Efficacy of Transdiagnostic Cognitive Behaviour Therapy for Anxiety Disorders: A Systematic Review and Meta-Analysis of Published Outcome Studies

REFERENCES

• American Psychiatric Association (2000). Diagnostic and statistical manual of mental disorders: DSM-IV-TR (4th ed.). Washington, DC: American Psychiatric Association.
   Google Scholar
• Arch, J. J., Eifert, G. H., Davies, C., Plumb Vilardaga, J. C., Rose, R. D., & Craske, M. G. (2012). Randomized clinical trial of cognitive behavioral therapy (CBT) versus acceptance and commitment therapy (ACT) for mixed anxiety disorders. Journal of Consulting and Clinical Psychology, 80, 750–765.
   PubMed Web of Science ®Google Scholar
• Bandelow, B., Zohar, J., Hollander, E., Kasper, S., & Möller, H. (2002). World federation of societies of biological psychiatry (WFSBP) guidelines for the pharmacological treatment of anxiety, obsessive-compulsive and posttraumatic stress disorders. World Journal of Biological Psychiatry, 3, 171–199.
   PubMedGoogle Scholar
• Barlow, D. (2002). Anxiety and its disorders: The nature and treatment of anxiety and panic (2nd ed.). New York: Guilford Press.
   Google Scholar
• Barlow, D. H. (2011). Unified protocol for transdiagnostic treatment of emotional disorders: Therapist guide. New York: Oxford University Press.
   Google Scholar
• Barlow, D. H., Allen, L. B., & Choate, M. L. (2004). Toward a unified treatment for emotional disorders. Behavior Therapy, 35, 205–230.
   Web of Science ®Google Scholar
• Boettcher, J., Aström, V., Påhlsson, D., Schenström, O., Andersson, G., & Carlbring, P. (2014). Internet-based mindfulness treatment for anxiety disorders: A randomized controlled trial. Behavior Therapy, 45, 241–253. 10.1016/j.beth.2013.11.003.
   PubMed Web of Science ®Google Scholar
• Borkovec, T. D., Abel, J. L., & Newman, H. (1995). Effects of psychotherapy on comorbid conditions in generalized anxiety disorder. Journal of Consulting and Clinical Psychology, 63, 479–483.
   PubMed Web of Science ®Google Scholar
• Brown, T. A., Antony, M. M., & Barlow, D. H. (1995). Diagnostic comorbidity in panic disorder: Effect on treatment outcome and course of comorbid diagnoses following treatment. Journal of Consulting and Clinical Psychology, 63, 408–418.
   PubMed Web of Science ®Google Scholar
• Brown, T. A., & Barlow, D. H. (2009). A proposal for a dimensional classification system based on the shared features of the DSM-IV anxiety and mood disorders: Implications for assessment and treatment. Psychological Assessment, 21, 256–271. 10.1037/a0016608.
   PubMed Web of Science ®Google Scholar
• Brown, T. A., Campbell, L. A., Lehman, C. L., Grisham, J. R., & Mancill, R. B. (2001). Current and lifetime comorbidity of the DSM-IV anxiety and mood disorders in a large clinical sample. Journal of Abnormal Psychology, 110, 585–599.
   PubMed Web of Science ®Google Scholar
• Brown, T. A., Chorpita, B. F., & Barlow, D. H. (1998). Structural relationships among dimensions of the DSM-IV anxiety and mood disorders and dimensions of negative affect, positive affect, and autonomic arousal. Journal of Abnormal Psychology, 107, 179–192.
   PubMed Web of Science ®Google Scholar
• Butler, A. C., Chapman, J. E., Forman, E. M., & Beck, A. T. (2006). The empirical status of cognitive-behavioral therapy: A review of meta-analyses. Clinical Psychology Review, 26, 17–31. 10.1016/j.cpr.2005.07.003.
   PubMed Web of Science ®Google Scholar
• Campbell-Sills, L., & Barlow, D. H. (2007). Incorporating emotion regulation into conceptualizations and treatments of anxiety and mood disorders. In J. J.Gross (Ed.), Handbook of emotion regulation (pp. 542–560). New York: Guilford Press.
