Positive Health Online

Abstract

NEWMAN and COLLEAGUES, 1. The Pennsylvania State University. Electronic address: mgn1@psu.edu ; 2. The Pennsylvania State University; 3. Seattle Pacific University; 4. University of California at Berkeley examined dimensional interpersonal problems as moderators of cognitive behavioural therapy (CBT) versus its components (cognitive therapy [CT] and behavioural therapy [BT]).

Background

We examined dimensional interpersonal problems as moderators of cognitive behavioural therapy (CBT) versus its components (cognitive therapy [CT] and behavioural therapy [BT]). We predicted that people with generalized anxiety disorder (GAD) whose interpersonal problems reflected more dominance and intrusiveness would respond best to a relaxation-based BT compared to CT or CBT, based on studies showing that people with personality features associated with a need for autonomy respond best to treatments that are more experiential, concrete, and self-directed compared to therapies involving abstract analysis of one's problems (e.g., containing CT).

Methodology

This was a secondary analysis of Borkovec, Newman, Pincus, and Lytle (2002). Forty-seven participants with principal diagnoses of GAD were assigned randomly to combined CBT (n = 16), CT (n = 15), or BT (n = 16).

Results

As predicted, compared to participants with less intrusiveness, those with dimensionally more intrusiveness responded with greater GAD symptom reduction to BT than to CBT at posttreatment and greater change to BT than to CT or CBT across all follow-up points. Similarly, those with more dominance responded better to BT compared to CT and CBT at all follow-up points. Additionally, being overly nurturant at baseline was associated with GAD symptoms at baseline, post, and all follow-up time-points regardless of therapy condition.

Conclusion

Generally anxious individuals with domineering and intrusive problems associated with higher need for control may respond better to experiential behavioural interventions than to cognitive interventions, which may be perceived as a direct challenge of their perceptions.

References

Newman MG1, Jacobson NC2, Erickson TM3, Fisher AJ4. Interpersonal Problems Predict Differential Response to Cognitive Versus Behavioral Treatment in a Randomized Controlled Trial. Behav Ther; 48(1):56-68. Jan 2017. doi: 10.1016/j.beth.2016.05.005. Epub Jun 6 2016.