Hostname: page-component-78c5997874-8bhkd Total loading time: 0 Render date: 2024-11-03T08:49:06.377Z Has data issue: false hasContentIssue false

A Controlled Comparison of Cognitive—Behaviour Therapy, Diazepam and Placebo in the Management of Generalized Anxiety

Published online by Cambridge University Press:  16 June 2009

K. G. Power
Affiliation:
Department of Psychology, University of Stirling
D. W. A. Jerrom
Affiliation:
Department of Clinical Psychology, Southmead General Hospital
R. J. Simpson
Affiliation:
Department of Psychology, University of Stirling
M. J. Mitchell
Affiliation:
Astra Clinical Research Unit, Edinburgh
V. Swanson
Affiliation:
Department of Psychology,University of Stirling

Abstract

Generalized anxiety patients were randomly allocated to Cognitive-Behaviour Therapy, Diazepam or Placebo and managed in a primary care setting. Treatments were balanced for degree of psychologist/patient contact. A range of outcome measures, including patient self report, psychologist assessor and general practitioner ratings were used. Large variations within group response to treatment emerged. At the end of active treatment the superiority of Cognitive-Behaviour Therapy was suggested. Post-study psychotropic prescription and psychological treatment was assessed at a 12-month follow-up. The Cognitive-Behaviour group revealed the lowest incidence of subsequent treatment interventions.