   Google Scholar
• Clark, L. A., & Watson, D. (1991). Tripartite model of anxiety and depression: Psychometric evidence and taxonomic implications. Journal of Abnormal Psychology, 100, 316–336. 10.1037/0021-843X.100.3.316.
   PubMed Web of Science ®Google Scholar
• Cohen, J. (1992). A power primer. Psychological Bulletin, 112, 155–159.
   PubMed Web of Science ®Google Scholar
• Craske, M. G. (2012). Transdiagnostic treatment for anxiety and depression. Depression and Anxiety, 29, 749–753. 10.1002/da.21992.
   PubMed Web of Science ®Google Scholar
• Craske, M. G., Farchione, T. J., Allen, L. B., Barrios, V., Stoyanova, M., & Rose, R. (2007). Cognitive behavioral therapy for panic disorder and comorbidity: More of the same or less of more?Behaviour Research and Therapy, 45, 1095–1109. 10.1016/j.brat.2006.09.006.
   PubMed Web of Science ®Google Scholar
• Dear, B., Titov, N., Schwencke, G., Andrews, G., Johnston, L., Craske, M., & McEvoy, P. (2011). An open trial of a brief transdiagnostic internet treatment for anxiety and depression. Behaviour Research and Therapy, 49, 830–837. doi:http://dx.doi.org/10.1016/j.brat.2011.09.007.
   PubMed Web of Science ®Google Scholar
• Ellard, K., Fairholme, C., Boisseau, C., Farchione, T., & Barlow, D. (2010). Unified protocol for the transdiagnostic treatment of emotional disorders: Protocol development and initial outcome data. Cognitive and Behavioral Practice, 17, 88–101. doi:http://dx.doi.org/10.1016/j.cbpra.2009.06.002.
   PubMed Web of Science ®Google Scholar
• Erickson, D. (2003). Group cognitive behavioural therapy for heterogeneous anxiety disorders. Cognitive Behaviour Therapy, 32, 179–186.
   PubMedGoogle Scholar
• Erickson, D. H., Janeck, A. S., & Tallman, K. (2007). A cognitive-behavioral group for patients with various anxiety disorders. Psychiatric Services (Washington, DC), 58, 1205–1211. 10.1176/appi.ps.58.9.1205.
   PubMed Web of Science ®Google Scholar
• Farchione, T. J., Fairholme, C. P., Ellard, K. K., Boisseau, C. L., Thompson-Hollands, J., Carl, J. R., … & Barlow, D. H. (2012). Unified protocol for transdiagnostic treatment of emotional disorders: A randomized controlled trial. Behavior Therapy, 43, 666–678. doi:http://dx.doi.org/10.1016/j.beth.2012.01.001.
   PubMed Web of Science ®Google Scholar
• Harvey, A. G. (2004). Cognitive behavioural processes across psychological disorders a transdiagnostic approach to research and treatment. Oxford/New York: Oxford University Press.
   Google Scholar
• Higgins, J., & Green, S. (2008). Cochrane handbook for systematic reviews of interventions. Cochrane Collaboration. Chichester/Hoboken, NJ: Wiley.
   Google Scholar
• Higgins, J., Thompson, S. G., Deeks, J. J., & Altman, D. G. (2003). Measuring inconsistency in meta-analyses. BMJ (Clinical Research ed.), 327, 557–560. 10.1136/bmj.327.7414.557.
   PubMed Web of Science ®Google Scholar
• Hofmann, S. G., & Smits, J. A. J. (2008). Cognitive-behavioral therapy for adult anxiety disorders: A meta-analysis of randomized placebo-controlled trials. The Journal of Clinical Psychiatry, 69, 621–632.
   PubMed Web of Science ®Google Scholar
• Johnston, L., Titov, N., Andrews, G., Dear, B. F., & Spence, J. (2013). Comorbidity and internet-delivered transdiagnostic cognitive behavioural therapy for anxiety disorders. Cognitive Behaviour Therapy, 42, 180–192. 10.1080/16506073.2012.753108.
   PubMed Web of Science ®Google Scholar
• Kabat-Zinn, J., Massion, A. O., Kristeller, J., Peterson, L. G., Fletcher, K. E., Pbert, L., … & Santorelli, S. F. (1992). Effectiveness of a meditation-based stress reduction program in the treatment of anxiety disorders. The American Journal of Psychiatry, 149, 936–943.
