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Cited by 129Anxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesChild and Adolescent Psychosocial and Emotional DevelopmentMental Health Research Topics

Changes in proposed mechanisms of action during an acceptance-based behavior therapy for generalized anxiety disorder

Open access
Hayes, Sarah A., Orsillo, Susan M., Roemer, Lizabeth·2010·Behaviour Research and Therapy
DOI 10.1016/j.brat.2009.11.006PMC PMC2829361
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Abstract

Based on the theory that generalized anxiety disorder (GAD) is maintained through a reactive and fused relationship with one's internal experiences and a tendency towards experiential avoidance and behavioral restriction, an acceptance-based behavior therapy (ABBT) was developed to specifically target these elements. Since ABBT has been shown to be an efficacious treatment in previous studies, the current study focuses on proposed mechanisms of change over the course of therapy. Specifically, the current study focuses on session-by-session changes in two proposed mechanisms of change: acceptance of internal experiences and engagement in meaningful activities. Overall, clients receiving ABBT reported an increase in the amount of time spent accepting internal experiences and engaging in valued activities. Change in both acceptance and engagement in meaningful activities was related to responder status at post-treatment and change in these two proposed mechanisms predicted outcome above and beyond change in worry. In addition, change in acceptance was related to reported quality of life at post-treatment. © 2009 Elsevier Ltd. All rights reserved.

Integrity signals

Registry

Crossref · 10.1016/j.brat.2009.11.006

Cites

47 of 47 references verified0 citation errors · 0 not checkable

Statistics

10 tests recomputed · 0 with the reported and recomputed p on opposite sides of .05

Claims the paper makes

6 of 25 cited sources checked · 6 supported · 0 flagged

  • Interpretationcitation

    The diminished quality of life reported by individuals with GAD may be accounted for by their living less consistently with their values.

    “This may account for the diminished quality of life reported by those with GAD”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites Henning, Turk, Mennin, Fresco, & Heimberg, 2007 source
  • Premiseown data

    After treatment or waiting, 75% of ABBT participants were treatment responders versus 8% of wait-list participants.

    “At post treatment or post waiting list, 75% of participants receiving ABBT were considered treatment responders, compared to 8% on the wait list.”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites Roemer, Orsillo, & Salters-Pedneault, 2008 source
  • Premisecitation

    In the wait-list controlled trial, ABBT clients improved significantly more than wait-list participants on GAD severity, worry, and depression.

    “In the wait list controlled trial, clients receiving ABBT showed significantly greater improvement on GAD severity, worry, and depression compared to those in the wait list.”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites Roemer, Orsillo, & Salters-Pedneault, 2008 source
  • Premisecitation

    ABBT has been shown to be an efficacious treatment for GAD in previous studies.

    “Since ABBT has been shown to be an efficacious treatment in previous studies”
    Quote in the paperSubstantial claim1 of 2 sources checked
    • cites Roemer & Orsillo, 2007 source
    • cites Roemer, Orsillo, & Salters-Pedneault, 2008 source
  • Premisecitation

    ABBT produced favorable outcomes for the majority of clients receiving it in both an open trial and a randomized controlled trial.

    “This acceptance based behavioral therapy (ABBT) produced favorable outcomes for the majority of clients receiving it in both an open trial and a randomized controlled trial (Roemer & Orsillo, 2007; Roemer et al., 2008).”
    Quote in the paperNot a substantial claim1 of 2 sources checked
    • cites Roemer & Orsillo, 2007 source
    • cites Roemer et al., 2008 source
  • May combine two claims. 25
  • Borderline: one of the tests for a substantial claim is unclear. 1
  • Classified as probably not a substantial claim. 20

  • May combine two claims.

    Premisecitation

    In the earlier trials, clients showed significant changes on a self-report measure of experiential avoidance and on a measure of anxiety about emotional responses, both proposed mechanisms.

