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Cited by 175Mindfulness and Compassion InterventionsAnxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesPsychotherapy Techniques and Applications

Acceptance and Commitment Therapy for generalized anxiety disorder in older adults: a preliminary report.

Open access
Wetherell, Julie Loebach, Liu, Lin, Patterson, Thomas L., Afari, Niloofar, Ayers, Catherine R., Thorp, Steven R., Stoddard, Jill A., Ruberg, Joshua +3 more·2011·Behavior Therapy
DOI 10.1016/j.beth.2010.07.002PMC PMC3496779
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Abstract

Some evidence suggests that acceptance-based approaches such as Acceptance and Commitment Therapy (ACT) may be well-suited to geriatric generalized anxiety disorder (GAD). The primary goal of this project was to determine whether ACT was feasible for this population. Seven older primary-care patients with GAD received 12 individual sessions of ACT; another 9 were treated with cognitive-behavioral therapy. No patients dropped out of ACT, and worry and depression improved. Findings suggest that ACT may warrant a large-scale investigation with anxious older adults.

Integrity signals

Registry

Crossref · 10.1016/j.beth.2010.07.002

Cites

49 of 49 references verified0 citation errors · 0 not checkable

Statistics

12 tests recomputed · 1 with the reported and recomputed p on opposite sides of .05

Claims the paper makes

8 of 34 cited sources checked · 4 supported · 0 flagged · accuracy not yet measured

  • Study design and conductcitation

    A 12-week waiting period was used to control for natural recovery.

    “A 12-week waiting period between randomization and the start of treatment was designed to control for potential natural recovery, which our team observed in a previous investigation (Wetherell et al., 2009).”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites Wetherell et al., 2009 source

      The source’s Conclusions (page unavailable) report symptomatic improvement in both the psychotherapy and enhanced-community-treatment groups, which supports the citing authors’ observation of improvement outside their psychotherapy arm. But the Methods (Procedures) and Conclusions say community-treatment patients could receive medication or other care; the study does not establish that their improvement was natural recovery. The 12-week waiting period is the citing authors’ own design, not a feature attributed to this source. (LLM, conf=0.83)

      Experimental — accuracy not yet measured
  • Premisecitation

    Evidence for CBT's efficacy in anxious older adults is mixed.

    “Although CBT is effective for older adults with depression (e.g., Serfaty, et al., 2009), evidence for its efficacy with anxious older adults is mixed (Hendriks, Oude Voshaar, Keijsers, Hoogduin, & van Balkom, 2008; Pinquart & Duberstein, 2007; Schuurmans, et al., 2006; Stanley et al., 2009; Thorp, et al., 2009; Wetherell et al., 2009).”
    Quote in the paperSubstantial claim1 of 3 sources checked
    • cites Hendriks, Oude Voshaar, Keijsers, Hoogduin, & van Balkom, 2008 source

      The Methodological considerations section reports that only two of nine individual trials had significant results, which supports describing the trial findings as mixed. But the Discussion and Clinical implications sections report significant pooled benefits and conclude that CBT is effective for anxiety disorders in adults over 60; the claim omits that overall conclusion. Page numbers were not available in our copy. (LLM, conf=0.84)

      Experimental — accuracy not yet measured
    • cites Pinquart & Duberstein, 2007 source
    • cites Schuurmans, et al., 2006 source
  • Premisecitation

    CBT appears less effective for anxiety in older adults than in younger adults.

    “CBT does not appear to ameliorate anxiety for older adults as well as it does for younger adults (Wolitzky-Taylor, Castriotta, Lenze, Stanley, & Craske, 2010).”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites Wolitzky-Taylor, Castriotta, Lenze, Stanley, & Craske, 2010 source
  • Interpretationcitation

    The effects of ACT in this study were substantially smaller than effects observed in younger adult GAD samples.

    “In general, the effects of ACT in this study were substantially smaller than effects observed in younger adult samples with GAD (e.g., Roemer & Orsillo, 2007; Roemer et al., 2008).”
    Quote in the paperSubstantial claim1 of 2 sources checked
    • cites Roemer & Orsillo, 2007 source
    • cites Roemer et al., 2008 source
    • Rests on an assumption: Pre-post improvements in the ACT condition reflect effects of ACT rather than natural recovery, nonspecific factors, or other confounds.
  • Interpretationcitation

    This replicates previous findings that older GAD patients may improve over time regardless of treatment.

