Abstract
The aim of this study was to evaluate the efficacy of cognitive therapy (CT) in the treatment of generalized anxiety disorder (GAD), as it would be reflected through both psychological and psychoneuroendocrinological parameters. For this purpose, a group of outpatients with GAD were treated with CT for up to a maximum of 24 sessions. In order to assess psychological and biological changes, anxiety-related symptoms were evaluated according to the Hamilton Anxiety Rating Scale (HAM-A), and the hypothalamic-pituitary-adrenal (HPA) function was determined through assessment of circulating cortisol levels. A significant decrease in the HAM-A scores, along with significant changes in plasma cortisol levels, were observed after completion of treatment with CT. These observations contribute to demonstrate that the effect of certain psychotherapeutic approaches, such as CT, may be observed at both psychological and biological levels.
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Akil, H. A., & Morano, M. I. (1995). Stress. In F. E. Bloom & D. J. Kupfer (Eds.), Psychopharmacology: The fourth generation of progress (pp. 773–785). New York: Raven.
American Psychiatric Association (1994). Diagnostic and statistical manual of mental disorders: DSM-IV (th ed., pp. 393–444). Washington, DC: Author.
Beck, A. T. (1976). Cognitive therapy and the emotional disorders. New York: International Universities Press.
Beck, A. T., Rush, A. J., Shaw, B. F., & Emery, G. (1979). Cognitive therapy of depression. New York: Guilford.
Borkovec, T. D., & Ruscio, A. M. (2001). Psychotherapy for generalized anxiety disorder. Journal of Clinical Psychiatry, 62(Suppl. 11), 37–42.
Butler, G. (1994). Treatment of worry in generalised anxiety disorder. In G. C. L. Davey & F. Tallis (Eds.), Worrying: Perspectives on theory, assessment, and treatment (pp. 209–228). Chichester, U.K.: Wiley.
Chrousos, G. P., & Gold, P. W. (1992). The concepts of stress and stress system disorders: Overview of physical and behavioral homeostasis. Journal of the American Medical Association, 267, 1244–1252.
Chrousos, G. P., & Gold, P. W. (1998). A healthy body in a healthy mind-and vice versa-The damaging power of “uncontrollable” stress. Journal of Clinical Endocrinology &Metabolism, 83, 1842–1845.
First, M. B., Spitzer, R. L., Gibbon, M., & Williams, J. B.W. (1997). Structured clinical interview for DSM-IV Axis I disorders, clinician version (SCID-CV). Washington, DC: American Psychiatric Publishing.
Gold, P. W., Goodwin, F. K., & Chrousos, G. P. (1988a). Clinical and biochemical manifestations of depression. Relation to the neurobiology of stress (1). New England Journal of Medicine, 319, 348–353.
Gold, P. W., Goodwin, F. K., & Chrousos, G. P. (1988b). Clinical and biochemical manifestations of depression. Relation to the neurobiology of stress (2). New England Journal of Medicine, 319, 413–420.
Gorman, J. M. (2002). Treating generalized anxiety disorder. Journal of Clinical Psychiatry, 63(Suppl. 8), 17–23.
Halbreich, U., Asnis, G. M., Schindledecker, R., Zumoff, B., & Nathan, R. S. (1985). Cortisol secretion in endogenous depression: I. Basal plasma levels. Archives of General Psychiatry, 42, 904–908.
Henry, J. P. (1992). Biological basis of the stress response. Integrative Physiological &Behavioral Science, 27, 66–83.
Holsboer, F. (2000). The corticosteroid receptor hypothesis of depression. Neuropsychopharmacology, 23, 477–501.
Lazarus, R. S., & Folkman, S. (1984). Stress, appraisal, and coping. New York: Springer-Verlag.
Ottenweller, J. E., Natelson, B. H., Pitman, D. L., & Drastal, S. D. (1989). Adrenocortical and behavioral responses to repeated stressors: Toward an animal model of chronic stress and stress-related mental illness. Biological Psychiatry, 26, 829–841.
Sapse, A. T. (1997). Cortisol, high cortisol diseases and anti-cortisol therapy. Psychoneuroendocrinology, 22(Suppl. 1), S3-S10.
Tafet, G. E., Idoyaga-Vargas, V. P., Abulafia, D. P., Calandria, J. M., Roffman, S. S., Chiovetta, A., & Shinitzky, M. (2001). Correlation between cortisol level and serotonin uptake in patients with chronic stress and depression. Cognitive, Affective, &Behavioral Neuroscience, 1, 388–393.
Tafet, G. E., Toister-Achituv, M., & Shinitzky, M. (2001). Enhancement of serotonin uptake by cortisol: A possible link between stress and depression. Cognitive, Affective, &Behavioral Neuroscience, 1, 96–104.
Wells, A., & Butler, G. (1997). Generalized anxiety disorder. In D. M. Clark & C. G. Fairburn (Eds.), Science and practice of cognitive behaviour therapy (pp. 155–178). Oxford: Oxford University Press.
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Tafet, G.E., Feder, D.J., Abulafia, D.P. et al. Regulation of hypothalamic-pituitary-adrenal activity in response to cognitive therapy in patients with generalized anxiety disorder. Cognitive, Affective, & Behavioral Neuroscience 5, 37–40 (2005). https://doi.org/10.3758/CABN.5.1.37
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DOI: https://doi.org/10.3758/CABN.5.1.37