a comparison of two ultra-brief treatments for generalized anxiety disorder symptoms
abstract
worrying is a common experience that many people engage in occasionally without issue.
however, some individuals are chronic worriers, and some develop generalized anxiety disorder
(gad) due to excessive worry (american psychiatric association, 2013). people with gad
experience significant distress and physiological issues, leading to high health care service
utilization (bélanger et al., 2005). two models of gad, the cognitive avoidance model
(sibrava & borkovec, 2006) and the metacognitive model (wells, 2009), have extensive basic
and applied support. in addition, a small body of research has shown that an ultra-brief treatment
can decrease gad symptoms and worry severity (borkovec et al., 1983; mcgowan & behar,
2013). yet, this research has used short follow-ups, and the relationships between change in
symptoms and cognitive factors have not been explored. the current study tested two ultra-brief
treatments based on the two models of gad. a total of 115 participants were assigned to
receive one of the treatments, or to a control condition. participants in the control condition were
assigned to one of the treatments after four weeks. treatments were completed in less than 20
minutes. participants completed a diagnostic interview and self-report measures at baseline, four
weeks, and four months post-treatment. participants who received treatment had large decreases
on measures of gad symptoms, worry severity, and negative affect, as well as on measures of
the proposed cognitive factors, with gains maintained at four month follow-up. while the
treatments were superior to the control condition, no differences were found between treatments.
negative beliefs about worry and meta-worry were related to changes in gad symptoms and
worry severity, while cognitive avoidance was related to changes in worry severity. overall, the
results indicate that these ultra-brief treatments appear well suited for use in primary care, and
the findings provide support for both the metacognitive model and cognitive avoidance model.