What are the recovery and attrition outcomes for group CBT and individual CBT for Generalised Anxiety Disorder in an IAPT Service? An exploratory study

Group cognitive behavioural therapy (gCBT) is commonly used in Increasing Access to Psychological Therapies (IAPT) services. However, there is limited knowledge of the efficacy of gCBT as a delivery format for generalised anxiety disorder (GAD). To address gaps in literature, this study aims to explore the efficacy and attrition of individual and group CBT interventions, respectively, at Step 3 for GAD using data from a routine IAPT service over a 24-month period. Data were retrospectively derived from a routine service's IAPTus database, separating those eligible for comparison into group (n = 44) and individual (n = 55) CBT for GAD. Outcomes were differences in pre-post self-reported anxiety (GAD-7) and depression (PHQ-9) scores, clinical recovery and attrition for gCBT and individual CBT. Both gCBT and individual CBT yielded significant reductions in self-reported anxiety and depression scores over time. Results indicate that 53% of patients attending individual CBT achieved clinical recovery, with similar but less competitive rates of 41% in gCBT. Attrition rates were similar between gCBT (29.5%) and individual CBT (27.3%), respectively. Preliminary results suggest that both individual and gCBT are effective interventions for GAD patients in IAPT, offering symptom alleviation and comparable recovery and attrition rates post-intervention. This observational design offers credibility and insight into a pragmatic evaluative and explorative comparison. gCBT may offer an acceptable and potentially economical alternative.Key learning aims(1)To explore whether gCBT and individual CBT yield significant symptom reduction in self-reported anxiety and depression in GAD patients from a routine IAPT service.(2)To explore gCBT and individual CBT clinical recovery rates in non-optimum routine conditions.(3)To explore whether gCBT for GAD produces unacceptable attrition rates and if this differs from attrition rates in individual CBT for GAD in a routine IAPT service.</p

Psychological Factors in Symptom Severity and Quality of Life in Raynaud’s Phenomenon

Background: Despite emotional stress being recognised as a key trigger for Raynaud’s phenomenon episodes, research in the area is still in its infancy.Aims: This study investigated the role of psychological factors relating to symptom severity and quality of life, and differences between Raynaud’s types (primary and secondary) to further inform the development of intervention in this field.Method: A cross-sectional design was used. Two hundred and ten adults with Raynaud’s completed an online questionnaire measuring stress, anxiety, depression, anxiety sensitivity, beliefs about emotions, symptom severity and quality of life. Results: Primary and secondary Raynaud’s groups differed in anxiety (p &lt; .004), symptom severity (p &lt; .001) and quality of life (p &lt; .001). Stepwise multiple regressions indicated anxiety and Raynaud’s type explained 23% variance in hand symptom severity (p &lt; .001); anxiety, Raynaud’s type and anxiety sensitivity explained 29% variance in symptom severity (global impact, p &lt; .001); depression, Raynaud’s type and anxiety sensitivity explained 32% variance in quality of life (p &lt; .001).Conclusions: Results highlight the importance of psychological factors in Raynaud’s phenomenon, indicating possible targets for treatment. Interventions such as cognitive behavioural therapy, which target both physical and psychological wellbeing, bear some promise as an adjuvant therapy for this group

Coping and Tolerance of Uncertainty: Predictors and Mediators of Mental Health During the COVID-19 Pandemic

The current pandemic wave of COVID-19 has resulted in significant uncertainty for the general public. Mental health and examining factors that may influence distress have been outlined as key research priorities to inform interventions. This research sought to examine whether intolerance of uncertainty and coping responses influence the degree of distress experienced by the U.K. general public during the COVID-19 pandemic. Using a crosssectional online questionnaire design, participants were recruited (N = 842) using snowball sampling over a 10-day period in the early "lockdown" phase of the pandemic. Around a quarter of participants demonstrated significantly elevated anxiety and depression, with 14.8% reaching clinical cutoff for health anxiety. A one-way multivariate analysis of variance indicated those in "vulnerable" groups were significantly more anxious (p &lt; .001), and also more anxious in relation to their health (p &lt; .001). Mediation modeling demonstrated maladaptive coping responses partially mediated the predictive relationship between intolerance of uncertainty and psychological distress. Mental health difficulties have become significantly raised during the first wave of the COVID-19 pandemic in the United Kingdom, particularly for the vulnerable. Findings support emerging research suggesting the general public is struggling with uncertainty, more so than normal. Vulnerable groups are more anxious about their health, but not more intolerant of uncertainty than the nonvulnerable. Finally, this study indicated two modifiable factors that could act as treatment targets when adapting interventions for mental health during the COVID-19 global health crisis.</p