    “This replicates our team’s previous findings that older GAD patients may improve over time regardless of treatment (Wetherell et al., 2009).”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites Wetherell et al., 2009 source
  • Classified as probably not a substantial claim. 18
  • May combine two claims. 13

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    GAD is common among older adults and substantially lowers their quality of life.

    “Generalized anxiety disorder (GAD) is a prevalent condition resulting in substantial impairment in quality of life among older adults (de Beurs, et al., 1999; Gum, King-Kallimanis, & Kohn, 2009; Porensky et al., 2009; Wetherell et al., 2004).”
    Quote in the paperNot a substantial claim1 of 3 sources checked
    • cites de Beurs, et al., 1999 source
    • cites Gum, King-Kallimanis, & Kohn, 2009 source
    • cites Porensky et al., 2009 source

  • May combine two claims.

    Premisecitation

    ACT and acceptance-based treatments have substantial support for depression and chronic pain and have shown efficacy for GAD in younger adults.

    “In the relatively short time since its development, ACT and acceptance-based treatments have amassed considerable support for depression and chronic pain and have recently demonstrated efficacy for GAD in younger adults (Hayes, Luoma, Bond, Masuda, & Lillis, 2006; Longmore & Worrell, 2007; Roemer & Orsillo, 2007; Roemer, Orsillo, & Salters-Pedneault, 2008).”
    Quote in the paperSubstantial claim1 of 3 sources checked
    • cites Hayes, Luoma, Bond, Masuda, & Lillis, 2006 source

      The Mediational studies section (p. 17) reports improved depression outcomes in a small ACT trial, and Other studies (p. 19) reports improvements following ACT-based treatment for chronic pain. The review describes the evidence as promising but not yet mature (Abstract, p. 1), so “considerable support” overstates its assessment. Its GAD material concerns questionnaire associations (Research on ACT, p. 12), not demonstrated treatment efficacy in younger adults. (LLM, conf=0.86)

      Experimental — accuracy not yet measured
    • cites Longmore & Worrell, 2007 source
    • cites Roemer & Orsillo, 2007 source

  • May combine two claims.

    Premisecitation

    Older adults with anxiety often avoid pharmacotherapy and many prefer psychotherapy.

    “Although antidepressant medications have demonstrated efficacy in the treatment of geriatric GAD, anxious older adults are often wary of pharmacotherapy due to hypervigilance for side effects, worry about potential adverse effects of medications, a desire to limit the number of drugs taken, or other factors, and many prefer psychotherapeutic treatment (Gum et al., 2006; Lenze et al., 2009; Metge,”
    Quote in the paperSubstantial claim1 of 3 sources checked
    • cites Gum et al., 2006 source
    • cites Lenze et al., 2009 source

      The COMMENT section (page unavailable) reports escitalopram efficacy in older adults with GAD and says patients with anxiety disorders are often poorly adherent to pharmacotherapy. It does not say that older adults avoid medication because they fear side effects or that many prefer psychotherapy; poor adherence does not establish those reasons or preferences. (LLM, conf=0.84)

      Experimental — accuracy not yet measured
    • cites Metge, Grymonpre, Dahl, & Yogendran, 2005 source

  • May combine two claims.

    Findingown data

    Overall adherence and competence ratings were in the adherent and competent range.

    “The overall ratings all fell in the range of adherent and competent performance.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    ACT-assigned patients improved significantly more on depressive symptoms over the waiting period than CBT-assigned patients, so groups were no longer equivalent on that variable at treatment start.

    “Because patients assigned to ACT improved significantly more on depressive symptoms over the waiting period than did those assigned to CBT, the groups were no longer equivalent on that variable at the commencement of treatment.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    All 7 ACT participants completed all 12 sessions.

    “All 7 ACT participants completed the therapy, and they showed improvement in worry scores and severity of depressive symptoms.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Mean CSQ scores were 26.4 (SD 5.4) for ACT and 26.7 (SD 6.9) for CBT, with no significant difference (t(14)=-.087, p>.05).

    “Mean CSQ scores were 26.4 (5.4) for ACT and 26.7 (6.9) for CBT, t (14) = −.087, p > .05, suggesting an overall high level of satisfaction with treatment.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    Five of 9 CBT participants completed treatment.

