The proposed study is a randomized clinical trial of group-administered cognitive behavioral therapy (CBT) for generalized anxiety disorder (GAD) in older adults. The design compares CBT to an attention placebo (discussion group) and a wait list control group at pre-, post-, and six- month follow-up assessment periods. Both treatment conditions will take place 90 minutes weekly for 12 weeks. The CBT condition will include relaxation training, cognitive restructuring, and worry exposure. Outcome measures will include subjective and interviewer-rated symptoms of anxiety and worry, depression, health-related quality of life and health service use, and physiological correlates of anxiety (frontailis electromyogram and salivary cortisol under baseline and stress conditions). CBT participants are expected to show greater reductions in anxiety and depression at post-treatment assessment; they are expected to show improvements in health outcomes and greater maintenance of treatment gains at the six-month follow-up period.
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