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Cognitive-Behavioral Treatment of Generalized Anxiety Disorder Among Adolescents: A Case Series

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ABSTRACT

Seven adolescents received a cognitive-behavioral treatment targeting generalized anxiety disorder. The treatment consisted of awareness training, worry interventions, and relapse prevention. The worry interventions targeted specifically intolerance of uncertainty, beliefs about worry, problem solving, and cognitive avoidance. According to the Anxiety Disorders Interview Schedule for DSM-IV diagnosis of generalized anxiety disorder, self-report questionnaire scores, and time spent worrying every day, three adolescents showed clinically significant change at post-test which was maintained at 6- and 12-month follow-up assessments. Minimal to moderate improvement was observed for other participants. Factors that may explain these differences are discussed.

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Participants

Seven adolescents who responded to an advertisement in a local newspaper were included in this study. They were four girls (aged 17, 17, 17, and 18 years) and three boys (aged 16, 18, and 18 years), and all were French Canadian. The principal entry criteria were (1) age 14 to 18 and (2) primary diagnosis of GAD. All participants, and parents for participants under 18, gave consent for this report to be published.

Diagnostic Assessment.

The Anxiety Disorders Interview Schedule for DSM-IV (ADIS-IV) (Brown et al., 1994)

RESULTS AND DISCUSSION

Table 1 presents scores on the different measures at each assessment time. The clinical significance of change was based on the evaluation of treatment response, following the lines of Ladouceur et al. (2000). For self-report questionnaires and daily self-monitoring of worry, treatment response was defined by a 20% change in pretreatment scores. For the GAD residual score on the ADIS-IV, a score of 3 or less was considered to reflect treatment response. For each participant, responder status

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This study was funded by the Medical Research Council of Canada.

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