The DOI matches its Crossref record; 36 of the 37 references it cites were found in a registry or an index.
Worry Exposure versus Applied Relaxation in the Treatment of Generalized Anxiety Disorder
Open accessAbstract
Background: Worry exposure (WE) is a core element of cognitive-behavioral treatment for generalized anxiety disorder (GAD). Its efficacy as a stand-alone treatment method (without further cognitive-behavioral therapy interventions) has never been tested.We aimed to examine whether WE alone is as efficacious as the empirically supported stand-alone treatment for GAD, applied relaxation (AR). Methods: In a randomized controlled study, 73 outpatients meeting DSM-IV criteria for GAD as primary diagnosis were allocated to either WE or AR or a waiting list control group; in a 2nd randomization procedure the waiting list subjects were reallocated to WE or AR. The treatment was manualized (15 sessions with WE or AR), included 6-month and 1-year follow-ups, as well as last observation carried forward and completer analyses, and was controlled for allegiance effects.The Hamilton Anxiety Rating Scale and the State-Trait Anxiety Scale were used as primary outcome measures. Self-report scales of anxiety, worrying and depression including negative metacognition about worrying and thought suppression served as secondary outcome measures. Results: The dropout rate was moderate. The pre-/posttreatment effects were high for the Hamilton Anxiety Rating Scale (standardized mean difference >1) and for the State-Trait Anxiety Inventory (standardized mean difference >0.87). The proportion of patients reaching high end state functioning was 48% (WE) and 56% (AR). WE and AR did not differ with regard to dropout rate or treatment effects. The treatment effects were stable at 6 month and 1 year follow-up. Conclusion: This is the first study to show that a stand-alone exposure in sensu technique – WE – is efficacious in the treatment of GAD. Both AR and WE seem to represent effective principles of change in GAD.
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“Prior efforts to implement exposure within GAD used techniques that induced worrisome fears via imagery (Hoyer et al., 2009; Zinbarg, Lee, & Yoon, 2007).”
From A novel theory of experiential avoidance in generalized anxiety disorder: A review and synthesis of research supporting a contrast avoidance model of worry (2011) · cites this paper as Hoyer et al., 2009
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“For example, randomized controlled trials demonstrated that AR was more efficacious than a nondirective, reflective listening therapy (Borkovec & Costello, 1993) and roughly as efficacious as cognitive therapy (Arntz, 2003; Öst & Breitholtz, 2000), cognitive behavioral therapy (Borkovec & Costello, 1993; Dugas et al., 2010), and worry exposure (Hoyer et al., 2009) in treating GAD.”
From A randomized clinical trial comparing an acceptance-based behavior therapy to applied relaxation for generalized anxiety disorder (2013) · cites this paper as Hoyer et al., 2009
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“Worry exposure (which also involved encouragement to reduce avoidance and reassurance seeking) was not significantly different from AR; both were superior to waitlist at posttreatment with maintenance of gains at 1-year follow-up [25].”
From Psychotherapeutic treatments for generalized anxiety disorder: cognitive and behavioral therapies, enhancement strategies, and emerging efforts (2022) · cites this paper as [25]
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“Dass eine Behandlungskonzeption, die mittels Sorgenexposition allein auf die pathologischen Sorgen abzielt, ebenso effektiv ist, konnten wir kürzlich in einer kontrollierten Studie zeigen [Hoyer et al., 2009].”
From Wann sind Sorgen pathologisch? (2009) · cites this paper as Hoyer et al., 2009
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Cites
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“The STAI served as the second primary outcome measure. The Penn State Worry Questionnaire (PSWQ) [”
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Beliefs about Worry and Intrusions: The Meta-Cognitions Questionnaire and its Correlates
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Cited by
Sorted by citations
Katzman, M. A., Bleau, P., Blier, P., Chokka, P., Kjernisted, K., Van Ameringen, M., & the Canadian Anxiety Guidelines Initiative Group on behalf of the Anxiety Disorders Association of Canada/Association Canadienne des troubles anxieux and McGill University (2014) · BMC Psychiatry · doi:10.1186/1471-244x-14-s1-s1 · Cited by 1,090
“Long-term follow-up data from a meta-analysis [520] and RCTs [523,525,535,543] suggest that benefits of psychological treatments are maintained at one to three years follow-up after treatment.”
BackgroundInfluentialA systematic review of personality trait change through intervention.
Roberts, B. W., Luo, J., Briley, D. A., Chow, P. I., Su, R., & Hill, P. L. (2017) · Psychological Bulletin · doi:10.1037/bul0000088 · Cited by 1,047
Newman, M. G., & Llera, S. J. (2011) · Clinical Psychology Review · doi:10.1016/j.cpr.2011.01.008 · Cited by 598
“Prior efforts to implement exposure within GAD used techniques that induced worrisome fears via imagery (Hoyer et al., 2009; Zinbarg, Lee, & Yoon, 2007).”
Cuijpers, P., Cristea, I. A., Karyotaki, E., Reijnders, M., & Huibers, M. J. H. (2016) · World Psychiatry · doi:10.1002/wps.20346 · Cited by 572
Psychological treatment of generalized anxiety disorder: A meta-analysis
Cuijpers, P., Sijbrandij, M., Koole, S., Huibers, M., Berking, M., & Andersson, G. (2014) · Clinical Psychology Review · doi:10.1016/j.cpr.2014.01.002 · Cited by 527
Metadata
- Authors
- Hoyer, J., Beesdo, K., Gloster, A. T., Runge, J., Höfler, M., & Becker, E. S.
- Affiliations
- Technische Universität Dresden (DE)
- Radboud University Nijmegen (NL)
- Venue
- Psychotherapy and Psychosomatics
- Publisher
- S. Karger AG
- Published
- 2009
- Volume
- 78
- Issue
- 2
- Pages
- 106-115
- ISSN
- 0033-3190 (ISSN-L)
- 1423-0348
- OpenAlex
- W2126294400
- Cited by
- 147
- References
- 37
- Citations by year
- 2026: 4 · 2025: 2 · 2024: 10 · 2023: 6 · 2022: 5 · 2021: 15 · 2020: 15 · 2019: 7 · 2018: 6 · 2017: 12 · 2016: 4 · 2015: 6 · 2014: 12 · 2013: 9 · 2012: 10
- FWCI
- 14.36
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Psychotherapy and Psychosomatics (publishedVersion)
- PubMed (publishedVersion)
- edoc (University of Basel) (acceptedVersion)
- Radboud Repository (Radboud University) (submittedVersion)
- Qucosa (Saxon State and University Library Dresden) (submittedVersion, other-oa)
- edoc (University of Basel)
- Funders
- Pfizer
- Deutsche Forschungsgemeinschaft
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Psychological Treatments and Assessments
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Keywords
- generalized anxiety disorder, applied relaxation, cognitive behavioral therapy, thought suppression, dropout
- MeSH terms
- Adult, Anxiety Disorders, Depressive Disorder, Female, Humans, Life Change Events, Male, Surveys and Questionnaires, Relaxation Therapy, Thinking, Diagnostic and Statistical Manual of Mental Disorders
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