Differential responses of positive affect, negative affect, and worry in CBT for generalized anxiety disorder: A person-specific analysis of symptom course during therapy
Abstract
Introduction Research indicates that individuals with generalized anxiety disorder (GAD) may experience deficits in positive affect (PA), and tend to dampen or intentionally suppress PA. Despite the presence of PA-related pathology in GAD, little is known about change in PA during GAD treatment. Objective This study examines changes in PA, negative affect (NA) and worry in seven participants during cognitive behavioral therapy (CBT) for GAD. Method Intensive repeated measures (i.e., time series) data were subjected to person-specific regression analysis to delineate individual change trajectories. Results Significant improvement in worry was observed in all but one participant. Fear and irritability - indices of NA - each improved in 5/7 participants while sadness improved in 4/7 participants (worsening in one). Of all symptom domains, PA had the poorest treatment response: PA improved in only 2/7 participants and actually significantly worsened in 5/7 individuals even as NA and worry improved during therapy. Conclusion These findings indicate that treatment gains from traditional CBT for GAD may not generalize to improvements in PA regulation, or even emotional functioning more broadly. This evidence is a call to increase the focus on PA regulation in treatment for GAD; perhaps PA could be a missing piece in our understanding of ways to bolster GAD treatment outcomes.
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Prior to this study, only one investigation had tested CBT's impact on positive affect in anxiety disorders, using person-specific analyses with seven generalized anxiety disorder patients.
“Thus far, the effect of CBT on positive affect for anxiety disorders has only been examined in one study through person-specific analyses on seven individuals with generalized anxiety disorder (Bosley, Fisher, & Taylor, 2018).”
From Examining Positive and Negative Affect as Outcomes and Moderators of Cognitive-Behavioral Therapy and Acceptance and Commitment Therapy for Social Anxiety Disorder. (2019) · cites this paper as Bosley, Fisher, & Taylor, 2018
In that prior study, negative affect improved over treatment.
“Positive affect was found to improve in only two of seven participants, and worsened in five of seven – even as negative affect improved over the course of treatment.”
From Examining Positive and Negative Affect as Outcomes and Moderators of Cognitive-Behavioral Therapy and Acceptance and Commitment Therapy for Social Anxiety Disorder. (2019) · cites this paper as Bosley, Fisher, & Taylor, 2018
In that prior study, positive affect improved in two of seven participants.
“Positive affect was found to improve in only two of seven participants, and worsened in five of seven – even as negative affect improved over the course of treatment.”
From Examining Positive and Negative Affect as Outcomes and Moderators of Cognitive-Behavioral Therapy and Acceptance and Commitment Therapy for Social Anxiety Disorder. (2019) · cites this paper as Bosley, Fisher, & Taylor, 2018
In that prior study, positive affect worsened in five of seven participants.
“Positive affect was found to improve in only two of seven participants, and worsened in five of seven – even as negative affect improved over the course of treatment.”
From Examining Positive and Negative Affect as Outcomes and Moderators of Cognitive-Behavioral Therapy and Acceptance and Commitment Therapy for Social Anxiety Disorder. (2019) · cites this paper as Bosley, Fisher, & Taylor, 2018
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- Authors
- Bosley, H. G., Fisher, A. J., & Taylor, C. B.
- Affiliations
- University of California, Berkeley (US)
- Palo Alto University (US)
- Corresponding author
- Bosley, Hannah G.
- Venue
- Psychotherapy Research
- Publisher
- Informa UK Limited
- Published
- 2016-10-31
- Volume
- 28
- Issue
- 4
- Pages
- 630-642
- ISSN
- 1050-3307 (ISSN-L)
- 1468-4381
- OpenAlex
- W2548429162
- Cited by
- 22
- References
- 17
- Citations by year
- 2026: 1 · 2024: 1 · 2023: 2 · 2022: 1 · 2021: 7 · 2020: 4 · 2019: 4 · 2018: 1 · 2017: 1
- FWCI
- 2.85
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychotherapy Research (publishedVersion)
- PubMed (publishedVersion)
- 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, positive affect, negative affect, worry, cognitive behavioral therapy, treatment response, symptom course, emotion regulation, fear, irritability, sadness
- MeSH terms
- Adult, Anxiety Disorders, Emotions, Humans, Psychotherapeutic Processes, Cognitive Behavioral Therapy, Outcome Assessment, Health Care
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