    “Five of the 9 individuals who started CBT completed treatment.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Fewer ACT participants (0/7) withdrew from treatment than CBT participants (4/9), but the difference was not statistically significant (Fisher's Exact Test, p=.088).

    “Fewer patients in the ACT condition (0/7) withdrew from treatment than in the CBT condition (4/9), although this difference did not reach statistical significance (Fisher’s Exact Test, p = .088).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    HAMA interrater reliability in this sample was .94.

    “Interrater reliability in this sample according to the interclass correlation coefficient was .94.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Study design and conductown data

    Participants were randomly assigned to ACT or CBT.

    “Therefore, after completing the baseline assessment, the 21 participants were randomly assigned to receive either 12 weekly hour-long individual sessions of ACT (n = 11) or CBT (n = 10).”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    An external rater evaluated adherence and competence from two tapes per therapist.

    “An external rater trained in both models evaluated adherence and competent delivery based on two tapes per therapist.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    Therapy sessions were videotaped and reviewed in weekly supervision to maintain fidelity.

    “Therapy sessions were videotaped and reviewed in weekly supervision sessions to maintain fidelity to the treatment protocol.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Study design and conductnone given

    Assessments were conducted by two research assistants blind to treatment condition.

    “Assessments were conducted by two research assistants blind to treatment condition.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    CSQ alpha in this sample was .96.

    “alpha in this sample = .96”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductown data

    Twelve therapy completers and two dropouts completed the posttreatment assessment; two were lost to follow-up.

    “Twelve therapy completers and 2 dropouts completed this third assessment; two participants were lost to follow-up.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Older adults with GAD typically have long-lasting symptoms, with mean reported duration of 20-30 years and often lifelong.

    “It typically persists for decades; older GAD patients report a mean symptom duration of 20 to 30 years across studies in community, medical, and mental health samples in multiple countries, and the modal duration is lifelong (Chou, 2009; Le Roux, Gatz, & Wetherell, 2005; Lenze, et al., 2005; Rubio & Lopez-Ibor, 2007; Schoevers, Deeg, van Tilburg, & Beekman, 2005).”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites Chou, 2009 source
    • cites Le Roux, Gatz, & Wetherell, 2005 source
    • cites Lenze, et al., 2005 source

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    PSWQ Cronbach's alpha in this sample was .79.

    “Cronbach’s alpha in this sample was .79.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductown data

    The sample size prevented between-group inferential statistics, so data are presented as separate open trials.

    “The sample size precluded inferential statistics between the groups, so the data in this report are presented as separate open trials of the interventions.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    Five participants withdrew during the waiting period.

    “Five participants withdrew from the study during the waiting period (due to time constraints, improvement in anxiety symptoms, or loss of contact).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    ACT aims to increase psychological flexibility, which buffers against experiential avoidance and ineffective coping.

    “The treatment focuses on acceptance as a process resulting in increased psychological flexibility that works as a buffer against experiential avoidance and ineffective coping (Luoma, Hayes, & Walser, 2007).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Luoma, Hayes, & Walser, 2007

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Classified as probably not a substantial claim. May combine two claims.

    Premisecitation

    ACT is an evidence-based psychotherapy that targets struggle with symptoms.

    “Acceptance and Commitment Therapy (ACT) is an evidence-based psychotherapy that targets the struggle with symptoms that may be most salient and disruptive in chronic disorders.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Luoma, Hayes, & Walser, 2007

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    BDI-II alpha in this sample was .91.

    “alpha in this sample = 0.91”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    All 12 therapy completers completed the six-month follow-up.

    “Therapy completers were contacted again after six months for a follow-up evaluation; all 12 completed this fourth and final assessment.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Older adults are the most rapidly growing demographic group.

    “older adults are the most rapidly growing demographic group (U.S. Department of Health and Human Services, 2009)”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites U.S. Department of Health and Human Services, 2009

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Interpretationown data

    ACT may be effective in reducing depressive symptoms and worry in older GAD patients, even when delivered by novice therapists.

    “Preliminary outcome data suggest that ACT may be effective in reducing depressive symptoms and worry, even when conducted by novice therapists.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: Pre-post improvements in the ACT condition reflect effects of ACT rather than natural recovery, nonspecific factors, or other confounds.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Anxiety disorders are three times more prevalent than depression in the elderly.

