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Cited by 28Anxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesPsychotherapy Techniques and ApplicationsPsychological Treatments and Assessments

Cognitive-behavioral therapy for late-life anxiety: Similarities and differences between Veteran and community participants

Open access
Barrera, Terri L., Cully, Jeffrey A., Amspoker, Amber B., Wilson, Nancy L., Kraus-Schuman, Cynthia, Wagener, Paula D., Calleo, Jessica S., Teng, Ellen J. +4 more·2015·Journal of Anxiety Disorders
DOI 10.1016/j.janxdis.2015.04.005PMC PMC4479977
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Abstract

Cognitive-behavioral therapy (CBT) is an evidence-based treatment for anxiety; however, a growing body of research suggests that CBT effect sizes are smaller in Veteran samples. The aim of this study was to perform secondary data analyses of a randomized controlled trial of CBT for late-life generalized anxiety disorder compared with treatment as usual (TAU) in a Veteran (n = 101) and community-based (n= 122) sample. Veterans had lower income and less education than community participants, greater severity on baseline measures of anxiety and depression, poorer physical health, and higher rates of psychiatric comorbidity. Treatment effects were statistically significant in the community sample (all ps< 0.01), but not in Veterans (all ps> 0.05). Further analyses in Veterans revealed that poorer perceived social support significantly predicted poorer outcomes (all ps< 0.05). Our results underscore the complexity of treating Veterans with anxiety, and suggest that additional work is needed to improve the efficacy of CBT for Veterans, with particular attention to social support. © 2015.

Integrity signals

Registry

Crossref · 10.1016/j.janxdis.2015.04.005

Cites

64 of 64 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

13 of 47 cited sources checked · 9 supported · 0 flagged · accuracy not yet measured

  • Premisecitation

    Among VA primary care patients, GAD is highly prevalent.

    “GAD is highly prevalent among VA primary care patients”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites Milanak, Gros, Magruder, Brawman-Mintzer & Frueh, 2013 source
  • Premisecitation

    GAD is associated with substantial impairment in functioning among VA primary care patients.

    “is associated with substantial impairment in functioning (Milanak, Gros, Magruder, Brawman-Mintzer & Frueh, 2013)”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites Milanak, Gros, Magruder, Brawman-Mintzer & Frueh, 2013 source
  • Premisecitation

    This CBT protocol has shown efficacy in previous trials of CBT for late-life generalized anxiety disorder in primary care.

    “This protocol has demonstrated efficacy in prior trials of CBT for late-life GAD in primary care (Calleo et al., 2013; Stanley et al., 2003, 2009).”
    Quote in the paperSubstantial claim1 of 2 sources checked
    • cites Calleo et al., 2013 source

      The Introduction says earlier trials found positive effects of CBT for late-life GAD in primary care. But it describes this paper’s protocol as an adaptation of earlier interventions, and the Discussion and Results report only preliminary improvements from an uncontrolled pilot. The paper therefore supports promising outcomes for the adapted protocol, not demonstrated efficacy for that same protocol in prior trials. (LLM, conf=0.84)

      Experimental — accuracy not yet measured
    • cites Stanley et al., 2003, 2009

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

  • Premisecitation

    Telemedicine collaborative care for depression in Veterans produced smaller symptom-improvement effects than a comparable study in federally qualified health center patients.

    “a study of telemedicine-based collaborative care for depression in Veterans (Fortney et al., 2007) found smaller effect sizes for symptom improvement than a similar study of telemedicine-based collaborative care in patients from federally qualified health centers (Fortney et al., 2013)”
    Quote in the paperNot a substantial claim1 of 2 sources checked
    • cites Fortney et al., 2007 source
    • cites Fortney et al., 2013 source
  • Premisecitation

    Previous studies examining treatment outcome for PTSD between Veteran cohorts suggest poorer treatment outcome in Vietnam-era Veterans than in returning Veterans from Iraq and Afghanistan.

    “Previous studies examining treatment outcome for PTSD between Veteran cohorts suggest poorer treatment outcome in Vietnam-era Veterans than in returning Veterans from the wars in Iraq and Afghanistan (Chard, Schumm, Owens, & Cottingham, 2010; Eftekhari et al., 2013; but see Yoder et al., 2012).”
    Quote in the paperNot a substantial claim1 of 3 sources checked
    • cites Chard, Schumm, Owens, & Cottingham, 2010 source
    • cites Eftekhari et al., 2013 source
    • cites Yoder et al., 2012 source
  • May combine two claims. 20
  • Classified as probably not a substantial claim. 25
  • The quote only partly states this claim. 2

  • May combine two claims.

