake.dear@mq.edu.au.
authors.forename: B F
authors.initials: BF
authors.lastname: Dear
authors.affiliation: eCentreClinic, Department of Psychology, Macquarie University, Sydney, Australia.
authors.forename: L G
authors.initials: LG
authors.lastname: Staples
authors.affiliation: eCentreClinic, Department of Psychology, Macquarie University, Sydney, Australia.
authors.forename: M D
authors.initials: MD
authors.lastname: Terides
authors.affiliation: eCentreClinic, Department of Psychology, Macquarie University, Sydney, Australia.
authors.forename: E
authors.initials: E
authors.lastname: Karin
authors.affiliation: eCentreClinic, Department of Psychology, Macquarie University, Sydney, Australia.
authors.forename: J
authors.initials: J
authors.lastname: Zou
authors.affiliation: eCentreClinic, Department of Psychology, Macquarie University, Sydney, Australia.
authors.forename: L
authors.initials: L
authors.lastname: Johnston
authors.affiliation: eCentreClinic, Department of Psychology, Macquarie University, Sydney, Australia.
authors.forename: M
authors.initials: M
authors.lastname: Gandy
authors.affiliation: eCentreClinic, Department of Psychology, Macquarie University, Sydney, Australia.
authors.forename: V J
authors.initials: VJ
authors.lastname: Fogliati
authors.affiliation: eCentreClinic, Department of Psychology, Macquarie University, Sydney, Australia; School of Medicine (Psychology), University of Tasmania, Tasmania, Australia.
authors.forename: B M
authors.initials: BM
authors.lastname: Wootton
authors.affiliation: School of Psychology and Speech Pathology, Curtin University, Western Australia, Australia.
authors.forename: P M
authors.initials: PM
authors.lastname: McEvoy
authors.affiliation: eCentreClinic, Department of Psychology, Macquarie University, Sydney, Australia.
authors.forename: N
authors.initials: N
authors.lastname: Titov
mesh_terms: D000293:Adolescent; D000328:Adult; D001008:Anxiety Disorders / Q000523:psychology / Q000628:therapy*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D015897:Comorbidity; D003865:Major Depressive Disorder / Q000628:therapy; D005260:Female; D006801:Humans; D020407:Internet; D008297:Male; D008875:Middle Aged; D016584:Panic Disorder / Q000628:therapy; D010698:Phobic Disorders / Q000628:therapy; D012648:Self Care / Q000379:methods; D040701:Stress Disorders, Traumatic, Acute / Q000628:therapy; D016896:Treatment Outcome; D055815:Young Adult
keywords: 24-Month follow-up; Anxiety disorders; Clinician-guided; Disorder-specific; Generalized anxiety disorder; Internet; Randomized controlled trial; Self-guided; Transdiagnostic; Treatment