Social well-being moderates behavioral therapy response for generalized anxiety disorder

Area of Science:

• Psychiatry and Behavioral Sciences
• Clinical Psychology
• Mental Health Research

Background:

• Identifying moderators of treatment outcomes is crucial for personalizing mental health interventions.
• Social well-being, encompassing social support, isolation, and loneliness, significantly impacts mental health and quality of life.
• Previous research suggests social well-being may influence treatment efficacy for anxiety and depression.

Purpose of the Study:

• To investigate whether social support, isolation, and loneliness moderate treatment outcomes for generalized anxiety disorder (GAD).
• To examine the differential effects of behavioral activation (BA) and exposure-based therapy (EXP) in relation to social well-being.
• To inform personalized treatment strategies for GAD based on individual social well-being profiles.

Main Methods:

• Secondary analysis of a randomized clinical trial involving 69 participants with GAD.
• Participants received either behavioral activation (BA) or exposure-based therapy (EXP).
• Measures included GAD-7, NIH PROMIS scales (Depression, Social Isolation, Support), and NIH Toolbox (Friendship, Loneliness); factor analysis identified social support and isolation/loneliness.

Main Results:

• Both social support and isolation/loneliness improved over time irrespective of treatment.
• Lower baseline social support was associated with greater improvement in GAD symptoms with BA compared to EXP.
• Higher baseline isolation/loneliness correlated with greater depression symptom improvement with BA and less improvement with EXP; individuals with high isolation/loneliness showed no significant improvement with EXP.

Conclusions:

• Social well-being measures significantly moderate treatment outcomes for GAD.
• Individuals with low social support and/or high isolation/loneliness may respond less favorably to exposure-based therapy.
• Adjunctive interventions targeting social well-being could enhance outcomes for these individuals, particularly with exposure-based treatments.