   PubMed Web of Science ®Google Scholar
• Kendler, K. S., Neale, M. C., Kessler, R. C., Heath, A. C., & Eaves, L. J. (1992). Major depression and generalized anxiety disorder: Same genes, (partly) different environments?Archives of General Psychiatry, 49, 716–722.
   PubMed Web of Science ®Google Scholar
• Kessler, R. C., Berglund, P., Demler, O., Jin, R., Merikangas, K. R., & Walters, E. E. (2005). Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry, 62, 593–602. 10.1001/archpsyc.62.6.593.
   PubMed Web of Science ®Google Scholar
• Kessler, R. C., Chiu, W. T., Demler, O., Merikangas, K. R., & Walters, E. E. (2005). Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry, 62, 617–627. 10.1001/archpsyc.62.6.617.
   PubMed Web of Science ®Google Scholar
• Mansell, W., Harvey, A., Watkins, E., & Shafran, R. (2009). Conceptual foundations of the transdiagnostic approach to CBT. Journal of Cognitive Psychotherapy, 23, 6–19.
   Google Scholar
• McEvoy, P. M., & Nathan, P. (2007). Effectiveness of cognitive behavior therapy for diagnostically heterogeneous groups: A benchmarking study. Journal of Consulting and Clinical Psychology, 75, 344–350. 10.1037/0022-006X.75.2.344.
   PubMed Web of Science ®Google Scholar
• McEvoy, P. M., Nathan, P., & Norton, P. J. (2009). Efficacy of transdiagnostic treatments: A review of published outcome studies and future research directions. Journal of Cognitive Psychotherapy, 23, 20–33. doi:http://dx.doi.org/10.1891/0889-8391.23.1.20.
   Google Scholar
• McLaughlin, T., Geissler, E. C., & Wan, G. J. (2003). Comorbidities and associated treatment charges in patients with anxiety disorders. Pharmacotherapy, 23, 1251–1256.
   PubMed Web of Science ®Google Scholar
• Norton, P. (2006). Toward a clinically-oriented model of anxiety disorders. Cognitive Behaviour Therapy, 35, 88–105.
   PubMedGoogle Scholar
• Norton, P. (2008). An open trial of a transdiagnostic cognitive-behavioral group therapy for anxiety disorder. Behavior Therapy, 39, 242–250. doi:http://dx.doi.org/10.1016/j.beth.2007.08.002.
   PubMed Web of Science ®Google Scholar
• Norton, P. (2012). Group cognitive-behavioral therapy of anxiety: A transdiagnostic treatment manual. New York: Guildford Press.
   Google Scholar
• Norton, P., & Barrera, T. L. (2012). Transdiagnostic versus diagnosis-specific CBT for anxiety disorders: A preliminary randomized controlled noninferiority trial. Depression and Anxiety, 29, 874–882. 10.1002/da.21974.
   PubMed Web of Science ®Google Scholar
• Norton, P., Barrera, T. L., Mathew, A. R., Chamberlain, L. D., Szafranski, D. D., Reddy, R., & Smith, A. H. (2013). Effect of transdiagnostic CBT for anxiety disorders on comorbid diagnoses. Depression and Anxiety, 30, 168–173. 10.1002/da.22018.
   PubMed Web of Science ®Google Scholar
• Norton, P., Hayes, S. A., & Hope, D. A. (2004). Effects of a transdiagnostic group treatment for anxiety on secondary depression. Depression and Anxiety, 20, 198–202. 10.1002/da.20045.
   PubMed Web of Science ®Google Scholar
• Norton, P., & Hope, D. A. (2005). Preliminary evaluation of a broad-spectrum cognitive-behavioral group therapy for anxiety. Journal of Behavior Therapy and Experimental Psychiatry, 36, 79–97.
   PubMed Web of Science ®Google Scholar
• Norton, P., & Philipp, L. (2008). Transdiagnostic approaches to the treatment of anxiety disorders: A quantitative review. Psychotherapy: Theory, Research, Practice, Training, 45, 214–226. doi:http://dx.doi.org/10.1037/0033-3204.45.2.214.
