PSYC 406: Psychopathology Forums:

 

Minimum Word counts per forums 500 words, includes the reference used.

 

Week 5 (Forum 4)

 

In the Week 5 Forum Article, the authors state that the study is possibly the first of its kind investigating how adults respond to being soothed in stressful situations. As stated in the article, the background and foundation for such studies comes from the work of John Bowlby and Mary Ainsworth. Through observation in laboratory settings, they investigated how very small children responded to stressful situations where parents would leave the room and then return (called the Strange Situation - a video about it is located at www.youtube.com/watch?v=QTsewNrHUHU). Upon return of the parent, depending on the mannerisms of the child, they would be hypothesized as having a particular attachment style (dismissive, secure, or avoidant). You can refer to page 468 of your journal article for the complete description of Bowlby and Ainsworth's Attachment Theory.

 

Forum Topic Instructions:

 

After reading the journal article in the Week 5 sub-folder (see week 5 discussion forum article) located in the classroom Resources folder, respond to the following:

 

-Describe your understanding of the 2 forms of relaxation therapy (RT) noted in the study.

-Compare and contrast RT with the other approach examined in the study: cognitive therapy, or cognitive-behavioral therapy (CT, CBT).

-What were the primary objectives of this study?

-Do the results of this study support the use of these treatment protocols over other psychotherapies? That is, are they superior to other protocols? Why or why not?

 

Week 6 (forum 5)

 

Forum Topic Instructions:

 

This week, we will be utilizing the course textbook rather than a journal article for our forum dialog. For this forum read Chapters 16, 17, and 18 and respond to the following:

 

According to the course textbook, the number of children through adolescence with SED (severe and impairing emotional disorders and/or behavioral problems) is significant.

 

-Explain the 2 dimensions of conceptualizing these disorders.

-Using additional resources (beyond the course text, but not Wikipedia or WebMD), support or refute the premise that the numbers of children with SEDs is significant.

-Provide an analysis of the potential causes and treatments for the observed numbers of children or adolescents with SEDs. You may include holistic perspectives if supportive documentation is provided. Remember that you must provide a thorough analysis of causes and treatments for several externalizing and internalizing disorders to receive full credit.

 

Week 7 (Forum 6):

 

A new study indicates that HALF of US children/adolescents meet the criteria for a mental disorder by childhood, through the age of 18. When reading the study, ADHD would fall under "behavior disorders." This study is summarized on the American Psychological Association website: http://www.apa.org/monitor/2011/02/mental-illness.aspx

 

This study focused on a possible link between adult ADHD and dementia (http://health.usnews.com/health-news/family-health/brain-and-behavior/articles/2011/01/19/adult-adhd-often-precedes-certain-type-of-dementia-study)

 

Forum Topic Instructions: After reading the journal article for this for this forum located in the Week 7 sub-folder of the classroom Resources folder, respond to the following:

 

-What do the authors claim as the basis for this study? What is the purpose?

-What did the study reveal regarding Personality Disorders that was not expected?

-Does the study indicate a propensity for Personality Disorder when the Axis I ADHD disorder is present? Why?

-What are the implications for further research?

-Provide your scholarly opinion of the findings, concepts, and hypotheses presented by the authors of this study.

 

Week 8 (forum 7):

 

Forum Topic Instructions:

 

After reading the Week 8 Capstone Forum 7 article, (see attachement) respond to the following:

 

-What role does a socio-cultural model of psychopathology have in the context of the study? Explain.

-How does attribution theory apply to reducing stigma and increasing employment?

-Describe your idea of a public health program that would serve to reduce stigma surrounding the mentally ill and promote rehabilitation.

-NOTE: This discussion will require exploring material outside the course textbook assigned readings. Be sure to source credit all sources used in APA format.

 

 

Forum Scoring Rubric

Initial posts content: are on-topic, show evidence of application to assigned learning materials, demonstrate meaning of the material rather than merely reiterating what a published author or classmate has already stated. For full credit, posts thoroughly address each question related to the assigned article or readings. (included in format points)

Initial Post Format: Initial posts are a minimum of 500 words in length, show clarity and good organization of ideas, and use correct spelling and grammar; texting style writing and slang are not used.