    “Clients also experienced significant changes on a self-report measure of experiential avoidance (Roemer et al., 2008), as well as on a measure of reported anxiety about emotional responses (Treanor, Erisman, Salters-Pedneault, Orsillo, & Roemer, 2009), both are proposed mechanisms of change.”
    Quote in the paperSubstantial claim1 of 2 sources checked
    • cites Roemer et al., 2008 source
    • cites Treanor, Erisman, Salters-Pedneault, Orsillo, & Roemer, 2009

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

  • Borderline on S4 (based): unclear from the text.

    Findingnone given

    Change in acceptance was related to reported quality of life at post-treatment.

    “In addition, change in acceptance was related to reported quality of life at post-treatment.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    In the study sample, for valued action, responders show a steady increase in time spent engaged in valued actions, whereas non-responders start with a higher percentage but show less movement over therapy.

    “On the other hand, for valued action, the responders show a steady increase in the amount of time spent engaged in valued actions whereas the non-responders started with a higher percentage than the non-responders, but then do not experience as much movement over the course of therapy.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    In the study sample, neither change in valued action nor change in worry was a significant predictor of quality of life, although both revealed medium-sized effects.

    “However, neither change in valued action nor change in worry was a significant predictor of quality of life, although both revealed medium-sized effects.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    In the study sample, average reported acceptance of internal experiences at session 2 was 45.71% and increased by 1.88 points per session over therapy, reaching 72.03% by the end.

    “In terms of the percentage of time that clients reported being accepting of their internal experiences, clients reported being accepting 45.71 percent of the time at session 2, which increased by 1.88 points per session over the course of therapy. In other words, clients reported an increase in their acceptance of internal experiences from 45.71% at session 2 to 72.03% of the time by the end of”
    Quote in the paperSubstantial claim

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

    Findingnone given

    In this sample, nonresponders appear to be beginning to catch up to responders by the fourth quarter of therapy.

    “It is also worth noting that the nonresponders appear to be beginning to “catch up” to the responders by the fourth quarter of therapy.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    In the study sample, clients reported fairly consistent percentages of time accepting internal experiences and engaging in valued actions in the first half of therapy, and then around session 8 they began to report larger percentages for both.

    “For example, an examination of the change in means over the course of treatment suggests that clients report fairly consistent percentages of time accepting internal experiences and engaging in valued actions in the first half of therapy and then around session 8, they begin to report larger percentages of times for both acceptance and engagement with valued action.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    In the study sample, adding change in acceptance and change in valued action significantly improved the model predicting responder status, making the overall model significant.

    “However, adding change in acceptance and change in valued action significantly improved the model [χ2 (2) = 9.18, p = .01], making the overall model significant [χ2 (3) = 10.43, p = .02].”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    In this sample, nonresponders appear to experience a decrease in acceptance as they enter the phase of therapy when they are asked to engage in more actions, whereas responders experience a continued increase.

    “Interestingly, nonresponders appear to experience a decrease in their acceptance as they enter the phase of therapy when they are asked to engage in more actions, whereas responders experience a continued increase.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    In the study sample, average reported engagement in valued action at session 2 was 48.31% and increased by 1.66 points per session over therapy, reaching 71.55% by the end.

    “Likewise, on average clients reported that they spent 48.31 percentage of time engaged in valued action at session 2, which increased by 1.66 points per session over the course of therapy. In other words, clients’ reports of engaging in valued actions increased from 48.31% to 71.55% over the course of therapy.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    In the study sample, neither initial worry levels nor change in worry predicted responder status at post-treatment.

    “Likewise, neither initial worry levels nor change in worry predicted responder status at post-treatment.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    In the study sample, both change in acceptance and change in valued action significantly predicted post-treatment responder status.

    “As hypothesized, both change in acceptance and change in valued action significantly predicted post-treatment responder status.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    In the study sample, average reported worry percentage at session 2 was 55.29% and decreased by 0.96 points per session from sessions 2 to 16, reaching 41.85% at the end of therapy.

    “For worry, the intercept, or average worry percentage at session 2, was 55.29 and the slope was −0.96. In other words, on average clients’ reported worry decreased from the 55.29% at session 2 to 41.85% of the time at the end of therapy (0.96 points per sessions from sessions 2 to 16).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Although the effect did not reach conventional levels of significance, the effect size was in the medium range for this relationship.