   PubMed Web of Science ®Google Scholar
• Norton, P., & Price, E. C. (2007). A meta-analytic review of adult cognitive-behavioral treatment outcome across the anxiety disorders. The Journal of Nervous and Mental Disease, 195, 521–531. 10.1097/01.nmd.0000253843.70149.9a.
   PubMed Web of Science ®Google Scholar
• Olatunji, B. O., Cisler, J. M., & Tolin, D. F. (2010). A meta-analysis of the influence of comorbidity on treatment outcome in the anxiety disorders. Clinical Psychology Review, 30, 642–654. 10.1016/j.cpr.2010.04.008.
   PubMed Web of Science ®Google Scholar
• Roy-Byrne, P., Craske, M. G., Sullivan, G., Rose, R. D., Edlund, M. J., Lang, A. J., … & Ste\in, M. B. (2010). Delivery of evidence-based treatment for multiple anxiety disorders in primary care: A randomized controlled trial. The Journal of the American Medical Association, 303, 1921–1928. 10.1001/jama.2010.608.
   PubMed Web of Science ®Google Scholar
• Sanchez-Garcia, M. (2004). Effectiveness of cognitive-behavioural group therapy in patients with anxiety disorders. Psychology in Spain, 8, 89–97.
   Google Scholar
• Savović, J., Jones, H. E., Altman, D. G., Harris, R. J., Jüni, P., Pildal, J., … & Sterne, J. A. C. (2012). Influence of reported study design characteristics on intervention effect estimates from randomized, controlled trials. Annals of Internal Medicine, 157, 429–438. 10.7326/0003-4819-157-6-201209180-00537.
   PubMed Web of Science ®Google Scholar
• Schmidt, N., Buckner, J., Pusser, A., Woolaway-Bickel, K., Preston, J., & Norr, A. (2012). Randomized controlled trial of false safety behavior elimination therapy: A unified cognitive behavioral treatment for anxiety psychopathology. Behavior Therapy, 43, 518–532.
   PubMed Web of Science ®Google Scholar
• Titov, N., Andrews, G., Johnston, L., Robinson, E., & Spence, J. (2010). Transdiagnostic internet treatment for anxiety disorders: A randomized controlled trial. Behaviour Research and Therapy, 48, 890–899. 10.1016/j.brat.2010.05.014.
   PubMed Web of Science ®Google Scholar
• Titov, N., Dear, B. F., Schwencke, G., Andrews, G., Johnston, L., Craske, M. G., & McEvoy, P. (2011). Transdiagnostic internet treatment for anxiety and depression: A randomised controlled trial. Behaviour Research and Therapy, 49, 441–452.
   PubMed Web of Science ®Google Scholar
• Tsao, J. C. I., Mystkowski, J. L., Zucker, B. G., & Craske, M. G. (2002). Effects of cognitive-behavioral therapy for panic disorder on comorbid conditions: Replication and extension. Behavior Therapy, 33, 493–509.
   Web of Science ®Google Scholar
• Twohig, M. P., Hayes, S. C., Plumb, J. C., Pruitt, L. D., Collins, A. B., Hazlett-Stevens, H., & Woidneck, M. R. (2010). A randomized clinical trial of acceptance and commitment therapy versus progressive relaxation training for obsessive-compulsive disorder. Journal of Consulting and Clinical Psychology, 78, 705–716. 10.1037/a0020508.
   PubMed Web of Science ®Google Scholar
• Wells, A. (1994). Attention and emotion: A clinical perspective. Hove: Lawrence Erlbaum.
   Google Scholar
• Wilamowska, Z., Thompson-Hollands, J., Fairholme, C., Ellard, K., Farchione, T., & Barlow, D. (2010). Conceptual background, development, and preliminary data from the unified protocol for transdiagnostic treatment of emotional disorders. Depression and Anxiety, 27, 882–890. doi:http://dx.doi.org/10.1002/da.20735.
   PubMed Web of Science ®Google Scholar
• Young, A. S., Klap, R., Sherbourne, C. D., & Wells, K. B. (2001). The quality of care for depressive and anxiety disorders in the United States. Archives of General Psychiatry, 58, 55–61.
   PubMed Web of Science ®Google Scholar