    “anxiety disorders are three times more prevalent than depression in the elderly (Gum et al., 2009)”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Gum et al., 2009 source
27 of 27

  • The paper relies on this without support.

    Pre-post improvements in the ACT condition reflect effects of ACT rather than natural recovery, nonspecific factors, or other confounds.

    “Preliminary outcome data suggest that ACT may be effective in reducing depressive symptoms and worry, even when conducted by novice therapists.”

  • The paper relies on this without support.

    The sample of older primary-care patients with GAD is representative enough that feasibility and effectiveness findings generalize to older adults with GAD.

    “Results from this pilot study suggest that ACT is feasible to use with older adults with GAD.”
2 of 2

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Wetherell and colleagues concluded that the intervention requires adaptation to ensure its relevance and acceptability to older adults.

    “Wetherell and colleagues concluded that the intervention requires adaptation to ensure its relevance and acceptability to older adults (13).”

    From Optimising the acceptability and feasibility of acceptance and commitment therapy for treatment-resistant generalised anxiety disorder in older adults. (2019) · cites this paper as [13]

    The Discussion suggests that an ACT adaptation with fewer elements particularly relevant to older adults may be more effective. It does not conclude that adaptation is required or that it is needed to ensure acceptability; the Discussion describes the existing intervention as feasible for older adults with GAD. Page numbers were not available in our copy. (LLM, conf=0.87)

    Experimental — accuracy not yet measured

  • Wetherell et al. (2011) found that ACT is feasible for use with older adults with GAD and effective at reducing worry, though the effects observed were significantly smaller than those reported in younger adults.

    “Wetherell et al. (2011) found that ACT is feasible for use with older adults with GAD and effective at reducing worry, though the effects observed were significantly smaller than those reported in younger adults.”

    From Optimising the acceptability and feasibility of acceptance and commitment therapy for treatment-resistant generalised anxiety disorder in older adults. (2019) · cites this paper as [13]

    The Results (Treatment Effects; page unavailable) report that all seven ACT participants completed treatment and that worry scores decreased significantly. The Discussion (page unavailable) concludes that ACT appears feasible and describes its effects as “substantially smaller” than those observed in younger adults, but it does not report a statistical test showing that the between-age difference was significant. The paper presents efficacy as a question for further study, rather than an established conclusion. (LLM, conf=0.90)

    Experimental — accuracy not yet measured

  • Very little research has tested ACT in older adults, with only one pilot study to date.

    “The research examining the effectiveness of ACT with older adults is extremely limited. To date, only one pilot study has been conducted to examine the effectiveness of ACT with older adults (Wetherell et al., 2011).”

    From Acceptance and Commitment Therapy With Older Adults: Rationale and Considerations (2013) · cites this paper as Wetherell et al., 2011

    The Discussion describes this as a pilot study of ACT for older adults with generalized anxiety disorder, and the Method > Procedure says it was intended to prepare for a larger trial. The paper supports identifying this study as a pilot, but it does not establish that it was the only pilot study of ACT with older adults to date. The indexed passages provide no page numbers. (LLM, conf=0.84)

    Experimental — accuracy not yet measured

  • Beneficial effects on symptoms of depression, anxiety and functional measures have been reported in studies of ACT in older people, along with high rates of attendance.

    “Beneficial effects on symptoms of depression, anxiety and functional measures have been reported in these studies, along with high rates of attendance.”

    From Acceptance and commitment therapy for older people with treatment-resistant generalised anxiety disorder: The FACTOID feasibility study (2021) · cites this paper as [27]

    The Results (Treatment Effects; page not provided) report that all seven older adults who began ACT completed it, with significant improvements in worry and depressive symptoms. Anxiety scores and the mental-health quality-of-life measure moved in a favorable direction but did not improve significantly; the paper does not establish a beneficial effect on functional measures. (LLM, conf=0.88)

    Experimental — accuracy not yet measured

  • 100% session attendance was reported in 7 out of 7 older people with GAD.

    “100% session attendance was reported in 7 out of 7 (100%) older people with GAD 27”

    From Acceptance and commitment therapy for older people with treatment-resistant generalised anxiety disorder: The FACTOID feasibility study (2021) · cites this paper as [27]

    The Results (Treatment Effects; page unavailable) state that all 7 older patients with GAD who started ACT completed therapy, supporting a 7-of-7 completion rate. The paper does not report that each attended every session, so 100% session attendance is more specific than the evidence supports. (LLM, conf=0.85)

    Experimental — accuracy not yet measured

Statistics that don’t add up

Each reported p-value recomputed from its test statistic and degrees of freedom.

