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Anxiety Disorder-Specific Predictors of Treatment Outcome in the Coordinated Anxiety Learning and Management (CALM) Trial

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Abstract

Identifying baseline characteristics associated with treatment outcome in generalized anxiety disorder, panic disorder, social anxiety disorder (SAD) or post-traumatic stress disorder. We performed two secondary analyses of the Coordinated Anxiety Learning and Management trial. Baseline characteristics and their interactions with treatment assignment were analyzed via stepwise logistic regression models and receiver-operating criterion analyses by disorder predicting remission and response for each disorder. Predictors for poor outcome across diagnoses were comorbid depression and low socioeconomic status. Good outcome was associated with positive treatment expectancy and high self-efficacy expectancy. SAD had the lowest rate of remission and response compared to the other anxiety disorders, and differed in respect to its predictors of treatment outcome. Perceived social support predicted treatment outcome in SAD. The special role of SAD among the other anxiety disorders requires further study both because of its worse prognosis and its more specific treatment needs.

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Acknowledgments

The authors acknowledge the support of the National Institutes of Health K23MH091240 (MHB), the Tourette Syndrome Association, the Patterson Foundation, NARSAD, the Rembrandt Foundation and UL1 RR024139 from the National Center for Research Resources, a component of the National Institutes of Health, and NIH roadmap for Medical Research (MHB). Data used in the preparation of this article were obtained from the limited access datasets distributed from the NIH-supported “Coordinated Anxiety Learning and Management (CALM): Improving Primary Care Anxiety Outcomes”. This is a multisite, clinical trial of persons with anxiety comparing the effectiveness of randomly assigned interventions (medication and CALM behavioral treatment with treatment as usual). The study was supported by NIMH Grant # U01 MH057858-05 to the University of Washington. The ClinicalTrials.gov identifier is NCT00347269. Our thanks go to Jilian Mulqueen and Catherine Coughlin for their help with manuscript preparation.

Disclosures

This manuscript reflects the views of the authors and may not reflect the opinions or views of the CALM Study Investigators or the NIH.

Author information

Authors and Affiliations

  1. Connecticut Mental Health Center and the Yale Child Study Center, 230 South Frontage Road, New Haven, CT, USA

    Ewgeni Jakubovski

  2. Yale Child Study Center and the Department of Psychiatry of Yale University, 230 South Frontage Road, New Haven, CT, USA

    Michael H. Bloch

  3. Child Study Center, Yale University School of Medicine, PO Box 207900, New Haven, CT, 06520, USA

    Ewgeni Jakubovski

  4. Hannover Medical School, Carl-Neuberg Strasse 1, Hannover, 30625, Germany

    Ewgeni Jakubovski

Authors
  1. Ewgeni Jakubovski
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  2. Michael H. Bloch
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Correspondence to Ewgeni Jakubovski.

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Conflict of interests

Ewgeni Jakubovski declares that he has no conflict of interest. Michael Bloch declares that he has no conflict of interest.

Ethical approval

This article does not contain any studies with human participants performed by any of the authors. All procedures performed during the initial data collection by the original CALM investigators were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Additional information

ClinicalTrials.gov Identifier: NCT00347269, http://clinicaltrials.gov/ct2/show/NCT00347269/.

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Jakubovski, E., Bloch, M.H. Anxiety Disorder-Specific Predictors of Treatment Outcome in the Coordinated Anxiety Learning and Management (CALM) Trial. Psychiatr Q 87, 445–464 (2016). https://doi.org/10.1007/s11126-015-9399-6

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  • DOI: https://doi.org/10.1007/s11126-015-9399-6

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