Cognitive Therapy and Research

, Volume 35, Issue 2, pp 151–160 | Cite as

Preliminary Evidence that Anxiety is Associated with Accelerated Response in Cognitive Therapy for Depression

  • Nicholas R. ForandEmail author
  • Kathleen C. Gunthert
  • Lawrence H. Cohen
  • Andrew C. Butler
  • Judith S. Beck
Original Article


We conducted two studies that assessed the role of initial anxiety in rate of change (depression reduction) in cognitive therapy for major depression. In both studies, depression and anxiety were assessed at intake, and depression was assessed at every treatment session. Longitudinal growth modeling was used to predict rate of change in treatment from sessions 1–12 controlling for intake depression, with intake anxiety as a moderator of change. In Study 1, high initial anxiety was associated with a faster rate of depression reduction across the course of cognitive therapy, whereas in Study 2, high initial anxiety was associated with a faster rate of depression reduction in the early sessions of treatment. The influence of intake depression on rate of change was controlled, and therefore the results are likely not due to greater symptom severity or distress among those high in anxiety. BAI subscale analyses suggest that the results are likely due to the physiological arousal characteristic of anxiety. These results suggest a potentially beneficial role for initial anxiety in cognitive therapy for depression.


Cognitive therapy Depression Anxiety Comorbidity Rate of change 



This research was supported by National Institute of Mental Health Grant R21MH067825 awarded to Lawrence H. Cohen. We thank Adele Hayes for providing helpful comments on an earlier version of this article.


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Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • Nicholas R. Forand
    • 1
    • 4
    Email author
  • Kathleen C. Gunthert
    • 1
  • Lawrence H. Cohen
    • 2
  • Andrew C. Butler
    • 3
    • 5
  • Judith S. Beck
    • 3
  1. 1.Psychology DepartmentAmerican UniversityWashingtonUSA
  2. 2.Department of PsychologyUniversity of DelawareNewarkUSA
  3. 3.Beck Institute for Cognitive Therapy and ResearchBala CynwydUSA
  4. 4.Department of PsychologyUniversity of PennsylvaniaPhiladelphiaUSA
  5. 5.MontereyCalifornia

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