Differential responses of positive affect, negative affect, and worry in CBT for generalized anxiety disorder: A person-specific analysis of symptom course during therapy

• Published in: Psychotherapy research 2018-07, Vol.28 (4), p.630-642
• Main Authors: Bosley, Hannah G., Fisher, Aaron J., Taylor, C. Barr
• Format: Article
• Language: English
• Subjects: afeto positivo; Affect (Psychology); Anxiety disorders; Behavioral psychology; Clinical outcomes; Cognitive behavioral therapy; Cognitive-behavioral factors; disturbo d'ansia generalizzato; Emotional regulation; Emotional well being; emozioni positive; generalisierte Angststörung; Generalized anxiety disorder; idiografica; idiographic; idiographisch; idiográfica; Irritability; Negative emotions; Pathology; person-specific; persona-specifico; personenspezifisch; pessoa específica; positive affect; Positive emotions; positiver Affekt; preocupação; Sadness; Sorge; Time series; Traditional medicine; transtorno de ansiedade generalizada; Worry; 個別-特定; 廣泛性焦慮症; 正向情緒; 焦慮; 獨特的
• ISSN: 1050-3307; 1468-4381
• DOI: 10.1080/10503307.2016.1233366

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.