    Study design and conductcitation

    The PSWQ-A can identify GAD in older primary care patients and can detect treatment-related change.

    “The PSWQ-A is useful for identifying GAD in older primary care patients (Webb et al., 2008), is capable of demonstrating change following treatment (Stanley et al., 2009; Shrestha et al., 2012)”
    Quote in the paperSubstantial claim2 of 3 sources checked
    • cites Webb et al., 2008 source
    • cites Stanley et al., 2009 source

      Stanley et al. support the treatment-change portion in part: the Results (Post-treatment Outcomes) report significantly greater improvement after CBT on a worry questionnaire. But the Methods (Measures and Data Collection) specify that this was the 16-item PSWQ, not the PSWQ-A, so the paper does not establish that the abbreviated version detects treatment-related change. The identification claim is attributed to Webb et al., not Stanley et al. (LLM, conf=0.88)

      Experimental — accuracy not yet measured
    • cites Shrestha et al., 2012

      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 conductcitation

    The GADSS has adequate psychometric properties among older adults.

    “has adequate psychometric properties among older adults (Andreescu et al., 2008; Weiss et al., 2009).”
    Quote in the paperNot a substantial claim2 of 2 sources checked
    • cites Andreescu et al., 2008 source
    • cites Weiss et al., 2009 source

      The Discussion reports adequate internal consistency and convergent validity, strong inter-rater reliability, and a unidimensional factor structure. But it concludes that psychometric properties were mixed among older adults in primary care, citing poor diagnostic accuracy and weak divergent validity; the unqualified claim overstates the findings. (LLM, conf=0.88)

      Experimental — accuracy not yet measured

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

    Study design and conductcitation

    The PHQ-9 has strong psychometric properties among older adults, and the PHQ-8 and PHQ-9 are highly correlated.

    “Psychometric properties of the PHQ-9 are strong among older adults, and the two versions of the scale are highly correlated (Razykov, Ziegelstein, Whooley, & Thombs, 2012).”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites Razykov, Ziegelstein, Whooley, & Thombs, 2012 source

      The PHQ-9 Versus the PHQ-8 results (page not provided) report a very high correlation between the scales (r = 0.997). The paper assesses outpatients with coronary artery disease, not older adults as a group, and does not establish that the PHQ-9 has strong psychometric properties among older adults. (LLM, conf=0.88)

      Experimental — accuracy not yet measured

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

    Study design and conductcitation

    The SIGH-A has demonstrated sensitivity to change in clinical trials.

    “The SIGH-A is a 14-item measure with demonstrated sensitivity to change in clinical trials (Brenes et al., 2012).”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites Brenes et al., 2012 source

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

    Premisecitation

    Recent data suggest that peer support interventions are valued by Veterans and have the potential to reduce psychiatric symptoms.

    “Recent data suggest that peer support interventions are valued by Veterans (Jain, McLean, & Rosen, 2012) and have the potential to reduce psychiatric symptoms (Barber, Rosenheck, Armstrong, & Resnick, 2008; Pfeiffer, Heisler, Piette, Rogers, & Valenstein, 2011).”
    Quote in the paperNot a substantial claim1 of 3 sources checked
    • cites Jain, McLean, & Rosen, 2012 source
    • cites Barber, Rosenheck, Armstrong, & Resnick, 2008 source
    • cites Pfeiffer, Heisler, Piette, Rogers, & Valenstein, 2011 source

  • The quote only partly states this claim.

    Findingown data

    Completer analyses for the self-report predictors revealed similar results.

    “Completer analyses revealed similar results.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    ITT multiple regression results with SIGH-A as the dependent variable revealed mental health service use as the only significant predictor, with increased use predicting worse clinician-rated anxiety severity.

    “ITT multiple regression results with SIGH-A as the dependent variable revealed mental health service use as the only significant predictor, such that increased mental health service use predicted worse clinician-rated anxiety severity.”
    Quote in the paperNot a substantial claim

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

    Findingnone given

    The Veterans included in this study were primarily of the Vietnam era.

    “The Veterans included in this study were primarily of the Vietnam era; and, in fact, the majority of CBT studies within Veteran samples have been conducted with Vietnam Veterans.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Although effect-size estimates were numerically larger in the community sample, overlapping confidence intervals suggest the effects are not statistically different between community and Veteran samples.