Type
Research Article
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 1989

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Ashton, H. (1984). Benzodiazepine withdrawal: and unfinished story. British Medical Journal 288, 11351140.CrossRefGoogle ScholarPubMed
Barlow, D. H., Cohen, A. S., Waddell, M. T., Vermilyea, B. B., Klosko, J. S., Blanchard, E. B. and Di Nardo, P. A. (1984). Panic and generalised anxiety disorders: nature and treatment. Behaviour Therapy 15, 431449.CrossRefGoogle Scholar
Beck, A. T. and Emery, G. (1979). Cognitive therapy of anxiety and phobic disorders. Unpublished treatment manual of the Center for Cognitive Therapy, Philadelphia.Google Scholar
Bellak, A. S. and Hersen, M. (1984). Research Methods in Clinical Psychology. Pergamon Press Inc.Google Scholar
Benson, H., Frankel, F. H., Apfel, R., Daniels, M. D., Schniewind, H. E., Nemiah, J. C., Sifrees, P. E., Crassweller, K. D., Greenwood, M. M., Kotch, J. B., Arns, P. A. and Rosner, B. (1978). Treatment of anxiety: a comparison of the usefulness of self-hypnosis and a meditational relaxation technique. Psychotherapy and Psychosomatics 30, 229242.CrossRefGoogle Scholar
Blowers, C., Cobb, J. and Mathews, A. (1987). Generalised anxiety; a controlled treatment study. Behaviour Research and Therapy 25, 493502.CrossRefGoogle ScholarPubMed
Butler, G., Cullington, A., Hibbert, G., Klimes, I. and Gelder, M. (1987). Anxiety management for persistent generalised anxiety. British Journal of Psychiatry 151, 535542.CrossRefGoogle ScholarPubMed
Canter, A., Kondo, C. Y. and Knott, J. R. (1975). A comparison of EMG feedback and progressive muscle relaxation training in anxiety neurosis. British Journal of Psychiatry 127, 470477.CrossRefGoogle ScholarPubMed
Committee on the Review of Medicines (1980). Systematic review of benzodiazepines. British Medical Journal 280, 910912.Google Scholar
Durham, R. C. and Turvey, A. A. (1987). Cognitive therapy versus behaviour therapy in the treatment of chronic general anxiety. Behaviour Research and Therapy 25, 229234.CrossRefGoogle Scholar
Enna, S. J. (1982). The role of neurotransmitters in the pharmacologic actions of benzodiazepines. In The Biology of Anxiety Mathew, R. J. and Feldman, L. (Eds), Bruner Mazel.Google Scholar
Hamilton, M. (1959). The assessment of anxiety states by rating. British Journal of Medical Psychology 32, 5055.CrossRefGoogle ScholarPubMed
Hamilton, M. (1960). A rating scale for depression. Journal of Neurology, Neurosurgery, and Psychiatry 23, 5662.CrossRefGoogle ScholarPubMed
Jacobson, E. (1938). Progressive Relaxation. Chicago: University of Chicago Press.Google Scholar
Kellner, R. and Sheffield, B. F. (1973). A self-rating scale of distress. Psychological Medicine 3, 88100.CrossRefGoogle ScholarPubMed
Kleinknecht, R. A. and Donaldson, D. (1979). A review of the effects of diazepam on cognitive and psychomotor performance. Journal of Nervous and Mental Disease 161, 399411.Google Scholar
Lader, M. H., Bond, A. J. and James, D. C. (1974). Clinical comparison of anxiolytic drug therapy. Psychological Medicine 4, 381387.CrossRefGoogle ScholarPubMed
Lader, M. (1978). Benzodiazepines — the opium of the masses? Neuroscience 3, 159165.CrossRefGoogle ScholarPubMed
Leboeuf, A. and Lodge, J. (1980). A comparison of frontalis EMG feedback training and progressive relaxation in the treatment of chronic anxiety. British Journal of Psychiatry 137, 279284.CrossRefGoogle ScholarPubMed
Lehrer, P. M. (1978). Psychophysiological effects of progressive relaxation in anxiety neurotic patients and of progressive relaxation and alpha feedback in non patients. Journal of Consulting and Clinical Psychology 36, 389404.CrossRefGoogle Scholar
Lindsay, W. R., Gamscu, C. V., McLaughlin, E., Hood, E. M. and Espie, C. A. (1987). A controlled trial of treatments for generalised anxiety. British Journal of Clinical Psychology 26, 315.CrossRefGoogle Scholar
Martin, L. L. (1983). The benzodiazepines and their receptors. In Cell Surface Receptors. Strange, P. G. (ed), Ellis Harwood.Google Scholar
Mathews, A. (1985). Anxiety states: a cognitive-behavioural approach. In Psychological Application in Psychiatry. Bradley, B. P. and Thomson, C. (Eds), John Wiley and Sons Ltd.Google Scholar
Mathews, A. and Shaw, P. (1977). Cognitions related to anxiety: a pilot study of treatment. Behaviour Research and Therapy 15, 503505.CrossRefGoogle ScholarPubMed
McCormick, J. (1983). A double-blind randomised control trial of diazepam. Journal of the Royal College of General Practitioners 33, 635636.Google Scholar
Meichenbaum, D. (1974). Therapist manual for cognitive behaviour modification. Unpublished manuscript. University of Waterloo.Google Scholar
Ost, L. G. (1982). Beteendeterapi vid angestneuros, en evlauerande oversikt. Scandinavian Journal of Behaviour Therapy 11, 113134.CrossRefGoogle Scholar
Petursson, H., Gudjonsson, G. H. and Lader, M. H. (1983). Psychometric performance during withdrawal from long-term benzodiazepine treatment. Psychopharmacology 81, 345349.CrossRefGoogle ScholarPubMed
Petursson, H. and Lader, M. H. (1981). Benzodiazepine dependence. British Journal of Addiction 76, 133145.CrossRefGoogle ScholarPubMed
Power, K. G., Jerrom, D. W. A., Simpson, R. J. and Mitchell, M. (1985). Controlled study of withdrawal symptoms and rebound anxiety after six week course of diazepam for generalised anxiety. British Medical Journal 290, 12461248.CrossRefGoogle ScholarPubMed
Raskin, M., Bali, L. R. and Peeke, H. V. (1980). Muscle biofeedback and transcendental meditation. Archives of General Psychiatry 37, 8397.CrossRefGoogle ScholarPubMed
Sakol, M. S. and Power, K. G. (1988). The effects of long-term benzodiazepine treatment and gradual withdrawal on psychometric performance. Psychopharmacology 95, 135138.CrossRefGoogle Scholar
Shapiro, A. K., Struering, E. L., Shapiro, E. and Milcarek, B. I. (1983). Diazepam: How much better than placebo? Journal of Psychiatric Research 17, 5173.CrossRefGoogle Scholar
Shepherd, M., Cooper, B., Brown, A. C. and Kalton, G. (1966). Psychiatric illness in General Practice. Oxford University Press.Google Scholar
Silverstone, T. and Turner, P. (1978). Drug Treatment in Psychiatry. Routledge and Kegan Paul.Google Scholar
Singh, A. N. and Saxena, B. (1974). A comparison of lorazepam, diazepam and placebo in the treatment of anxiety states. Current Therapeutic Research 16, 149.Google ScholarPubMed
Snedecor, G. W. and Cochran, W. G. (1967). Statistical Methods (6th ed) Ames, Iowa: Iowa State University Press.Google Scholar
Spitzer, R. L., Endicott, J. and Robins, E. (1978). Research Diagnostic Criteria. New York State Psychiatric Institute.CrossRefGoogle ScholarPubMed
Tarrier, N. and Main, C. J. (1986). Applied relaxation training for generalised anxiety and panic attacks. British Journal of Psychiatry 149, 330336.CrossRefGoogle ScholarPubMed
Townsend, R. E., House, J. F. and Addario, D. (1975). A comparison of biofeedback — mediated relaxation and group therapy in the treatment of chronic anxiety. American Journal of Psychiatry 132, 598601.Google ScholarPubMed
Tryer, P. (1980). Dependence on benzodiazepines. British Journal of Psychiatry 137, 576577.CrossRefGoogle Scholar
Tryer, P., Rutherford, D. and Huggett, T. (1981). Benzodiazepine withdrawal symptoms and propranolol. Lancet i, 520522.CrossRefGoogle Scholar
Williams, J. M. G. (1984). The Psychological Treatment of Depression: A Guide to the Theory and Practice of Cognitive—Behaviour Therapy: Croom-Helm: London and Canberra.Google Scholar
Wing, J. K., Cooper, J. E. and Sartorius, N. (1973). Present State Examination. Cambridge University Press.Google Scholar
Woodward, R. and Jones, R. B. (1980). Cognitive restructuring treatment: a controlled trial with anxious patients. Behaviour Research and Therapy 18, 401407.CrossRefGoogle ScholarPubMed
Submit a response

Comments

No Comments have been published for this article.