    “Although this effect did not reach conventional levels of significance, the effect size was in the medium range for this relationship.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    In the open trial, the 16 ABBT clients showed large, significant improvements in GAD severity, worry, and anxiety symptoms from before to after treatment and at the three-month follow-up.

    “In the open trial, the 16 clients who received ABBT reported large and significant changes in GAD severity, worry, and anxiety symptoms from pre to post treatment and at a three month follow-up assessment.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Roemer & Orsillo, 2007 source

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

    Study design and conductown data

    In this sample, the AAQ showed adequate internal consistency at pre-treatment (α = .73) and post-treatment (α = .88).

    “In the present sample, the AAQ demonstrated adequate internal consistency at pre- (α = .73) and post-treatment (α = .88).”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Premisecitation

    GAD is maintained in part by a reactive and over-identified relationship with internal experiences.

    “According to this model, anxiety is maintained in part by a reactive and over-identified relationship with internal experiences”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites Borkovec, Alcaine, & Behar, 2004

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

    • cites Hayes, Strosahl, & Wilson, 1999

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

    • cites Roemer and Orsillo, 2005

      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

    Thirty-seven of the 43 clients who started ABBT completed the post-treatment assessment.

    “Of the 43 clients who began therapy, 37 completed the post-treatment assessment.”
    Quote in the paperNot a substantial claim

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

    Study design and conductown data

    Because the study had a small sample, effect sizes were reported when relevant.

    “Given the small sample size in this study, effect sizes are reported where relevant.”
    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 conductcitation

    The AAQ has shown adequate internal consistency (α = .70) and four-month test-retest reliability (r = .64) in an undergraduate sample.

    “The AAQ has demonstrated adequate internal consistency (α = .70) and test-retest reliability (r = .64) over four months in an undergraduate sample (Hayes et al., 2004).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Hayes et al., 2004 source

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

    Study design and conductown data

    In this sample, the PSWQ showed adequate internal consistency at pre-treatment (α = .77) and post-treatment (α = .92).

    “In this sample, the PSWQ demonstrated adequate internal consistency at pre- (α = .77) and post-treatment (α = .92).”
    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

    In this sample, the VLQ consistency subscale showed adequate internal consistency at pre-treatment (α = .77) and post-treatment (α = .90).

    “In this sample, the VLQ consistency subscale demonstrated adequate internal consistency at pre- (α = .77) and post-treatment (α = .90).”
    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 conductcitation

    The PSWQ has shown very good reliability (α's from .86 to .93) and good test-retest reliability.

    “This well-established measure of worry has been shown to have very good reliability (α’s from .86 to .93) and good test-retest reliability (Molina & Borkovec, 1994).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Molina & Borkovec, 1994

      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). May combine two claims.

    Study design and conductown data

    In the current sample, the QOLI showed good internal consistency at pre-treatment (α = .83) and post-treatment (α = .80).

    “In the current sample, the QOLI demonstrated good internal consistency at pre- (α = .83) and post-treatment (α = .80).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S4 (based). May combine two claims.

    Interpretationreasoning

    Developing acceptance of or willingness to have internal experiences should reduce distress and interference associated with those experiences, thereby reducing negative reactivity and the cycle of anxiety.

    “developing an acceptance of, or a willingness to have these internal experiences should reduce distress and interference associated with the internal experiences, thus reducing the negative reactivity”
    Quote in the paperNot a substantial claim
    • The authors state this as an assumption: The problematic aspect of internal experiences is not the initial worry, feeling, physical sensation, or image itself, but the rigid unwillingness to have these experiences.

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

    Study design and conductcitation

    The VLQ has shown adequate reliability and correlates positively with other valued-living measures.

    “The VLQ has demonstrated adequate reliability and is positively correlated with other measures of valued living (Wilson et al., 2009).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Wilson et al., 2009

      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). May combine two claims.

    Study design and conductcitation

    The QOLI has shown good internal consistency, excellent test-retest reliability, and adequate validity.

    “The QOLI has demonstrated good internal consistency (α's ranging from .83 to .89 in clinical samples), excellent test-retest reliability (r = .91), and adequate validity through correlations with other measures of well-being and satisfaction (Frisch et al., 1992).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Frisch et al., 1992 source

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

    Premisecitation

    GAD is maintained through a reactive and fused relationship with one's internal experiences and a tendency towards experiential avoidance and behavioral restriction.