    “Although the effect-size estimates are numerically larger in the community sample than in the Veteran sample, the overlapping confidence intervals suggest that the effects are not statistically different between community and Veteran samples.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Poorer perceived social support and increased mental health service use predicted poorer outcomes on self-report measures of worry and anxiety.

    “The direction of these relationships indicate that poorer perceived social support and increased use of mental health services predict poorer outcomes on self-report measures of worry and anxiety.”
    Quote in the paperNot a substantial claim

  • The quote only partly states this claim.

    Findingown data

    Completer analyses for the clinician-rated predictors revealed similar results.

    “Completer analyses revealed similar results.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Effect-size estimates in the community sample suggested moderate improvements in worry and anxiety and large improvements in GAD symptom severity for CBT relative to UC.

    “Effect-size estimates in the community sample suggested moderate improvements in worry and anxiety, and large improvements in GAD symptom severity for CBT relative to UC.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingcitation

    The Veteran sample had greater psychiatric symptom severity, poorer physical health status, and higher rates of psychiatric comorbidity than the community sample.

    “the greater psychiatric symptom severity, poorer physical health status, and higher rates of psychiatric comorbidity among the Veteran sample support previous assertions that Veterans tend to have more chronic and severe presentations than non-Veterans (Goodson et al., 2011; Selim et al., 2004).”
    Quote in the paperSubstantial claim

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

    Study design and conductnone given

    Assessments were done by telephone; evaluators did not know treatment assignment and had no other project involvement.

    “All assessments were administered via telephone, and IEs were unaware of treatment assignment and not involved in any other way with the project.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    The CBT protocol used in this study was based on elements of earlier CBT protocols for generalized anxiety disorder in younger adults and was modified for flexible delivery to older adults in primary care.

    “The CBT protocol utilized in this study is based on elements of prior CBT protocols for GAD in younger adults (Borkovec & Costello, 1993; Craske, Barlow, & O’Leary, 1992) and modified to include a flexible delivery format to meet the needs of older adults in primary care medical settings (Stanley, Diefenbach, & Hopko, 2004).”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites Borkovec & Costello, 1993 source
    • cites Craske, Barlow, & O’Leary, 1992

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

    • cites Stanley, Diefenbach, & Hopko, 2004 source

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

    Study design and conductcitation

    The MSPSS has good psychometric properties in older adults.

    “with good psychometric properties in older adults (Stanley, Beck, & Zebb, 1998).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Stanley, Beck, & Zebb, 1998 source

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

    Study design and conductown data

    Participants were randomly assigned to one of three treatment conditions (CBT by PLP, CBT by BLP, or UC) within each subsample, using a 1:1:1 ratio in blocks of nine.

    “Patients were randomly assigned to treatment condition (CBT delivered by PLP, CBT delivered by BLP, or UC) within each subsample (Veteran vs. community) according to a 1:1:1: ratio within blocks of nine.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing), S4 (based).

    Interpretationnone given

    These participants may have fared worse without the additional CBT received through this study.

    “However, these participants may have fared worse without the additional CBT received through this study.”
    Quote in the paperNot a substantial claim

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

    Study design and conductnone given

    All analyses controlled for baseline values of the respective outcome measure and for treatment condition.

    “All analyses controlled for baseline values of the respective outcome measure, as well as treatment condition.”
    Quote in the paperNot a substantial claim

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

    Study design and conductnone given

    Analyses were repeated using only data from participants who completed the six-month assessment (n = 180).

    “Analyses were then repeated using only data from participants who completed the six-month assessment (n = 180).”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Study design and conductcitation

    The PLP and BLP conditions were combined into a single CBT condition for analysis, based on comparative findings from the primary trial.

    “we first collapsed the PLP and BLP conditions into a single CBT condition (based on comparative findings in the primary trial – Stanley et al., 2014) to allow comparison of only two treatment arms: CBT vs. UC.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Stanley et al., 2014 source

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

    Interpretationnone given

    Disparities in socioeconomic arenas such as education, employment status, and income may contribute to differences in uptake of CBT materials between Veteran and community participants.

    “Another possibility is that disparities in socioeconomic arenas, such as education, employment status, and income, may contribute to differences in uptake of CBT materials in Veteran and community participants.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductown data

    Inter-rater agreement was adequate for GAD (kappa = .68), depression (kappa = .91), and other anxiety disorders (kappa = .75).

