Adult attachment as a moderator of treatment outcome for generalized anxiety disorder: Comparison between cognitive–behavioral therapy (CBT) plus supportive listening and CBT plus interpersonal and emotional processing therapy.

Newman, Michelle G.; Castonguay, Louis G.; Jacobson, Nicholas C.; Moore, Ginger A.

doi:10.1037/a0039359

Cited by 51Anxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesPsychotherapy Techniques and ApplicationsAttachment and Relationship Dynamics

Adult attachment as a moderator of treatment outcome for generalized anxiety disorder: Comparison between cognitive–behavioral therapy (CBT) plus supportive listening and CBT plus interpersonal and emotional processing therapy.

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Newman, Michelle G., Castonguay, Louis G., Jacobson, Nicholas C., Moore, Ginger A.·2015·Journal of Consulting and Clinical Psychology

DOI 10.1037/a0039359PMC PMC4961354

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Abstract

OBJECTIVE: To determine whether baseline dimensions of adult insecure attachment (avoidant and anxious) moderated outcome in a secondary analysis of a randomized controlled trial comparing cognitive-behavioral therapy (CBT) plus supportive listening (CBT + SL) versus CBT plus interpersonal and emotional processing therapy (CBT + I/EP). METHOD: Eighty-three participants diagnosed with generalized anxiety disorder (GAD) were recruited from the community and assigned randomly to CBT + SL (n = 40) or to CBT + I/EP (n = 43) within a study using an additive design. PhD-level psychologists treated participants. Blind assessors evaluated participants at pretreatment, posttreatment, 6-month, 12-month, and 2-year follow-up with a composite of self-report and assessor-rated GAD symptom measures (Penn State Worry Questionnaire, Hamilton Anxiety Rating Scale, Clinician's Severity Rating). Avoidant and anxious attachment were assessed using self-reported dismissing and angry states of mind, respectively, on the Perceptions of Adult Attachment Questionnaire. RESULTS: Consistent with our prediction, at all assessments higher levels of dismissing styles in those who received CBT + I/EP predicted greater change in GAD symptoms compared with those who received CBT + SL for whom dismissiveness was unrelated to the change. At postassessment, higher angry attachment was associated with less change in GAD symptoms for those receiving CBT + I/EP, compared with CBT + SL, for whom anger was unrelated to change in GAD symptoms. Pretreatment attachment-related anger failed to moderate outcome at other time points and therefore, these moderation effects were more short-lived than the ones for dismissing attachment. CONCLUSIONS: When compared with CBT + SL, CBT + I/EP may be better for individuals with GAD who have relatively higher dismissing styles of attachment.

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Clients reporting dismissive childhood attachment respond more strongly to CBT plus interpersonal and emotional processing therapy than to CBT plus supportive listening.
“clients reporting dismissive childhood attachment responded more strongly to CBT+I/EP versus CBT+SL [42].”
From Psychotherapeutic treatments for generalized anxiety disorder: cognitive and behavioral therapies, enhancement strategies, and emerging efforts (2022) · cites this paper as [42]
The Results (Abstract) report that higher dismissing styles predicted greater improvement in GAD symptoms with CBT + I/EP than with CBT + SL. But the Method (Measures) identifies dismissing/derogating as a measure of clients’ current attitudes toward their primary caregiver, not their childhood attachment; the Discussion likewise describes it as current adult attachment. (LLM, conf=0.89)
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Authors: Newman, M. G., Castonguay, L. G., Jacobson, N. C., & Moore, G. A.
Affiliations: Pennsylvania State University (US)
ORCID: Newman, Michelle G.
Castonguay, Louis G.
Jacobson, Nicholas C.
Moore, Ginger A.
Venue: Journal of Consulting and Clinical Psychology
Publisher: American Psychological Association (APA)
Published: 2015-10
Volume: 83
Issue: 5
Pages: 915-925
ISSN: 0022-006X (ISSN-L)
1939-2117
DOI: 10.1037/a0039359
PMC: PMC4961354
OpenAlex: W2346691996
Cited by: 51
References: 69
Citations by year: 2026: 3 · 2025: 1 · 2024: 2 · 2023: 3 · 2022: 10 · 2021: 2 · 2020: 5 · 2019: 6 · 2018: 9 · 2017: 5 · 2016: 5
FWCI: 9.54
Type: journal article
Language: en
Open access: hybrid
doi.org
Licence: other-oa
www.apa.org/pubs/journals/resources/open-access.aspx (am, 250 d)
Locations: Journal of Consulting and Clinical Psychology (publishedVersion, other-oa)
PubMed (publishedVersion)
PubMed Central (acceptedVersion)
ScholarSphere (Penn State Libraries) (submittedVersion, cc-by)
SSRN Electronic Journal (submittedVersion)
Funders: National Institute of Mental Health (MH58593-02)
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 › Social Psychology › Attachment and Relationship Dynamics
Keywords: adult attachment, insecure attachment, generalized anxiety disorder, cognitive behavioral therapy, dismissing attachment, attachment styles
MeSH terms: Adolescent, Adult, Aged, Anxiety Disorders, Combined Modality Therapy, Emotions, Female, Follow-Up Studies, Humans, Interpersonal Relations, Male, Middle Aged, Object Attachment, Cognitive Behavioral Therapy, Treatment Outcome, Young Adult, Self Report

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Adult attachment as a moderator of treatment outcome for generalized anxiety disorder: Comparison between cognitive–behavioral therapy (CBT) plus supportive listening and CBT plus interpersonal and emotional processing therapy.

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