TRAJECTORIES OF CHANGE IN ANXIETY SEVERITY AND IMPAIRMENT DURING AND AFTER TREATMENT WITH EVIDENCE-BASED TREATMENT FOR MULTIPLE ANXIETY DISORDERS IN PRIMARY CARE.
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| Title: | TRAJECTORIES OF CHANGE IN ANXIETY SEVERITY AND IMPAIRMENT DURING AND AFTER TREATMENT WITH EVIDENCE-BASED TREATMENT FOR MULTIPLE ANXIETY DISORDERS IN PRIMARY CARE. |
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| Authors: | Joesch, Jutta M., Golinelli, Daniela, Sherbourne, Cathy D., Sullivan, Greer, Stein, Murray B., Craske, Michelle G., Roy‐Byrne, Peter P. |
| Source: | Depression & Anxiety (1091-4269). Nov2013, Vol. 30 Issue 11, p1099-1106. 8p. |
| Subjects: | Mild cognitive impairment, Anxiety disorders treatment, Primary care, Symptoms, Cognitive therapy, Randomized controlled trials |
| Abstract: | Background Coordinated Anxiety Learning and Management (CALM) is a model for delivering evidence-based treatment for anxiety disorders in primary care. Compared to usual care, CALM produced greater improvement in anxiety symptoms. However, mean estimates can obscure heterogeneity in treatment response. This study aimed to identify (1) clusters of participants with similar patterns of change in anxiety severity and impairment (trajectory groups); and (2) characteristics that predict trajectory group membership. Methods The CALM randomized controlled effectiveness trial was conducted in 17 primary care clinics in four US cities in 2006-2009. 1,004 English- or Spanish-speaking patients age 18-75 with panic, generalized anxiety, social anxiety, and/or posttraumatic stress disorder participated. The Overall Anxiety Severity and Impairment Scale was administered repeatedly to 482 participants randomized to CALM treatment. Group-based trajectory modeling was applied to identify trajectory groups and multinomial logit to predict trajectory group membership. Results Two predicted trajectories, representing about two-thirds of participants, were below the cut-off for clinically significant anxiety a couple of months after treatment initiation. The predicted trajectory for the majority of remaining participants was below the cut-off by 9 months. A small group of participants did not show consistent improvement. Being sicker at baseline, not working, and reporting less social support were associated with less favorable trajectories. Conclusions There is heterogeneity in patient response to anxiety treatment. Adverse circumstances appear to hamper treatment response. To what extent anxiety symptoms improve insufficiently because adverse patient circumstances contribute to suboptimal treatment delivery, suboptimal treatment adherence, or suboptimal treatment response requires further investigation. [ABSTRACT FROM AUTHOR] |
| Copyright of Depression & Anxiety (1091-4269) is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) | |
| Database: | Psychology and Behavioral Sciences Collection |
| FullText | Links: – Type: pdflink Text: Availability: 0 |
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| Header | DbId: pbh DbLabel: Psychology and Behavioral Sciences Collection An: 91809101 AccessLevel: 6 PubType: Academic Journal PubTypeId: academicJournal PreciseRelevancyScore: 0 |
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| Items | – Name: Title Label: Title Group: Ti Data: TRAJECTORIES OF CHANGE IN ANXIETY SEVERITY AND IMPAIRMENT DURING AND AFTER TREATMENT WITH EVIDENCE-BASED TREATMENT FOR MULTIPLE ANXIETY DISORDERS IN PRIMARY CARE. – Name: Author Label: Authors Group: Au Data: <searchLink fieldCode="AR" term="%22Joesch%2C+Jutta+M%2E%22">Joesch, Jutta M.</searchLink><br /><searchLink fieldCode="AR" term="%22Golinelli%2C+Daniela%22">Golinelli, Daniela</searchLink><br /><searchLink fieldCode="AR" term="%22Sherbourne%2C+Cathy+D%2E%22">Sherbourne, Cathy D.</searchLink><br /><searchLink fieldCode="AR" term="%22Sullivan%2C+Greer%22">Sullivan, Greer</searchLink><br /><searchLink fieldCode="AR" term="%22Stein%2C+Murray+B%2E%22">Stein, Murray B.</searchLink><br /><searchLink fieldCode="AR" term="%22Craske%2C+Michelle+G%2E%22">Craske, Michelle G.</searchLink><br /><searchLink fieldCode="AR" term="%22Roy‐Byrne%2C+Peter+P%2E%22">Roy‐Byrne, Peter P.</searchLink> – Name: TitleSource Label: Source Group: Src Data: <searchLink fieldCode="JN" term="%22Depression+%26+Anxiety+%281091-4269%29%22">Depression & Anxiety (1091-4269)</searchLink>. Nov2013, Vol. 30 Issue 11, p1099-1106. 