Andrea N Niles1, Kate B Wolitzky-Taylor2, Joanna J Arch3, Michelle G Craske4. 1. University of California, Los Angeles, Department of Psychology, 1285 Franz Hall, Box 951563, Los Angeles, CA 90095-1563, USA. Electronic address: aniles@ucla.edu. 2. University of California, Los Angeles, Department of Psychiatry and Biobehavioral Science, 760 Westwood Plaza, Los Angeles, CA 90095, USA. 3. University of Colorado Boulder, Department of Psychology, Muenzinger D244, 345 UCB, Boulder, CO 80309-0345, USA. 4. University of California, Los Angeles, Department of Psychology, 1285 Franz Hall, Box 951563, Los Angeles, CA 90095-1563, USA; University of California, Los Angeles, Department of Psychiatry and Biobehavioral Science, 760 Westwood Plaza, Los Angeles, CA 90095, USA.
Abstract
BACKGROUND: No prior studies have examined moderators of dropout between distinct treatments for anxiety disorders. This study applied a novel statistical approach for examining moderators of dropout from traditional cognitive behavioral therapy (CBT) and acceptance and commitment therapy (ACT). METHOD: We combined data from two randomized controlled trials (N = 208) comparing CBT and ACT for patients with DSM-IV anxiety disorders. Adapting Kraemer's method for constructing and evaluating composite moderators (2013), 26 variables were examined for individual effect sizes. Forward-stepwise regression combined with k-fold cross validation was used to identify a model to predict treatment dropout. RESULTS: Four baseline variables comprised the final composite moderator: self-reported degree of control over internal anxiety, current psychiatric medication use, religiosity, and endurance in a voluntary hyperventilation stressor. This composite moderator predicted differential dropout from ACT vs. CBT with a medium effect size (r = 0.28), and had a significantly larger effect size than any individual moderator. CONCLUSIONS: Findings reveal that specific patient profiles predict differential dropout from ACT vs. CBT for anxiety disorders. In the first investigation of a composite moderator with a dichotomous outcome, findings also support the superiority of composite over individual moderators.
RCT Entities:
BACKGROUND: No prior studies have examined moderators of dropout between distinct treatments for anxiety disorders. This study applied a novel statistical approach for examining moderators of dropout from traditional cognitive behavioral therapy (CBT) and acceptance and commitment therapy (ACT). METHOD: We combined data from two randomized controlled trials (N = 208) comparing CBT and ACT for patients with DSM-IV anxiety disorders. Adapting Kraemer's method for constructing and evaluating composite moderators (2013), 26 variables were examined for individual effect sizes. Forward-stepwise regression combined with k-fold cross validation was used to identify a model to predict treatment dropout. RESULTS: Four baseline variables comprised the final composite moderator: self-reported degree of control over internal anxiety, current psychiatric medication use, religiosity, and endurance in a voluntary hyperventilation stressor. This composite moderator predicted differential dropout from ACT vs. CBT with a medium effect size (r = 0.28), and had a significantly larger effect size than any individual moderator. CONCLUSIONS: Findings reveal that specific patient profiles predict differential dropout from ACT vs. CBT for anxiety disorders. In the first investigation of a composite moderator with a dichotomous outcome, findings also support the superiority of composite over individual moderators.
Authors: H Oughli; E J Lenze; A E Locke; M D Yingling; Y Zhong; J P Miller; C F Reynolds; B H Mulsant; J W Newcomer; T R Peterson; D J Müller; G E Nicol Journal: J Psychiatr Res Date: 2019-04-23 Impact factor: 4.791
Authors: Andrea N Niles; Amanda G Loerinc; Jennifer L Krull; Peter Roy-Byrne; Greer Sullivan; Cathy D Sherbourne; Alexander Bystritsky; Michelle G Craske Journal: Behav Ther Date: 2017-02-23
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