    “Based on the theory that GAD is maintained through a reactive and fused relationship with one’s internal experiences and a tendency towards experiential avoidance and behavioral restriction, Roemer and Orsillo (2005) developed a treatment for GAD specifically targeting these elements.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Roemer and Orsillo (2005)

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

  • Classified as probably not a substantial claim.

    Interpretationown data

    The observation that increased reports of acceptance during the second half of therapy predict responder status, while increased reports during the first half do not, indicates that continued focus on the cultivation of acceptance while engaging in valued action may be a particularly important element of treatment.

    “This observation, combined with the finding that increased reports of acceptance during the second half of therapy predict responder status, while increased reports during the first half do not, indicates that continued focus on the cultivation of acceptance while engaging in valued action may be a particularly important element of treatment.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: In ABBT, sessions one to seven are primarily psychoeducational, and the remaining sessions focus on practicing and implementing mindfulness and valued action practice in everyday life.

  • Classified as probably not a substantial claim.

    Study design and conductreasoning

    In this study, the authors attempted to address limitations by utilizing trajectories of change rather than relying on ratings at a single time point.

    “In this study, we attempted to address this by utilizing trajectories of change rather than relying on ratings at a single time point.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing).

    Interpretationreasoning

    Because the two measures are intended to measure slightly different constructs, it is difficult to interpret these correlations.

    “However, because the two measures are intended to measure slightly different constructs, it is difficult to interpret these correlations.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: The single-item measures and the longer measures are intended to measure slightly different constructs.

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

    Study design and conductreasoning

    Within the confines of this secondary data analysis, the authors attempted to address limitations by collecting multiple data points from each individual and by reporting effect sizes where possible.

    “Within the confines of this secondary data analysis, we have attempted to address these limitations by collecting multiple data points from each individual and by reporting effect sizes where possible.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Interpretationnone given

    This may only be true for this specific therapy which directly provides clients with an acceptance-based model of change.

    “However, it should be noted that this may only be true for this specific therapy which directly provides clients with an acceptance-based model of change.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationown data

    These secondary analyses of data from both the open and randomized controlled trials of ABBT are promising in that the treatment seems to decrease the distress and avoidance associated with GAD.

    “These secondary analyses of data from both the open and randomized controlled trials of ABBT are promising in that the treatment seems to decrease the distress and avoidance associated with GAD, a chronic and treatment resistant condition.”
    Quote in the paperSubstantial claim

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

    Study design and conductcitation

    The PSWQ has been found to distinguish GAD from other anxiety disorders.

    “The PSWQ has been found to discriminate GAD from other anxiety disorders (Brown, Antony, & Barlow, 1992).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Brown, Antony, & Barlow, 1992 source
35 of 35

  • The authors state this as an assumption.

    The problematic aspect of internal experiences is not the initial worry, feeling, physical sensation, or image itself, but the rigid unwillingness to have these experiences.

    “An assumption underlying ABBT is that it is not the initial worry, feeling, physical sensation, or image that is problematic, but rather the rigid unwillingness to have these internal experiences.”

  • The paper relies on this without support.

    Single-item measures typically have lower reliability and validity than multi-item measures.

    “For example, single item measures typically have lower reliability and validity than multi-item measures.”

  • The paper relies on this without support.

    The single-item measures and the longer measures are intended to measure slightly different constructs.

    “However, because the two measures are intended to measure slightly different constructs, it is difficult to interpret these correlations.”

  • The paper relies on this without support.

    In ABBT, the primary aim is not necessarily to reduce worry, but to change the relationship one has with worries or other internal experiences.

    “In ABBT, the primary aim is not necessarily to reduce worry, but to change the relationship one has with the worries or other internal experiences”

  • The paper relies on this without support.

    ABBT focuses on finding ways to move forward with meaningful activities regardless of whether worry is present.

    “ABBT instead focuses on finding ways to move forward with meaningful activities regardless of whether or not worry is present.”

