TRANSDIAGNOSTIC VERSUS DIAGNOSIS-SPECIFIC CBT FOR ANXIETY DISORDERS: A PRELIMINARY RANDOMIZED CONTROLLED NONINFERIORITY TRIAL: Research Article: Transdiagnostic versus Diagnosis-Specific CBT
Open accessAbstract
BACKGROUND: Transdiagnostic cognitive-behavioral treatments for anxiety disorders have been gaining increased attention and empirical study in recent years. Despite this, research on transdiagnostic anxiety treatments has, to date, relied on open trials, or comparisons to waitlist conditions, published benchmarks, or relaxation-based interventions. METHODS: The current study was a randomized clinical trial examining the efficacy of a 12-week transdiagnostic cognitive-behavioral group treatment in comparison to 12-week diagnosis-specific group Cognitive-Behavioral Therapy (CBT) protocols for panic disorder, social anxiety disorder, and generalized anxiety disorder. RESULTS: Results from 46 treatment initiators suggested significant improvement during treatment, strong evidence for treatment equivalence across transdiagnostic and diagnosis-specific CBT conditions, and no differences in treatment credibility. CONCLUSIONS: This study provides evidence supporting the efficacy of transdiagnostic CBT by comparison to current gold-standard diagnosis-specific CBT for social anxiety disorder, generalized anxiety disorder, and panic disorder. Transdiagnostic group CBT has the benefit of potentially easing dissemination and increasing access to evidence-based treatments for anxiety without sacrificing efficacy.
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Norton (2012) found lower drop-out rates during group TD-CBT, but no significant differences in anxiety severity at post-treatment compared to relaxation training.
“although Norton (2012) found lower drop-out rates during group TD-CBT, there were no significant differences in anxiety severity at post-treatment compared to relaxation training.”
From Systematic review and meta-analysis of transdiagnostic psychological treatments for anxiety and depressive disorders in adulthood (2015) · cites this paper as Norton (2012)
The paper’s background discussion reports that an earlier Norton trial found greater dropout with relaxation training than with transdiagnostic group CBT, alongside statistically equivalent outcomes. However, the cited 2012 paper’s own trial compared transdiagnostic CBT with diagnosis-specific CBT, not relaxation training; the passage also does not specify a post-treatment anxiety-severity comparison. (LLM, conf=0.85)
Experimental — accuracy not yet measuredNorton and Barrera (2012) found no significant differences between group-based TD-CBT and disorder-specific group CBT for anxiety disorders.
“In contrast, in another RCT, Norton and Barrera (2012) found no significant differences between group-based TD-CBT and disorder-specific group CBT for anxiety disorders.”
From Systematic review and meta-analysis of transdiagnostic psychological treatments for anxiety and depressive disorders in adulthood (2015) · cites this paper as Norton and Barrera (2012)
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Labbe, A. K., Wilner, J. G., Coleman, J. N., Marquez, S. M., Kosiba, J. D., Zvolensky, M. J., Smits, J. A. J., Norton, P. J., Rosenfield, D., & O'Cleirigh, C. (2019) · AIDS Care · doi:10.1080/09540121.2018.1533225 · Cited by 3 · see citing works
“We modified an existing 8-week cognitive–behavioral treatment protocol for smoking cessation and anxiety (Norton & Barrera, 2012) to address transdiagnostic domains such as anxiety sensitivity, distress tolerance, and depressive symptomatology (Labbe et al., 2017).”
MethodSelf-citation
- Authors
- Norton, P. J., & Barrera, T. L.
- Affiliations
- University of Houston (US)
- Corresponding author
- Norton, Peter J.
- ORCID
- Norton, Peter J.
- Venue
- Depression and Anxiety
- Publisher
- Wiley
- Published
- 2012-07-05
- Volume
- 29
- Issue
- 10
- Pages
- 874-882
- ISSN
- 1091-4269 (ISSN-L)
- PMC
- PMC3463777
- OpenAlex
- W1922010307
- Cited by
- 193
- References
- 26
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 5 · 2023: 16 · 2022: 13 · 2021: 16 · 2020: 8 · 2019: 17 · 2018: 21 · 2017: 25 · 2016: 18 · 2015: 23 · 2014: 17 · 2013: 8 · 2012: 2
- FWCI
- 21.46
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Depression and Anxiety (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health (K01MH073920, MH073920)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Psychological Treatments and Assessments
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Keywords
- transdiagnostic cognitive behavioral therapy, anxiety disorders, panic disorder, social anxiety disorder, generalized anxiety disorder, non-inferiority, group cognitive behavioral therapy, treatment equivalence, treatment credibility, dissemination of evidence-based treatment
- MeSH terms
- Adult, Anxiety Disorders, Female, Humans, Male, Middle Aged, Psychotherapy, Group, Cognitive Behavioral Therapy, Treatment Outcome, Young Adult
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