CORRECTED AUGUST 22, 2008; SEE LAST PAGE
Journal of Consulting and Clinical Psychology
2007, Vol. 75, No. 4, 513–522 Copyright 2007 by the American Psychological Association
0022-006X/07/$12.00 DOI: 10.1037/0022-006X.75.4.513 Specificity of Treatment Effects: Cognitive Therapy and Relaxation for
Generalized Anxiety and Panic Disorders
Jedidiah Siev and Dianne L. Chambless
University of Pennsylvania
The aim of this study was to address claims that among bona fide treatments no one is more efficacious
than another by comparing the relative efficacy of cognitive therapy (CT) and relaxation therapy (RT) in
the treatment of generalized anxiety disorder (GAD) and panic disorder without agoraphobia (PD). Two
fixed-effects meta-analyses were conducted, for GAD and PD separately, to review the treatment
outcome literature directly comparing CT with RT in the treatment of those disorders. For GAD, CT and
RT were equivalent. For PD, CT, which included interoceptive exposure, outperformed RT on all
panic-related measures, as well as on indices of clinically significant change. There is ample evidence
that both CT and RT qualify as bona fide treatments for GAD and PD, for which they are efficacious and
intended to be so. Therefore, the finding that CT and RT do not differ in the treatment of GAD, but do
for PD, is evidence for the specificity of treatment to disorder, even for 2 treatments within a CBT class,
and 2 disorders within an anxiety class.
Keywords: generalized anxiety disorder, panic disorder, cognitive therapy, relaxation therapy, treatment
specificity spurious conclusions” (p. 254). Certainly in conducting a metaanalysis, the researcher paints with broad strokes. However, if the
findings are to be clinically useful, the researcher must consider
meaningful subsets in the data so as not to obscure potentially
important differences among treatments. It is our argument that
significant differences among treatments may exist for specific
disorders. For example, there are at least four studies in which
exposure and response prevention for obsessive– compulsive disorder (OCD) has proven more efficacious than relaxation therapy
(RT; see Chambless & Ollendick, 2001).
The primary goal of this article is to address this specific aspect
of the common factors approach by evaluating two efficacious,
active treatments across studies, but within particular domains of
psychopathology. A second goal, which forms the framework for
this investigation, is to review the treatment outcome literature
comparing cognitive therapy (CT) and RT for generalized anxiety
disorder (GAD) and panic disorder without agoraphobia (PD) to
determine the relative efficacy of each treatment for each disorder.
GAD and PD are related, and, until the introduction of the Diagnostic and Statistical Manual of Mental Disorders (3rd ed.; American Psychiatric Association, 1980), were not diagnostically distinct. In fact, even subsequent to the formalization of that
distinction, some studies evaluating cognitive– behavioral therapy
(CBT) and RT in treating anxiety have used mixed GAD–PD
¨
samples (e.g., Borkovec & Mathews, 1988; Ost, 1988). By analyzing particular treatments in particular domains, it is possible
accurately to compare two specific active ingredients in psychotherapy, and by doing so within the context of two related anxiety
disorders, one executes a conservative comparison. Although the
absence of significant differences between treatments would not
necessarily imply that common factors account for all effects, the
presence of differences would support the notion that treatment
effects are influenced by specific therapy techniques. There has been extensive debate and controversy in recent years
regarding the utility of examining active ingredients versus common factors in psychotherapy. Wampold and colleagues (e.g., Ahn
& Wampold, 2001; Wampold et al., 1997) and Luborsky and
colleagues (e.g., Luborsky et al., 2002) have claimed that all forms
of psychotherapy are equivalent; what matters are the quality of
the therapeutic alliance and other factors common to all treatments
such as the presentation of a treatment rationale. Their assertions
are based on meta-analyses that combine treatments of all types
and disorders of all types, largely for adult patients. Researchers
have challenged their conclusions on the grounds that the fact that
all treatments for all disorders when combined do not differ from
each other does not imply that a particular treatment for a particular disorder is not superior (Chambless, 2002). Proponents of a
common factors approach to psychotherapy limit their contentions
to bona fide treatments, defined as “those that were delivered by
trained therapists and were based on psychological principles,
were offered to the psychotherapy community as viable treatments
(e.g., through professional books or manuals), or contained specified components” (Wampold et al., 1997, p. 205). This reasoning,
however, presupposes that a treatment can be, in and of itself, bona