  • The paper relies on this without support.

    Movement towards engagement in valued actions is aided by and also encourages greater acceptance of one’s internal experiences.

    “This movement towards engagement in valued actions is aided by and also encourages a greater acceptance of one’s internal experiences.”

  • The paper relies on this without support.

    In ABBT, sessions one to seven are primarily psychoeducational, and the remaining sessions focus on practicing and implementing mindfulness and valued action practice in everyday life.

    “In ABBT for GAD, the first seven sessions are primarily psychoeducational, whereas the remaining sessions are more focused on practicing and implementing mindfulness and valued action practice in everyday life.”
7 of 7

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?

  • Engaging in valued activities significantly predicts outcome.

    “Moreover, both the time spent accepting internal experiences and engaging in valued activities significantly predict outcome (Hayes, Orsillo, & Roemer, 2010) providing support for the proposed mechanisms of action.”

    From A randomized clinical trial comparing an acceptance-based behavior therapy to applied relaxation for generalized anxiety disorder (2013) · cites this paper as Hayes, Orsillo, & Roemer, 2010

    The Results section reports that increases in valued action during therapy significantly predicted post-treatment responder status. It also says that valued action at the beginning of therapy did not predict responder status, and that change in valued action did not significantly predict quality of life. The claim omits these limits on what ‘engaging in valued activities’ predicts. (LLM, conf=0.88)

    Experimental — accuracy not yet measured

  • Time spent accepting internal experiences significantly predicts outcome.

    “Moreover, both the time spent accepting internal experiences and engaging in valued activities significantly predict outcome (Hayes, Orsillo, & Roemer, 2010) providing support for the proposed mechanisms of action.”

    From A randomized clinical trial comparing an acceptance-based behavior therapy to applied relaxation for generalized anxiety disorder (2013) · cites this paper as Hayes, Orsillo, & Roemer, 2010

    The Results section reports that increases in time spent accepting internal experiences and engaging in valued action significantly predicted post-treatment responder status. It also says that time spent on either activity at the beginning of therapy did not predict responder status, and that change in valued action did not significantly predict quality of life. The citing sentence omits these distinctions, so its unqualified claim about time spent predicting outcome is broader than the findings. (LLM, conf=0.88)

    Experimental — accuracy not yet measured

  • Other acceptance and commitment therapy studies support mediation by the theory's proposed change processes, such as psychological flexibility, valued action, and mindfulness facets, for several outcomes.

    “Data from other ACT studies also support the mediating role of hypothesized processes of change, including psychological flexibility, valued action, and aspects of mindfulness, on various outcomes (e.g., symptom severity, functioning, quality of life; Cederberg et al., 2016; Hayes et al., 2010; Pots et al., 2016; Twohig et al., 2015).”

    From The role of psychological flexibility in acceptance-enhanced behavior therapy for trichotillomania: Moderation and mediation findings (2023) · cites this paper as Hayes et al., 2010

    The Results (Predicting responder status; page unavailable) report that changes in acceptance and valued action predicted treatment response, and the Discussion reports that change in acceptance predicted quality of life. This was a study of acceptance-based behavioral therapy for generalized anxiety disorder, not an ACT study; it did not establish mediation or report mindfulness facets as mediators. The authors describe their findings as preliminary. (LLM, conf=0.86)

    Experimental — accuracy not yet measured

  • The purpose of acceptance and commitment therapy is to reduce experiential avoidance and increase psychological flexibility.

    “The purpose of this treatment is to reduce experiential avoidance and increase psychological flexibility.30”

    From The effectiveness of acceptance and commitment therapy for social anxiety disorder: A randomized clinical trial (2020) · cites this paper as [30]

    The paper’s introductory discussion (page unavailable) says treatment should decrease avoidance and increase flexibility. But it describes an acceptance-based behavioral therapy for generalized anxiety disorder that draws on acceptance and commitment therapy; it does not directly identify the purpose of acceptance and commitment therapy itself. (LLM, conf=0.87)

    Experimental — accuracy not yet measured

  • This effort to control is ineffective and leads to intensification of feelings, emotions and thoughts that the person tried to avoid (Hayes et al., 2010).

