Systematic review of cognitive interventions specialized against generalized anxiety disorder
Translated title
Systematic review of cognitive interventions specialized against generalized anxiety
Author
Okholm, Jakob Bach
Term
4. term
Education
Publication year
2015
Submitted on
2015-05-29
Pages
71
Abstract
This framework paper supports a systematic review that evaluates three GAD-specific cognitive interventions—intolerance of uncertainty, metacognitive therapy, and interpersonal emotional processing therapy—aimed at reducing core symptoms of generalized anxiety disorder: pathological worry and state and trait anxiety. It motivates the need for disorder-specific approaches by outlining GAD’s prevalence and burden, its diagnostic evolution from DSM-II to DSM-5, the central role of worry and attentional bias, and its differentiation from depression amid high comorbidity. Methodologically, the review uses DSM-5 criteria, primarily includes studies from 1994 onward, and appraises the included studies and the review itself for internal, external, and construct validity with steps to limit bias and confounding. The methodological quality is judged to be high, lending credibility to the results presented in Part 2; specific efficacy findings are not detailed here. For future research, a meta-analysis is recommended with consistently calculated effect sizes, more representative samples with balanced sex and age distributions, and harmonized outcome measures.
Denne rammeartikel understøtter en systematisk review, der undersøger tre GAD-specialiserede kognitive interventioner – intolerance of uncertainty, metacognitive therapy og interpersonal emotional processing therapy – med fokus på reduktion af GADs kernesymptomer: patologisk bekymring samt tilstands- og trækangst. Artiklen begrunder behovet for disorderspecifikke tilgange ved at skitsere GADs udbredelse og belastning, dets diagnostiske udvikling fra DSM-II til DSM-5, centraliteten af bekymring og opmærksomhedsbias samt afgrænsning i forhold til depression og anden komorbiditet. Metodisk beskrives brugen af DSM-5 som udgangspunkt, primært inddragelse af studier publiceret efter 1994, samt en kvalitetsvurdering af de inkluderede studier og reviewet med fokus på intern, ekstern og konstruktvaliditet samt reduktion af bias og confoundere. Den metodologiske kvalitet vurderes som høj, hvilket styrker troværdigheden af de resultater, der rapporteres i del 2; konkrete effektresultater gengives ikke her. For fremtidig forskning anbefales meta-analyse med ensartet beregning af effektstørrelser og mere repræsentative stikprøver med mere jævn køns- og aldersfordeling samt ensartede outcome-mål.
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