fide, with no clinical referent: for the treatment of what?
Ahn and Wampold (2001) noted that “a familiar criticism of
meta-analysis” is that “aggregating across diverse studies yields Jedidiah Siev and Dianne L. Chambless, Department of Psychology,
University of Pennsylvania.
¨
We wish to thank Arnoud Arntz and Lars-Goran Ost for generously
¨
sharing data to facilitate this meta-analysis. We are grateful, as well, to
Arnoud Arntz for suggesting this investigation.
Correspondence concerning this article should be addressed to Jedidiah
Siev, Department of Psychology, University of Pennsylvania, 3720 Walnut
Street, Philadelphia, PA 19104-6241. E-mail: jsiev@psych.upenn.edu
513 SIEV AND CHAMBLESS 514 The reasons GAD and PD were selected from the anxiety
disorders as domains of investigation are as follows. Similar studies of panic disorder with agoraphobia (PDA) have all included in
vivo exposure as an element of CBT, and for anxiety disorders, in
vivo exposure typically renders supplemental CT unnecessary
¨
(e.g., Ost, Thulin, & Ramnero, 2004). In contrast, most PD studies
¨
have included interoceptive exposure in the CT condition, but not
in vivo exposure to phobic situations. CBT as administered in
studies of PDA was therefore judged to be qualitatively different
from that used in studies of GAD and PD. Studies of OCD were
also not included, not only because the CBT condition in CBT
versus RT studies for OCD consisted almost entirely of exposure
and response prevention, but also because RT was intended as a
control condition in those studies and might not satisfy the criteria
of a bona fide treatment. GAD and PD are the only other anxiety
disorders for which multiple randomized clinical trials have been
conducted that compare CT and RT directly. CT and RT for GAD and PD
GAD and PD are common and costly. The National Comorbidity Survey found lifetime prevalence rates of approximately 5%
and 3.5% for GAD and PD, respectively (Kessler et al., 1994;
Wittchen, Zhao, Kessler, & Eaton, 1994). Furthermore, GAD is
often chronic, resistant to change, and characterized by early onset
(Sanderson & Wetzler, 1991; Zuellig & Newman, 1996, as cited
by Borkovec, Newman, Pincus, & Lytle, 2002). The substantial
individual health and social costs associated with PD rival those
connected with major depressive disorder, and PD patients utilize
medical services at exceptionally high rates (Katon, 1996;
Markowitz, Weissman, Ouellette, Lish, & Klerman, 1989). Although it is perhaps the basic anxiety disorder (Brown, Barlow, &
Liebowitz, 1994), GAD has proven particularly difficult to treat,
with clinical trials producing clinically significant improvement in
only about 50% of participants (Borkovec & Newman, 1998;
Borkovec & Whisman, 1996). Treatments for PD, in contrast, have
produced clinically significant improvement in more than 80% of
¨
research participants (Clark, 1996; Ost & Westling, 1995).
Among other psychotherapy approaches, CT and RT have received considerable empirical support in the treatment of anxiety
disorders, and GAD and PD in particular (e.g., Gould, Otto, &
Pollack, 1995; Gould, Otto, Pollack, & Yap, 1997; Mitte, 2005a,
2005b). Variations of the two are often combined in CBT packages, but they are based, in principle, on different theoretical
approaches, and each one individually appears efficacious in clinical trials. According to the cognitive model, anxiety is maintained
by an individual’s misperception of danger and catastrophic misinterpretations of generally benign stimuli, sometimes internal and
other times external. For example, a stimulus might precipitate a
physiological or cognitive reaction from an individual, which is
followed by an exaggerated perception of danger or threat, which
strengthens the reaction, and so forth, creating a self-perpetuating
cycle of progressively intensified anxiety. Adherents to the cognitive model propose that these thoughts are accessible to conscious consideration and intentional reevaluation, staples of CT
(e.g., A. T. Beck, Emery, & Greenberg, 1985; Clark, 1986). The
applications of the cognitive model to GAD and PD are discussed
more specifically later, in terms of the treatment protocols used by
the authors of studies analyzed herein. RT is a coping technique with a behavioral treatment component, whereby individuals learn to relax in the presence or antic¨
ipation of feared stimuli or general anxiety (e.g., Ost, 1987, 1988).
Proponents of RT subscribe to a model of anxiety similar to the
cognitive model, but the focus in treatment is entirely different.
The goal is to abort the anxiety cycle by decreasing the intensity of
the physiological reaction and to avoid catastrophic thoughts without addressing the cognitions directly. Although there is limited
empirical evidence for particular mechanisms of change, it is
believed that RT works by (a) reducing general tension and anxiety
and, consequently, the likelihood that any particular stressor will
