Predictors of CBT outcome in older adults with GAD
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The current study is a secondary analysis of data from a randomized controlled trial of CBT for late-life GAD (Stanley et al., 2014) which provided an opportunity to examine predictors of outcome among those who received CBT. Participants were 150 older adults who were randomized to receive 10 sessions of CBT. Completer analyses found that homework completion, number of sessions attended, lower worry severity, lower depression severity, and recruitment site predicted 6-month worry outcome on the PSWQ-A, whereas homework completion, credibility of the therapy, lower anxiety severity, and site predicted 6-month anxiety outcome on the STAI-T. In intent-to-treat multivariate analyses, however, only initial worry and anxiety severity, site, and number of sessions completed predicted treatment outcome. These results are largely consistent with predictors of outcome in younger adults and suggest that lower initial symptom severity and variables consistent with greater engagement in treatment predict outcome.
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In an analysis restricted to the two CBT arms, subsample predicted response: community CBT recipients improved more in anxiety and worry than Veteran CBT recipients.
“A secondary examination of only data from the two CBT conditions found that subsample (community vs. Veteran participants) was a predictor of treatment response, such that community participants receiving CBT showed greater improvements in anxiety and worry symptoms than Veteran participants receiving CBT (Hundt et al., 2014)”
From Cognitive-behavioral therapy for late-life anxiety: Similarities and differences between Veteran and community participants (2015) · cites this paper as Hundt et al., 2014
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“…of outcome in younger adults, as credibility of the therapy, number of sessions, homework completion, and initial severity of GAD and depression symptoms have predicted CBT outcome in prior adult studies (e.g., Anderson & Lambert, 2001; Kampman et al., 2007; Schmidt & Woolaway-Bickel, 2000).”
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“…& Lytle, 2002), patient expectancies of positive outcome from treatment and treatment credibility (Price & Anderson, 2012), homework completion (Schmidt & Woolaway-Bickel, 2000), and therapist fidelity and competence in delivering the treatment protocol (Kazantzis, 2003; Kuyken & Tsivrikos, 2009).”
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“Two prior studies have found that cognitive/ executive functioning difficulties are associated with poorer response to CBT among older adults (Caudle et al., 2007; Mohlman, 2013).”
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“However, research also indicates that homework completion is associated with better outcomes (Kazantzis et al., 2003; Hundt et al., 2014).”
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Ajulo, O. M., Ukpai, P. J., & Abikoye, G. E. (2024) · Nigerian Journal of Pharmacy · doi:10.51412/psnnjp.2024.35
- Authors
- Hundt, N. E., Amspoker, A. B., Kraus-Schuman, C., Cully, J. A., Rhoades, H., Kunik, M. E., & Stanley, M. A.
- Affiliations
- Michael E. DeBakey VA Medical Center (US)
- The University of Texas Health Science Center at Houston (US)
- Corresponding author
- Hundt, Natalie E.
- Venue
- Journal of Anxiety Disorders
- Publisher
- Elsevier BV
- Published
- 2014-12
- Volume
- 28
- Issue
- 8
- Pages
- 845-850
- ISSN
- 0887-6185 (ISSN-L)
- PMC
- PMC4254548
- OpenAlex
- W2048103860
- Cited by
- 33
- References
- 44
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 5 · 2023: 2 · 2022: 2 · 2021: 4 · 2020: 6 · 2019: 1 · 2018: 2 · 2017: 5 · 2016: 1 · 2015: 2
- FWCI
- 3.71
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Anxiety Disorders (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health (MH053932)
- Department of Veterans Affairs South Central Mental Illness Research Education and Clinical Center (MIRECC)
- VA HSR&D Houston Center for Innovations in Quality, Effectiveness and Safety (no.13-413)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Social Sciences › Psychology › Clinical Psychology › Psychological Treatments and Assessments
- Keywords
- generalized anxiety disorder, older adults, cognitive behavioral therapy, predictors of treatment outcome, anxiety levels, homework completion, treatment engagement, late-life anxiety
- MeSH terms
- Aged, Aged, 80 and over, Anxiety Disorders, Female, Humans, Male, Middle Aged, Patient Compliance, Surveys and Questionnaires, Cognitive Behavioral Therapy, Multivariate Analysis, Treatment Outcome, Self Report
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