Physical exercise augmented cognitive behaviour therapy for older adults with generalised anxiety disorder (PEXACOG): study protocol for a randomized controlled trial
Abstract Background Generalised anxiety disorder (GAD) is a frequent and severe anxiety disorder among older adults. GAD increases the risk of developing other disorders such as depression and coronary heart disease. Older adults with GAD exhibit a poorer response to cognitive behaviour therapy (CBT...
| Main Authors: | , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2019-03-01
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| Series: | Trials |
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| Online Access: | http://link.springer.com/article/10.1186/s13063-019-3268-9 |
| _version_ | 1828482815739559936 |
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| author | Silje Haukenes Stavestrand Kristine Sirevåg Inger Hilde Nordhus Trond Sjøbø Trygve Bruun Endal Hans M. Nordahl Karsten Specht Åsa Hammar Anne Halmøy Egil W. Martinsen Eva Andersson Helene Hjelmervik Jan Mohlman Julian F. Thayer Anders Hovland |
| author_facet | Silje Haukenes Stavestrand Kristine Sirevåg Inger Hilde Nordhus Trond Sjøbø Trygve Bruun Endal Hans M. Nordahl Karsten Specht Åsa Hammar Anne Halmøy Egil W. Martinsen Eva Andersson Helene Hjelmervik Jan Mohlman Julian F. Thayer Anders Hovland |
| author_sort | Silje Haukenes Stavestrand |
| collection | DOAJ |
| description | Abstract Background Generalised anxiety disorder (GAD) is a frequent and severe anxiety disorder among older adults. GAD increases the risk of developing other disorders such as depression and coronary heart disease. Older adults with GAD exhibit a poorer response to cognitive behaviour therapy (CBT) compared to younger patients with GAD. The normal age-related cognitive decline can be a contributor to reduced treatment efficacy. One strategy for improving treatment efficacy is to combine CBT with adjunctive interventions targeted at improving cognitive functions. Physical exercise is a viable intervention in this regard. Increased levels of brain-derived neurotrophic factor may mediate improvement in cognitive function. The present study aims to investigate the proposed effects and mechanisms related to concomitant physical exercise. Methods The sample comprises 70 participants aged 60–75 years, who have GAD. Exclusion criteria comprise substance abuse and unstable medication; inability to participate in physical exercise; and conditions which precludes GAD as primary diagnosis. The interventions are individual treatment in the outpatient clinic at the local psychiatric hospital, with two experimental arms: (1) CBT + physical exercise and (2) CBT + telephone calls. The primary outcome measure is symptom reduction on the Penn State Worry Questionnaire. Other measures include questionnaires, clinical interviews, physiological, biological and neuropsychological tests. A subset of 40 participants will undergo magnetic resonance imaging (MRI). After inclusion, participants undergo baseline testing, and are subsequently randomized to a treatment condition. Participants attend five sessions of the add-on treatment in the pre-treatment phase, and move on to interim testing. After interim testing, participants attend 10 sessions of CBT in parallel with continued add-on treatment. Participants are tested post-intervention within 2 weeks of completing treatment, with follow-up testing 6 and 12 months later. Discussion This study aims to develop better treatment for GAD in older adults. Enhancing treatment response will be valuable from both individual and societal perspectives, especially taking the aging of the general population into account. Trial registration ClinicalTrials.gov, NCT02690441. Registered on 24 February 2016. |
| first_indexed | 2024-12-11T08:22:41Z |
| format | Article |
| id | doaj.art-0d43fe2705a344c7844bb05bab506e7d |
| institution | Directory Open Access Journal |
| issn | 1745-6215 |
| language | English |
| last_indexed | 2024-12-11T08:22:41Z |
| publishDate | 2019-03-01 |
| publisher | BMC |
| record_format | Article |
| series | Trials |