trigger panic; (b) increasing awareness about how anxiety works,
thereby demystifying it and diminishing its impact; and (c) enhancing perceived self-efficacy, so that the individual feels
¨
equipped to cope with an anxiety reaction (Ost, 1987, 1992). This
approach is consistent both with the cognitive model and with
behavioral models of anxiety in which anxious processes are
viewed as primarily automatic and out of consciousness, and
successful treatment as operating at that level (e.g., Marks, 1987;
Ohman & Soares, 1994).
There are two primary forms of RT investigated in the GAD and
PD treatment outcome literatures during the past 3 decades: progressive relaxation (PR; e.g., Bernstein & Borkovec, 1973) and
¨
applied relaxation (AR; Ost, 1987). During the former, which also
composes the first stage of AR training, the individual learns to
relax by tensing and then relaxing various muscle groups. After
one is able to achieve a state of relaxation in that way, one learns
to relax without first physically tensing muscles, to relax in response to a self-generated cue, and finally to relax those muscles
not involved in a particular activity even as one engages in that
¨
activity (differential relaxation). Ost (1987) added application
training to PR, in which individuals practice applying the relaxation in vivo by approaching increasingly feared situations and
using the relaxation techniques to manage the evoked anxiety.
Although AR, by definition, involves exposure, the goal is not to
extinguish the anxiety through a process of habituation, but rather
to practice applying the skills in vivo. In fact, exposures are often
not sufficiently long to allow for habituation.
Although a number of previous meta-analyses have evaluated
the efficacy of CBT for GAD and PD (e.g., Mitte, 2005a, 2005b),
they did not focus specifically on the relative efficacy of CT and
RT, two known active treatments. Not only is there considerable
evidence that these therapies work, both in combination with each
other and separately, but a number of studies have now been
published that directly compare the two active treatments for GAD
and PD (see references marked with an asterisk). It is important,
scientifically and clinically, that the results of these trials be
synthesized to describe the state of the literature with respect to
these treatments.
Of specific interest as outcome measures are those related to
core features of the psychopathology of each disorder: generalized anxiety and anxiety-related cognitions in the case of
GAD, and panic, fear of anxiety, and panic-related cognitions in
the case of PD. Although other symptoms such as depression
are certainly of interest, it is clinically most important to
determine whether treatments differ in impact on the patients’
core presenting problems. CT AND RELAXATION FOR GAD AND PANIC Meta-Analytic Procedure 515 tation, summary statistics were then transformed back to odds
ratios by taking antilogarithms. Standardized Mean Difference
The standardized mean difference effect size was calculated
from posttreatment data to evaluate between-groups differences
based on their respective mean scores. This effect size was adjusted for a slight upward bias, yielding Hedges’ g (Hedges, 1981).
As reported in the present article, a positive sign denotes that an
effect size favors CT over RT, whereas a negative sign indicates a
relative advantage for RT over CT.
In addition, each effect size in a given analysis was weighted to
account for its relative precision, in large part a function of sample
size. Hedges and Olkin (1985) suggested basing the weights on the
standard errors of the effect sizes, rather than simply the sample
size. Specifically, the inverse variance weight was used, which is
the reciprocal of the squared standard error:
wϭ 1
.
SE2 Fixed-effects meta-analyses proceeded as follows. First, the
effect size, standard error, and inverse variance weight were calculated for each construct measured within each study. Second, the
weighted mean effect size was computed for a given domain
across all studies, according to the formula
ES ϭ
៮ ¥ ͑wi ϫ ESЈ͒
i ͸ wi , as was the standard error of the weighted mean effect size,
SEES ϭ
៮ ͱ 1
.
¥ wi Often, individual studies report multiple dependent measures of
a single construct. Including more than one measure per study
would violate assumptions of independence, inflate the sample
size, and distort standard error estimates. Hence, a single effect
size for each domain within each study was calculated by taking
the arithmetic mean of the effect sizes for all included measures in
that domain. The standard error was computed by treating the
mean effect size as a single effect size from which to calculate a
standard error; it was not the mean of the standard errors. This
method has been demonstrated to produce appropriate estimates
when homogeneity of effect sizes is assumed, as is the case in
fixed-effects analyses (Marin-Martinez & Sanchez-Meca, 1999). Odds Ratio
