Efficacy of Adding Interpersonal and Emotional Processing Therapy Techniques to Cognitive Behavioral Therapy to Treat Generalized Anxiety Disorder

Generalized anxiety disorder (GAD) is characterized by chronic worry that interrupts normal
functioning. Some research has shown cognitive behavioral therapy (CBT) to be an effective
treatment for GAD, but only half of people treated with CBT for GAD experience treatment
benefits long-term. Standard CBT for GAD may lose effectiveness over time because it does
not address interpersonal and emotional processing problems. This study will determine the
efficacy of a version of CBT with additional therapeutic techniques for addressing
interpersonal interactions and emotional processing among adults with GAD.

Participation in this study will include 14 weeks of treatment and 2 years of follow-up
visits. All participants will receive 14 weekly, 2-hour, individual therapy sessions and one
maintenance session scheduled after completing treatment. During the first hour of each
session, all participants will receive standard CBT. Participants will be randomly assigned
to receive one of two therapies during the second hour: training in interpersonal and
emotional processing techniques or listening therapy. Participants may continue taking their
current medications if they maintain a fixed dosage and keep a daily dairy of medication
use, starting 2 weeks before study entry and lasting throughout treatment.

In-depth study assessments will take place at baseline and after completing the 14 weeks of
therapy. Assessments will include clinical interviews, self-report questionnaires, and a
physiological measurement session. Questions will pertain to anxiety symptoms,
self-perceptions, emotional experience, and perceptions of the world. The physiological
measurement session will involve recording bodily reactions, including brain waves, heart
rate, eye movement, and breathing, while performing simple perceptual tasks. Brief
psychological assessments will also follow each therapy session. Follow-up assessments
conducted 6, 12, and 24 months after completing treatment will involve interviews and
questionnaires as well as recording a week's worth of medication diaries.

Inclusion Criteria:

- Principal diagnosis of generalized anxiety disorder (GAD), as defined by the DSM-IV
and agreed on by two diagnostic interviewers

- Clinician's Severity Rating for GAD of 4 (moderate) or greater

Exclusion Criteria:

- Concurrent psychosocial therapy or past adequate dosage of CBT

- Any medical contributions to anxiety

- Current substance abuse, psychosis, or organic brain syndrome