    “Kappa coefficients indicated adequate agreement for GAD (.68), depression (major depression or dysthymia; .91), and other anxiety disorders (.75).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductcitation

    The original study design lacked statistical power to test interactions between treatment condition and subsample, and those interactions were very small to small.

    “the original study design was not powered to test treatment condition by subsample interactions, which were very small to small”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Stanley et al., 2014 source

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

    Study design and conductcitation

    Among older primary care adults, the PCL-C shows good internal consistency and convergent validity.

    “The PCL-C has good internal consistency and convergent validity among older adults in primary care (Cook, Elhai & Aréan, 2005).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Cook, Elhai & Aréan, 2005 source

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

    Premisecitation

    APA and NICE endorse CBT as a first-line intervention for GAD.

    “endorsement of CBT as a first-line intervention for GAD by the American Psychiatric Association and The United Kingdom’s National Institute for Health and Clinical Excellence as a first-line intervention (APA, 2010; NICE; 2009)”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites APA, 2010

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

    • cites NICE; 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 conductown data

    A random fifth of SCID interviews were audio recorded for a second clinician to rate, allowing assessment of inter-rater agreement.

    “All SCID interviews were audio taped so that a random 20% could be rated by a second clinician to assess inter-rater agreement.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductcitation

    Agreement was excellent for the SIGH-A (ICC = .92) and GADSS (ICC = .87).

    “intraclass correlation coefficients indicated excellent agreement for the SIGH-A (.92) and GADSS (.87).”
    Quote in the paperNot a substantial claim

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

    Study design and conductown data

    Initial analyses used intent-to-treat methods with multiple imputation to handle missing six-month data.

    “Initial analyses included all observations and used intent-to-treat (ITT) methods with multiple imputation procedures (Proc MI and Proc MIANALYZE, SAS Version 9.3) to address missing data at six months.”
    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

    The second author met regularly with evaluators for calibration and rated one tenth of their recorded interviews to estimate inter-rater agreement.

    “The second author held regular calibration meetings with the IEs and rated 10% of each IE’s audiotaped interviews to estimate inter-rater agreement.”
    Quote in the paperNot a substantial claim

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

    Premisecitation

    Using a p-value threshold of 0.25 to select variables for multivariable models allows weakly associated variables that may be important collective predictors to be included.

    “Using a more conservative p value of < 0.25 to inform which variables should be included in the multivariable predictor models enables variables that could be important collective predictors of an outcome to be simultaneously included in the model even though they are only weakly associated with the outcome in and of themselves (Bendel & Afifi, 1977).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Bendel & Afifi, 1977 source

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

    Study design and conductcitation

    The SF-12 PCS has adequate reliability and validity in older adults.

    “Adequate reliability and validity of the SF-12 PCS have been demonstrated in older adults (Resnick & Nahm, 2001).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Resnick & Nahm, 2001 source

  • Classified as probably not a substantial claim.

    Study design and conductown data

    Identical outcome analyses were performed separately for the Veteran and community samples.

    “Identical outcome analyses were conducted separately within the Veteran and community samples.”
    Quote in the paperSubstantial claim

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

    Study design and conductnone given

    Each provider (PLP and BLP) delivered CBT to both Veteran and community participants.

    “Each PLP and BLP delivered CBT to both Veteran and community participants.”
    Quote in the paperNot a substantial claim

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

    Study design and conductnone given

    Other dimensions of social support, such as social connectedness and enacted social support, were not assessed.

    “Other dimensions of social support, such as social connectedness (the quantity and quality of interpersonal relationships) and enacted social support (specific supportive actions), were not assessed.”
    Quote in the paperNot a substantial claim

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

    Premisecitation

    These other dimensions of social support may interact with perceived social support in predicting distress.

    “However, these may interact with perceived social support in predicting distress (Wethington & Kessler, 1986).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Wethington & Kessler, 1986 source

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

    Premisecitation

    Veterans with complex psychiatric and social service needs may benefit from a combination of CBT and case management, an approach shown to benefit impoverished older adults with depression.

    “Alternatively, Veterans with complex psychiatric and social service needs (e.g., unemployment, homelessness) may benefit from a combination of CBT and case management, an approach shown to benefit impoverished older adults with depression (Areán et al., 2005; 2010).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Areán et al., 2005; 2010

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

37 of 37

  • The paper relies on this without support.