Dichotomous variables were analyzed using the odds ratio effect
size, which denotes the ratio of odds for a particular outcome for
two groups, where the odds of an event is the probability of an
outcome divided by 1 minus that probability. If any cell frequency
was equal to 0, 0.5 was added to all cells. An odds ratio of 1
indicates identical odds for the two comparison groups. Because
the distribution is skewed, analyses were performed on the natural
log of the odds ratio. The inverse variance weight and weighted
mean effect size were calculated by the same formulas as when
computing the standardized mean difference. For ease of interpre- Proportion
Weighted average proportions were calculated to give the percentage of each group that met certain criteria. Because proportions are constrained to values between 0 and 1, using simple
proportions can distort the results, especially when the mean
proportion approaches 0 or 1. Therefore, proportions were converted into logits as the effect sizes, analyses were conducted on
the logits, and the results were converted back to proportions.
Again, the same formulas as described earlier were applied to
compute the weighted effect size. Homogeneity Analysis
Fixed-effects models are predicated on the assumption that the
variance in effect sizes among the studies can be attributed to
sampling error. That is, a homogeneous distribution describes a set
of effect sizes that are dispersed around their mean as would be
expected due only to subject-level sampling error. A heterogeneous distribution suggests that there is additional variability,
either random or systematic, that usually warrants modeling, given
sufficient power. It is possible statistically to test whether there is
evidence of heterogeneity. This test is based on the Q statistic,
which has a chi-square distribution (Hedges & Olkin, 1985). A
significant Q statistic suggests heterogeneity.
Because relatively few studies were included in this metaanalysis, fixed-effects analyses were preferred to avoid Type II
error. However, Q has poor power to detect heterogeneity, so a
conservative level of ␣ ϭ .10 was set to denote significant heterogeneity. In the case of significant homogeneity tests, randomeffects analyses were planned to model the between-studies variability; for nonsignificant homogeneity tests, fixed-effects
analyses were used. Recently, Higgins and Thompson (2002)
proposed an index, I2, which can be interpreted as the percentage
of variability due to heterogeneity; it therefore contains information about the degree of heterogeneity, not just significance level
(see also Huedo-Medina, Sanchez-Meca, Marin-Martinez, &
Botella, 2006). Higgins and Thompson offered the tentative heuristic that “mild heterogeneity might account for less than 30 per
cent of the variability in point estimates, and notable heterogeneity
substantially more than 50 per cent” (p. 1553). Similarly, HudeoMedina et al. referred to a classification of low, medium, and high
heterogeneity corresponding to I2 values of 25, 50, and 75. GAD
CBT for GAD typically comprises some or all of the following
elements: (a) self-monitoring; (b) cognitive restructuring, including evaluating and reconsidering interpretive and predictive cognitions; (c) relaxation training; and (d) rehearsal of coping skills
(Borkovec & Ruscio, 2001). Because GAD is not strongly characterized by avoidance of specific external environments or situations, CBT for GAD makes use of imagery rehearsal (e.g., stress
inoculation) more than the in vivo exposure that would be fundamental to CBT for other anxiety disorders (Borkovec & Ruscio,
2001). As previously mentioned, the efficacy of CBT packages for SIEV AND CHAMBLESS 516 GAD is well documented, if less impressive than for other disorders (e.g., Roemer & Orsillo, 2002).
Studies were located via a search of PsycINFO using the keywords cognitive therapy or cognitive– behavioral therapy and generalized anxiety disorder. In addition, the major journals publishing CBT outcome studies were checked by hand from 1992 to
2005: Behavior Therapy, Behaviour Research and Therapy, Cognitive Therapy and Research, Journal of Anxiety Disorders, and
Journal of Consulting and Clinical Psychology. Last, the text and
reference sections of relevant studies, articles, and chapters were
scanned. Studies were included if they compared therapistadministered, individual CT and RT; participants met diagnostic
criteria for GAD and were randomized to treatment condition; and
the two treatment protocols were judged not to contain overlapping
ingredients presumed to be active. For example, whereas structural
features such as format and length were expected to be similar,
four studies were excluded primarily because the CT condition
included relaxation training or similar behavioral techniques. Including only studies that compared CT and RT directly, although
limiting in number, is advantageous because it minimizes apparent