  • Inconsistent p-value across alpha = .05: z = −2.20, p = .08

    Major

    The paper reports p = .08 here; recomputing from the test statistic and its degrees of freedom gives p = .028 (two-tailed). The two fall on opposite sides of alpha = .05. The check cannot tell whether the statistic or the p-value is the misprint.

    Reported p = .08 · recomputed p = .028

1 of 1

Statistics recomputed

Every reported test result, recomputed from its test statistic and degrees of freedom. A result shows as not adding up only once an independent check has confirmed it.

  • Doesn’t add upz = -2.2reported p = .08 · recomputed p = .028The two fall on opposite sides of .05

    “z = −2.20, p = .08”

  • Consistentz = -2.45reported p < .05 · recomputed p = .014

    “z = −2.45, p < .05”

  • Consistentz = -2.37reported p < .05 · recomputed p = .018

    “z = −2.37, p < .05”

  • Consistentz = -2.5reported p < .05 · recomputed p = .012

    “z = −2.50, p < .05”

  • Consistentz = -3.09reported p < .01 · recomputed p = .002

    “z = −3.09, p < .01”

  • Consistentz = -1.95reported p = .05 · recomputed p = .051

    “z = −1.95, p = .05”

  • Consistentz = -2.13reported p < .05 · recomputed p = .033

    “z = −2.13, p < .05”

  • Consistentz = -1.89reported p = .06 · recomputed p = .059

    “z = −1.89, p = .06”

  • Consistentz = -1.69reported p = .09 · recomputed p = .091

    “z = −1.69, p = .09”

  • Consistentz = -2.02reported p < .05 · recomputed p = .043

    “z = −2.02, p < .05”

  • Consistentz = -0.67reported n.s. · recomputed p = .503

    “z = −0.67, ns”

  • Consistentt(14) = -0.087reported p > .05 · recomputed p = .932

    “t (14) = −.087, p > .05”

12 of 12

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Self-check results appear here once an independent check has confirmed them.

Cites

Flagged first, then by citations

3 of the 52 references couldn’t be matched to a known paper.

Research works printed but not linked: 1

  1. Wetherell, J. L., Ruberg, J., & Petkus, A. (in press). Generalized anxiety disorder. In H. Sorocco & S. Lauderdale (Eds.), Cognitive-behavioral therapy with older adults: An interdisciplinary guide. New York: Guilford Press.

Cited by

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Related

Authors
Wetherell, J. L., Liu, L., Patterson, T. L., Afari, N., Ayers, C. R., Thorp, S. R., Stoddard, J. A., Ruberg, J., Kraft, A., Sorrell, J. T., & Petkus, A. J.
Affiliations
  • University of California San Diego (US)
  • Alliant University (US)
  • VA San Diego Healthcare System (US)
  • San Mateo Medical Center (US)
  • San Diego State University (US)
Corresponding author
Wetherell, Julie Loebach
ORCID
Venue
Behavior Therapy
Publisher
Elsevier BV
Published
2011-03
Volume
42
Issue
1
Pages
127-134
ISSN
0005-7894 (ISSN-L)
DOI
10.1016/j.beth.2010.07.002
PMC
PMC3496779
OpenAlex
W2111326443
Cited by
175
References
52
Citations by year
2026: 3 · 2025: 4 · 2024: 12 · 2023: 6 · 2022: 8 · 2021: 21 · 2020: 15 · 2019: 14 · 2018: 10 · 2017: 21 · 2016: 9 · 2015: 11 · 2014: 16 · 2013: 7 · 2012: 12
FWCI
8.76
Type
journal article
Language
en
Open access
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Behavior Therapy (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Institute of Mental Health (K23MH067643)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
  • Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
Keywords
acceptance and commitment therapy, generalized anxiety disorder, older adults, feasibility, cognitive behavioral therapy, worry, depression, primary care
MeSH terms
Aged, Anxiety Disorders, Behavior Therapy, Depression, Female, Health Services for the Aged, Humans, Male, Pilot Projects, Cognitive Behavioral Therapy, Patient Satisfaction

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-09-28.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-09-28.

Cited sources are checked by gpt-6-sol.

Statistics and arithmetic are recomputed, not judged.

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