Treating Worry and Anxiety

Cognitive behavioral therapy and applied relaxation are both effective for anxiety disorder

(RxWiki News) Worry and anxiety are difficult to live with and can cause muscular tension that can lead to severe physical problems with time.

Although there has been success treating Generalized Anxiety Disorder (GAD), little is known about what occurs during the treatment.

A recent study published in the Journal of Consulting and Clinical Psychology examined how GAD symptoms changed with cognitive-behavioral therapy (CBT) and applied relaxation (AR) and whether one treatment method worked better than the other.

The study found that both AR and CBT reduced the amount of daily anxiety by nearly half, but that physical symptoms reduced at a greater rate when anxiety was reduced through CBT.

"Talk to your doctor about available anxiety treatment programs."

Eleanor Donegan of the Department of Psychology at Concordia University in Montreal and Michel Dugas, PhD of Concordia University and Hospital du Sacre´-Coeur de Montre´al studied 57 patients in a randomized controlled trial at the Anxiety Disorders Clinic of the Hospital du Sacre´-Coeur de Montre´al.

Participants in the study had a primary diagnosis of GAD, were between 18 and 64 years of age, had no suicidal intent, current substance abuse of history of mental disorder and had stable psychoactive medication.

Participants were randomly assigned to either CBT or AR for 12 weekly individual sessions that could be increased or decreased at the treating clinician’s discretion. The 31 participants receiving CBT and 26 receiving AR completed daily ratings of worry and somatic anxiety before and after treatment.

CBT is based on the theory that negative beliefs about uncertainty can lead to excessive worry and seeks to change the patient’s views of uncertainty through a goal-oriented, systematic process. Anxiety provoked by mental concerns or worry is commonly referred to as cognitive anxiety.

In AR, patients are taught to apply muscle relaxation techniques to reduce the physical manifestations of anxiety. Anxiety provoked by bodily symptoms of tension is commonly referred to as somatic anxiety.

The amount of time the participants spent worrying or feeling anxious in both groups reduced from 5-6 hours a day to just over 3 hours a day with treatment. Individuals without GAD report experiencing worry and anxiety for about one hour a day.

The authors found that reduction in cognitive anxiety leads to change in somatic anxiety and vice versa, in both CBT and AR. This suggests that not all symptoms of a disorder must be addressed for improvement to occur.

The major difference between CBT and AR treatment results was that the effect worry had on somatic anxiety was more significant in the individuals who underwent CBT.

There were several limitations to the study. The sample was mostly Caucasian and French speaking, secondary conditions of the participants including panic disorder and specific phobia rather than the more common social anxiety and depression disorders and the participants were not assessed for symptoms prior to treatment.

More research using a broader population sample should be carried out to substantiate this study.

This study was supported by a grant from the Canadian Institutes of Health Research. No conflicts of interest were reported.

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Review Date: 
July 26, 2012