8p. – Name: Subject Label: Subjects Group: Su Data: <searchLink fieldCode="DE" term="%22Mild+cognitive+impairment%22">Mild cognitive impairment</searchLink><br /><searchLink fieldCode="DE" term="%22Anxiety+disorders+treatment%22">Anxiety disorders treatment</searchLink><br /><searchLink fieldCode="DE" term="%22Primary+care%22">Primary care</searchLink><br /><searchLink fieldCode="DE" term="%22Symptoms%22">Symptoms</searchLink><br /><searchLink fieldCode="DE" term="%22Cognitive+therapy%22">Cognitive therapy</searchLink><br /><searchLink fieldCode="DE" term="%22Randomized+controlled+trials%22">Randomized controlled trials</searchLink> – Name: Abstract Label: Abstract Group: Ab Data: Background Coordinated Anxiety Learning and Management (CALM) is a model for delivering evidence-based treatment for anxiety disorders in primary care. Compared to usual care, CALM produced greater improvement in anxiety symptoms. However, mean estimates can obscure heterogeneity in treatment response. This study aimed to identify (1) clusters of participants with similar patterns of change in anxiety severity and impairment (trajectory groups); and (2) characteristics that predict trajectory group membership. Methods The CALM randomized controlled effectiveness trial was conducted in 17 primary care clinics in four US cities in 2006-2009. 1,004 English- or Spanish-speaking patients age 18-75 with panic, generalized anxiety, social anxiety, and/or posttraumatic stress disorder participated. The Overall Anxiety Severity and Impairment Scale was administered repeatedly to 482 participants randomized to CALM treatment. Group-based trajectory modeling was applied to identify trajectory groups and multinomial logit to predict trajectory group membership. Results Two predicted trajectories, representing about two-thirds of participants, were below the cut-off for clinically significant anxiety a couple of months after treatment initiation. The predicted trajectory for the majority of remaining participants was below the cut-off by 9 months. A small group of participants did not show consistent improvement. Being sicker at baseline, not working, and reporting less social support were associated with less favorable trajectories. Conclusions There is heterogeneity in patient response to anxiety treatment. Adverse circumstances appear to hamper treatment response. To what extent anxiety symptoms improve insufficiently because adverse patient circumstances contribute to suboptimal treatment delivery, suboptimal treatment adherence, or suboptimal treatment response requires further investigation. [ABSTRACT FROM AUTHOR] – Name: AbstractSuppliedCopyright Label: Group: Ab Data: <i>Copyright of Depression & Anxiety (1091-4269) is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.) |
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| RecordInfo | BibRecord: BibEntity: Identifiers: – Type: doi Value: 10.1002/da.22149 Languages: – Code: eng Text: English PhysicalDescription: Pagination: PageCount: 8 StartPage: 1099 Subjects: – SubjectFull: Mild cognitive impairment Type: general – SubjectFull: Anxiety disorders treatment Type: general – SubjectFull: Primary care Type: general – SubjectFull: Symptoms Type: general – SubjectFull: Cognitive therapy Type: general – SubjectFull: Randomized controlled trials Type: general Titles: – TitleFull: TRAJECTORIES OF CHANGE IN ANXIETY SEVERITY AND IMPAIRMENT DURING AND AFTER TREATMENT WITH EVIDENCE-BASED TREATMENT FOR MULTIPLE ANXIETY DISORDERS IN PRIMARY CARE. Type: main BibRelationships: HasContributorRelationships: – PersonEntity: Name: NameFull: Joesch, Jutta M. – PersonEntity: Name: NameFull: Golinelli, Daniela – PersonEntity: Name: NameFull: Sherbourne, Cathy D. – PersonEntity: Name: NameFull: Sullivan, Greer – PersonEntity: Name: NameFull: Stein, Murray B. – PersonEntity: Name: NameFull: Craske, Michelle G. – PersonEntity: Name: NameFull: Roy‐Byrne, Peter P. IsPartOfRelationships: – BibEntity: Dates: – D: 01 M: 11 Text: Nov2013 Type: published Y: 2013 Identifiers: – Type: issn-print Value: 10914269 Numbering: – Type: volume Value: 30 – Type: issue Value: 11 Titles: – TitleFull: Depression & Anxiety (1091-4269) Type: main |
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