| spelling | doaj.art-0d43fe2705a344c7844bb05bab506e7d2022-12-22T01:14:37ZengBMCTrials1745-62152019-03-0120111410.1186/s13063-019-3268-9Physical exercise augmented cognitive behaviour therapy for older adults with generalised anxiety disorder (PEXACOG): study protocol for a randomized controlled trialSilje Haukenes Stavestrand0Kristine Sirevåg1Inger Hilde Nordhus2Trond Sjøbø3Trygve Bruun Endal4Hans M. Nordahl5Karsten Specht6Åsa Hammar7Anne Halmøy8Egil W. Martinsen9Eva Andersson10Helene Hjelmervik11Jan Mohlman12Julian F. Thayer13Anders Hovland14Faculty of Psychology, University of BergenFaculty of Psychology, University of BergenFaculty of Psychology, University of BergenSolli DPSSolli DPSDepartment of Mental Health, Norwegian University of Science and TechnologyFaculty of Psychology, University of BergenFaculty of Psychology, University of BergenFaculty of Medicine, K.G. Jebsen Centre for Neuropsychiatric Disorders, University of BergenFaculty of Medicine, University of OsloThe Swedish School of Sport and Health Sciences, GIHFaculty of Psychology, University of BergenDepartment of Psychology, William Paterson UniversityDepartment of Psychology, Ohio State UniversityFaculty of Psychology, University of BergenAbstract Background Generalised anxiety disorder (GAD) is a frequent and severe anxiety disorder among older adults. GAD increases the risk of developing other disorders such as depression and coronary heart disease. Older adults with GAD exhibit a poorer response to cognitive behaviour therapy (CBT) compared to younger patients with GAD. The normal age-related cognitive decline can be a contributor to reduced treatment efficacy. One strategy for improving treatment efficacy is to combine CBT with adjunctive interventions targeted at improving cognitive functions. Physical exercise is a viable intervention in this regard. Increased levels of brain-derived neurotrophic factor may mediate improvement in cognitive function. The present study aims to investigate the proposed effects and mechanisms related to concomitant physical exercise. Methods The sample comprises 70 participants aged 60–75 years, who have GAD. Exclusion criteria comprise substance abuse and unstable medication; inability to participate in physical exercise; and conditions which precludes GAD as primary diagnosis. The interventions are individual treatment in the outpatient clinic at the local psychiatric hospital, with two experimental arms: (1) CBT + physical exercise and (2) CBT + telephone calls. The primary outcome measure is symptom reduction on the Penn State Worry Questionnaire. Other measures include questionnaires, clinical interviews, physiological, biological and neuropsychological tests. A subset of 40 participants will undergo magnetic resonance imaging (MRI). After inclusion, participants undergo baseline testing, and are subsequently randomized to a treatment condition. Participants attend five sessions of the add-on treatment in the pre-treatment phase, and move on to interim testing. After interim testing, participants attend 10 sessions of CBT in parallel with continued add-on treatment. Participants are tested post-intervention within 2 weeks of completing treatment, with follow-up testing 6 and 12 months later. Discussion This study aims to develop better treatment for GAD in older adults. Enhancing treatment response will be valuable from both individual and societal perspectives, especially taking the aging of the general population into account. Trial registration ClinicalTrials.gov, NCT02690441. Registered on 24 February 2016.http://link.springer.com/article/10.1186/s13063-019-3268-9Generalised anxiety disorderGADOlder adultsPhysical exerciseCognitive behavioural therapyCBT |
| spellingShingle | Silje Haukenes Stavestrand Kristine Sirevåg Inger Hilde Nordhus Trond Sjøbø Trygve Bruun Endal Hans M. Nordahl Karsten Specht Åsa Hammar Anne Halmøy Egil W. Martinsen Eva Andersson Helene Hjelmervik Jan Mohlman Julian F. Thayer Anders Hovland Physical exercise augmented cognitive behaviour therapy for older adults with generalised anxiety disorder (PEXACOG): study protocol for a randomized controlled trial Trials Generalised anxiety disorder GAD Older adults Physical exercise Cognitive behavioural therapy CBT |
| title | Physical exercise augmented cognitive behaviour therapy for older adults with generalised anxiety disorder (PEXACOG): study protocol for a randomized controlled trial |
| title_full | Physical exercise augmented cognitive behaviour therapy for older adults with generalised anxiety disorder (PEXACOG): study protocol for a randomized controlled trial |
| title_fullStr | Physical exercise augmented cognitive behaviour therapy for older adults with generalised anxiety disorder (PEXACOG): study protocol for a randomized controlled trial |
| title_full_unstemmed | Physical exercise augmented cognitive behaviour therapy for older adults with generalised anxiety disorder (PEXACOG): study protocol for a randomized controlled trial |
| title_short | Physical exercise augmented cognitive behaviour therapy for older adults with generalised anxiety disorder (PEXACOG): study protocol for a randomized controlled trial |
| title_sort | physical exercise augmented cognitive behaviour therapy for older adults with generalised anxiety disorder pexacog study protocol for a randomized controlled trial |
| topic | Generalised anxiety disorder GAD Older adults Physical exercise Cognitive behavioural therapy CBT |
| url | http://link.springer.com/article/10.1186/s13063-019-3268-9 |
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