Expectancy/Credibility Change as a Mediator of Cognitive Behavioral Therapy for Generalized Anxiety Disorder: Mechanism of Action or Proxy for Symptom Change?
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Examined the mediating effect of changes in expectancy/credibility from sessions 4-7 of 14-session cognitive and behavioral therapy for generalized anxiety disorder (GAD). In 76 adults with primary GAD, we predicted that expectancy/credibility would change significantly from sessions 4-7, that degree of change in expectancy/credibility would predict degree of reliable change at posttreatment, and that changes in expectancy/credibility would mediate the relationship between pretreatment severity and change at posttreatment. In support of the hypotheses, a latent growth model revealed significant increases in expectancy/credibility over the critical period. In addition, baseline GAD severity, expectancy/credibility intercept, and rate of change in expectancy/credibility all positively predicted degree of reliable change at posttreatment. Rate of change in expectancy/credibility during the critical period partially mediated the effect of baseline GAD severity, accounting for 38% of the variance in this relationship. This effect was not accounted for by preceding or concurrently changing anxiety levels.
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Mediators of CBT include the establishment of flexible emotional responding and change in expectancy or credibility.
“mediators of CBT have included the establishment of flexible emotional responding [34] and change in expectancy/credibility [37].”
From Psychotherapeutic treatments for generalized anxiety disorder: cognitive and behavioral therapies, enhancement strategies, and emerging efforts (2022) · cites this paper as [37]
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“Lastly, mediators of CBT have included the establishment of flexible emotional responding [34] and change in expectancy/credibility [37].”
Self-citationCognitive-behavioral therapy (CBT) for generalized anxiety disorder (GAD)
Newman, M. G., Zainal, N. H., & Hoyer, J. (2020) · Generalized Anxiety Disorder and Worrying · doi:10.1002/9781119189909.ch10 · Cited by 25 · see citing works
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Perceptions of animal‐assisted interventions: The influence of attitudes toward companion animals
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Zainal, N. H., & Newman, M. G. (2024) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2024.102825 · Cited by 17 · see citing works
Self-citationThe importance of problem-focused treatments: A meta-analysis of anxiety treatments.
Yulish, N. E., Goldberg, S. B., Frost, N. D., Abbas, M., Oleen-Junk, N. A., Kring, M., Chin, M. Y., Raines, C. R., Soma, C. S., & Wampold, B. E. (2017) · Psychotherapy · doi:10.1037/pst0000144 · Cited by 16 · see citing works
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Treatment expectancy for anxiety change and response to cognitive behavioral therapy for OCD
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Constantino, M. J., Castonguay, L. G., Coyne, A. E., Boswell, J. F., & Newman, M. G. (2022) · Psychotherapy Research · doi:10.1080/10503307.2022.2086836 · Cited by 13 · see citing works
Self-citationPortuguese validation of the credibility/expectancy questionnaire in routine practice
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Expectations in psychotherapy: An overview
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Predictors and moderators of treatment outcome in late-life anxiety: A systematic review
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“Consistent with our predictions and past research (e.g. Newman and Fisher 2010; Wetherell et al ., 2005), greater GAD ( d = – 0.17) and chronic worry severity ( d = – 0.20), and greater number of co – morbid diagnoses ( d = – 0.13) were associated with greater improvements in chronic worry over the…”
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Limited Motivation, Patient-Therapist Mismatch, and the Therapeutic Alliance
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Role of Religion in Psychotic Illness in the Israeli Ultra-Orthodox Jewish Population
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Mechanisms and Treatment of Generalized Anxiety Disorder
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Credibility Beliefs towards Nicotine Replacement Therapy and Exercise as Smoking Cessation Aids
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Adaptação Transcultural e Evidências de Validade do Questionário de Credibilidade/Expectativa
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Depressive Symptoms in the Cognitive-Behavioural Treatment of Generalized Anxiety Disorder
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A Multi-Study Investigation of Patient Engagement in Psychological Treatment
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A Social Healing Model and Its Application to Cognitive Behavioral Therapy
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- Authors
- Newman, M. G., & Fisher, A. J.
- Affiliations
- Pennsylvania State University (US)
- Venue
- International Journal of Cognitive Therapy
- Published
- 2010-09
- Volume
- 3
- Issue
- 3
- Pages
- 245-261
- ISSN
- 1937-1209 (ISSN-L)
- PMC
- PMC2995495
- OpenAlex
- W2124842786
- Cited by
- 83
- References
- 84
- Citations by year
- 2026: 3 · 2025: 5 · 2024: 7 · 2023: 3 · 2022: 9 · 2021: 6 · 2020: 4 · 2019: 4 · 2018: 3 · 2017: 9 · 2016: 5 · 2015: 2 · 2014: 6 · 2013: 10 · 2012: 3
- FWCI
- 7.07
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- International Journal of Cognitive Therapy (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- ScholarSphere (Penn State Libraries) (submittedVersion, cc-by)
- SSRN Electronic Journal (submittedVersion)
- Funders
- National Institute of Mental Health (R01MH039172)
- 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, cognitive behavioral therapy, treatment expectancy, treatment credibility, mechanism of action, reliable change, pretreatment severity, mediation, latent growth curve models
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