The proposed study is a revised version of application #RO1-MH53932-01 that will examine the relative effects of cognitive behavior therapy (CBT) and a minimal contact control condition (MCC) for the treatment of generalized anxiety disorder (GAD) in older adults. The relative effects of CBT and MCC at posttreatment will be examined with regard to both primary outcome measures (global severity of GAD, worry, general anxiety) and the transfer of treatment effects to coexistent pathology (associated fears, depression) and social functioning (quality of life, social support). In addition, the impact of CBT over a long-term follow-up interval (one year) will be examined. The proposed study also will allow for exploratory examination of nonspecific predictor variables, in particular, measures of pretreatment psychopathology (anxiety, depression) and therapy process (credibility of treatment, expectancy for improvement,group cohesion, and alliance). Ninety-eight adults, 60 years or older, who meet DSM-IV criteria for GAD will be assigned randomly to CBT or MCC. Treatment will be conducted in a small group format, with 15 weekly sessions. After posttreatment evaluations at 15 weeks, patients assigned to CBT will be assessed at 3-, 6-, and 12-month follow-ups. After posttreatment assessments, MCC subjects will receive treatment with CBT and subsequent follow-up evaluations, also over a 12-month period. As such, this group will allow for indirect replication of primary study results.
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