    “This effort to control is ineffective and in contrast leads to the intensification of feelings, emotions and thoughts that the person at first tried to avoid them (Hayes, Orsillo, & Roemer, 2010).”

    From Effectiveness of Acceptance and Commitment Therapy on Interpersonal Problemsand Psychological Flexibility in Female High School Students With Social Anxiety Disorder (2015) · cites this paper as Hayes, Orsillo, & Roemer, 2010

    The paper says strategies to avoid anxiety and distress can paradoxically increase those responses (passages [1]–[2]) and that attempts to stop worrying appear to increase worry (Discussion, passage [5]). The claim presents this as an inevitable effect of efforts to control feelings, emotions, and thoughts in people generally, whereas the paper discusses a GAD-focused model and qualifies parts of the effect. (LLM, conf=0.82)

    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: r(33) = .40, p = .03

    Minor

    The paper reports p = .03 here; recomputing from the test statistic and its degrees of freedom gives p = .017 (two-tailed). The check cannot tell whether the statistic or the p-value is the misprint.

    Reported p = .03 · recomputed p = .017

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 upr(33) = 0.4reported p = .03 · recomputed p = .017

    “r(33) = .40, p = .03”

  • Consistentr(36) = 0.37reported p = .02 · recomputed p = .022

    “r(36) = .37, p = .02”

  • Consistentr(36) = -0.31reported p = .06 · recomputed p = .058

    “r(36) = −.31, p = .06”

  • Consistentr(36) = -0.32reported p = .05 · recomputed p = .050

    “r(36) = −.32, p = .05”

  • Consistentr(33) = 0.32reported p = .06 · recomputed p = .061

    “r(33) = .32, p = .06”

  • Consistentχ²(1) = 1.25reported p = .26 · recomputed p = .264

    “χ2 (1) = 1.25, p = .26”

  • Consistentχ²(2) = 9.18reported p = .01 · recomputed p = .010

    “χ2 (2) = 9.18, p = .01”

  • Consistentχ²(3) = 10.43reported p = .02 · recomputed p = .015

    “χ2 (3) = 10.43, p = .02”

  • ConsistentF(1, 41) = 3.49reported p = .07 · recomputed p = .069

    “F(1, 41) = 3.49, p = .07”

  • ConsistentF(3, 39) = 3.33reported p = .03 · recomputed p = .029

    “F(3, 39) = 3.33, p = .03”

10 of 10

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

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

Research works printed but not linked: 1

  1. Michelson, S. E., Lee, J. K., Orsillo, S. M., & Roemer, L. (2008, November). The relationship between values in symptom severity, experiential avoidance and quality of life in generalized anxiety disorder. Poster presented at the 42nd Annual Association for Behavioral and Cognitive Therapies Conference, Orlando, Florida.

Cited by

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Related

Authors
Hayes, S. A., Orsillo, S. M., & Roemer, L.
Affiliations
  • Boston University (US)
  • University of Massachusetts Boston (US)
Corresponding author
Hayes, Sarah A.
ORCID
Venue
Behaviour Research and Therapy
Publisher
Elsevier BV
Published
2010-03
Volume
48
Issue
3
Pages
238-245
ISSN
0005-7967 (ISSN-L)
DOI
10.1016/j.brat.2009.11.006
PMC
PMC2829361
OpenAlex
W2165737053
Cited by
129
References
52
Citations by year
2026: 4 · 2025: 3 · 2024: 5 · 2023: 5 · 2022: 5 · 2021: 9 · 2020: 10 · 2019: 10 · 2018: 6 · 2017: 11 · 2016: 5 · 2015: 6 · 2014: 13 · 2013: 13 · 2012: 8
FWCI
6.94
Type
journal article
Language
en
Open access
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Behaviour Research and Therapy (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (submittedVersion)
  • PubMed Central (submittedVersion)
Topics
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
  • Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Mental Health Research Topics
Keywords
generalized anxiety disorder, mechanisms of change, experiential avoidance, worry, quality of life, treatment outcome prediction
MeSH terms
Adult, Aged, Anxiety Disorders, Behavior Therapy, Female, Humans

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 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.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

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