    Before this study, no CBT outcome trial had enrolled both Veteran and community participants together.

    “Although no CBT outcome studies have included both Veteran and community participants within the same trial”
    “To our knowledge this trial is the first study of CBT for anxiety to include both community and Veteran participants”

  • The paper relies on this without support.

    Few studies have reported predictors of CBT outcomes among Veterans.

    “few studies report predictors of CBT outcomes among Veterans.”

  • The paper relies on this without support.

    VA has not issued clinical guidelines for treating GAD.

    “the Department of Veterans Affairs has not yet published clinical practice guidelines for the treatment of GAD”

  • The paper relies on this without support.

    Just one RCT of CBT for GAD had previously enrolled Veterans.

    “only a single randomized controlled trial of CBT for GAD recently published by our group has included a Veteran sample.”

  • The paper relies on this without support.

    GAD is understudied in Veteran samples.

    “Understudied in Veteran samples”

  • The paper relies on this without support.

    This is the first study to include Veteran and community participants within a single CBT trial.

    “This is the first study to include Veteran and community participants within a single CBT trial, allowing examination of differences in treatment outcome.”

  • The paper relies on this without support.

    This was the first trial of CBT for GAD to include Veterans.

    “This was the first trial of CBT for GAD to include Veterans, and, given our findings suggesting that Veterans may show smaller treatment effects with a standard CBT package than community participants, future work should identify how to better adapt CBT protocols for Veteran populations.”

  • The paper relies on this without support.

    The majority of CBT studies within Veteran samples have been conducted with Vietnam Veterans.

    “The Veterans included in this study were primarily of the Vietnam era; and, in fact, the majority of CBT studies within Veteran samples have been conducted with Vietnam Veterans.”
8 of 8

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.

  • Consistentχ²(1) = 0.74reported p = .39 · recomputed p = .390

    “χ2(1) = 0.74, p = .39”

  • Consistentχ²(1) = 1.31reported p = .25 · recomputed p = .252

    “χ2(1) = 1.31, p = .25”

  • Consistentχ²(1) = 0.09reported p = .76 · recomputed p = .764

    “χ2(1) = 0.09, p = .76”

3 of 3

Self-check

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

Each contradiction between two passages listed here was confirmed by an independent check.

  • Completer sample size conflicts with dropout counts

    Major

    One passage says 21 Veterans and 14 community participants dropped out of the 223 randomized participants, implying 188 completers. Another passage explicitly says the completer analyses used n = 180, which contradicts that arithmetic.

  • Community dropout percentage does not match enrollment

    Minor

    The paper reports 122 enrolled community participants. Fourteen dropouts among 122 participants is 11.5%, not the stated 17%.

    Reported 17 · recomputed 11.47541

2 of 2

Cites

Flagged first, then by citations

3 of the 67 references couldn’t be matched to a known paper.

Cited by

Sorted by citations

Related

Authors
Barrera, T. L., Cully, J. A., Amspoker, A. B., Wilson, N. L., Kraus-Schuman, C., Wagener, P. D., Calleo, J. S., Teng, E. J., Rhoades, H. M., Masozera, N., Kunik, M. E., & Stanley, M. A.
Affiliations
  • Michael E. DeBakey VA Medical Center (US)
  • The University of Texas Health Science Center at Houston (US)
ORCID
Venue
Journal of Anxiety Disorders
Publisher
Elsevier BV
Published
2015-06
Volume
33
Pages
72-80
ISSN
0887-6185 (ISSN-L)
DOI
10.1016/j.janxdis.2015.04.005
PMC
PMC4479977
OpenAlex
W236121655
Cited by
28
References
67
Citations by year
2026: 1 · 2024: 5 · 2022: 1 · 2021: 3 · 2020: 3 · 2019: 5 · 2018: 3 · 2017: 4 · 2016: 2 · 2015: 1
FWCI
5.02
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of Anxiety Disorders (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Institute of Mental Health (MH053932)
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
cognitive behavioral therapy, late-life anxiety, generalized anxiety disorder, veterans, community sample, treatment effect heterogeneity, perceived social support, psychiatric comorbidity, usual care, older adults
MeSH terms
Aged, Anxiety Disorders, Depressive Disorder, Female, Humans, Male, Patient Acceptance of Health Care, Social Support, Veterans, Cognitive Behavioral Therapy, Treatment Outcome

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.

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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.

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