Efficacy of Cognitive Behavioral Therapy for Anxiety-Related Disorders: A Meta-Analysis of Recent Literature

Summary & key facts

Researchers combined results from about 10 recent trials with roughly 1,250 adults to see how well cognitive behavioral therapy, or CBT, works for anxiety-related disorders. They found that CBT produced a small benefit over placebo-style control treatments for the main anxiety symptoms overall, but the effect was smaller in studies that only looked at PTSD. Most of the recent trials were about PTSD, so we still have little recent evidence from placebo-controlled trials for other anxiety disorders.

Key facts:

• The review looked at about 10 randomized placebo-controlled trials published since 2017, including roughly 1,250 adults.
• About 7 of the 10 studies focused on post-traumatic stress disorder, or PTSD.
• Across all studies, CBT showed a small improvement in the main disorder symptoms compared with placebo-like controls, with an effect size of about 0.24.
• When the researchers looked only at the PTSD studies, the benefit was smaller, about 0.14, but still statistically detectable.
• CBT’s effect on depressive symptoms in these trials was smaller, around 0.15, and was not statistically significant in this analysis.
• The analyses had very low variability between studies and the authors did not find signs that unpublished negative studies were missing (no publication bias).
• The authors note that effect sizes in these recent placebo-controlled trials are smaller than what older reviews have reported.
• A key limitation is that most recent placebo-controlled research was on PTSD, so these results may not tell us much about CBT for other anxiety disorders.

Abstract

PURPOSE OF REVIEW: Effective treatment of anxiety-related disorders is crucial, considering the prevalence of such disorders and their association with poor psychosocial functioning. To evaluate the most recent evidence on the efficacy of cognitive behavioral therapy (CBT) for anxiety-related disorders in adults, we conducted a meta-analysis of randomized placebo-controlled trials published since 2017. RECENT FINDINGS: Ten studies with a total of 1250 participants met the inclusion criteria. Seven of these studies examined PTSD. The findings demonstrated small placebo-controlled effects of CBT on target disorder symptoms (Hedges' g = 0.24, p < 0.05) and depression (Hedges' g = 0.15, p = n.s). When examining only PTSD studies, effects were reduced (Hedges' g = 0.14, p < 0.05). Heterogeneity in most analyses was very low, and no publication bias was found. Effect sizes from placebo-controlled trials from the past 5 years appear to be smaller than those in prior meta-analyses. The findings are largely driven by research on PTSD, with few placebo-controlled trials of other anxiety-related disorders published since 2017.

Topics

Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes Child and Adolescent Psychosocial and Emotional Development Mental Health Treatment and Access

Categories

Experimental and Cognitive Psychology Psychology Social Sciences

Tags

Anxiety Clinical psychology Cognition Cognitive behavioral therapy Cognitive therapy Internal medicine Medicine Meta-analysis Psychiatry Psychology Psychotherapist

Conditions & symptoms

Anxiety PTSD Anxiety or worry Panic Sadness or low mood