treatment differences that are artifacts of cross-study particularities
(see Weisz, Jensen-Doss, & Hawley, 2006). Five studies were
identified that directly compared CT and RT (Arntz, 2003; Barlow,
Rapee, & Brown, 1992; Borkovec et al., 2002; Butler, Fennell,
¨
Robson, & Gelder, 1991; Ost & Breitholtz, 2000); a sixth was in
the stage of data collection and was unavailable for this metaanalysis (Dugas & Koerner, 2005).
By and large, the five studies were methodologically sound.
With the exception of a subset of the participants in Arntz (2003),
all participants were screened on the basis of validated structured
interviews, and reanalysis of that study excluding other participants did not change the results. Also with the exception of Arntz
(2003), who collected only self-report data, participants in all
studies were assessed by independent raters blind to treatment
¨
condition. All but Ost and Breitholtz (2000) reported that therapists received regular supervision to enhance quality and adher- ence to treatment protocol, and three formally assessed integrity
with excellent results (Barlow et al., 1992; Borkovec et al., 2002;
Butler et al., 1991). Perceived treatment credibility or client expectations were assessed by all studies except Arntz (2003); they
appeared rather high, and in no case differed by treatment group.
The mean age of study participants was consistent across studies
(approximately 33– 40 years old), and in all studies therapists were
crossed with treatment condition.
Overall, there was little evidence across studies for the superiority of either treatment over the other; only Butler et al. (1991)
found that CT outperformed RT. One of the methodological limitations common to the studies, however, is the relatively small
sample size and consequent low power to detect group differences.
To address this concern and synthesize the various findings quantitatively, data were meta-analyzed using completer samples because data for intention-to-treat samples were not consistently
available. Follow-up data were also not consistently available.
Measures were categorized in three domains: primary domains of
anxiety and anxiety-related cognitions, and the secondary domain
of depression, which often occurs concurrently with anxiety. Effect sizes were calculated for between-groups differences at posttreatment. Particular measures that composed each domain for
each study are given in Table 1. In addition, effect sizes were
calculated to assess between-groups differences in rates of clinically significant change and drop-outs. As referred to herein,
clinically significant change includes both measures of change and
high end-state functioning, which refers to the quality of functioning at posttreatment. Results
Between-groups comparisons. Between-groups effect sizes
were calculated from uncontrolled posttreatment means and standard deviations. Unpublished data were obtained (A. Arntz, personal communication, January 27, 2006) to supplement those Table 1
Measures Included in Generalized Anxiety Disorder Meta-Analysis
Study
Arntz (2003)
Barlow et al. (1992) Borkovec et al.
(2002)
Butler et al. (1991)
¨
Ost & Breitholtz
(2000) Anxiety
Fear of Fear (van den Hout et al., 1987),
SCL-90 Anxiety, STAI-T
ADIS-R Severity, CSAQ-Somatic,
HARS, STAI-T, average daily
anxiety, intense anxiety episodes per
week
ADIS-R Severity, HARS, STAI-T, diary
severity
BAI, HARS, Leeds Anxiety, STAI-T,
Watson & Marks (1971), self-rated
anxiety
ADIS-R Severity, BAI, CSAQ-Somatic,
HARS, STAI-T, self-rated severity Cognitive Depression
Bouman CSAQ-Cognitive, percentage of day
spent worrying BDI, HDRS, daily depression PSWQ BDI, HDRS SPQ, Interpretations, Individual
Thoughts BDI, Leeds Depression, Watson &
Marks (1971), self-rated
depression
BDI, HDRS PSWQ, CSAQ-Cognitive Note. SCL-90 Anxiety ϭ Symptom Checklist-90 Anxiety—Dutch version (Arrindell & Ettema, 1981); STAI-T ϭ State-Trait Anxiety Inventory—Trait
scale (Spielberger et al., 1970); Bouman ϭ Bouman Depression Inventory (Bouman, 1987); ADIS-R ϭ Anxiety Disorders Interview Schedule— Revised
(DiNardo & Barlow, 1988); CSAQ ϭ Cognitive Somatic Anxiety Questionnaire (Schwartz et al., 1978); HARS ϭ Hamilton Anxiety Scale (Hamilton,
1959); BDI ϭ Beck Depression Inventory (A. T. Beck et al., 1961); HDRS ϭ Hamilton Depression Rating Scale (Hamilton, 1960); PSWQ ϭ Penn State
Worry Questionnaire (Meyer et al., 1990); BAI ϭ Beck Anxiety Inventory (A. T. Beck et al., 1988); Leeds ϭ Leeds Scales (Snaith et al., 1976); SPQ ϭ
Subjective Probabilities Questionnaire (Butler & Mathews, 1983). CT AND RELAXATION FOR GAD AND PANIC printed in Arntz (2003). See Table 2 for between-groups effect
sizes.
There was little difference between the effects of CT and RT on
anxiety, anxiety-related cognitions, and depression, for which the
weighted mean effect sizes were all small and nonsi...

 

Attachments:

• 1506752385-Week 5 Discussion Forum Article.pdf
• 1506752395-Week 8 Capstone Discussion Forum Article.pdf
• 1506752703-Psychopathology Book.pdf