The Ohio State University College of Medicine, Comprehensive Cancer Center & Institute for Behavioral Medicine Research, Columbus, OH, USA.
Aarhus University, Department of Psychology and Behavioral Sciences, Aarhus, Denmark.
J Anxiety Disord. 2021 May;80:102403. doi: 10.1016/j.janxdis.2021.102403. Epub 2021 Apr 15.
Generalized anxiety disorder (GAD) is characterized, in part, by physical symptoms such as muscle tension and gastrointestinal (GI) distress. To date, little research has examined how changes in psychological symptoms associated with GAD may impact physical symptoms. This study investigated if reductions in worry, anxiety, and depression precede changes in muscle tension and GI distress throughout psychotherapy.
Participants with GAD (N = 85) completed 20 weeks of emotion regulation therapy (ERT) in addition to assessments pre, mid, and post treatment. They completed a physical symptom questionnaire, evaluating muscle tension and GI distress. Participants also completed psychological symptoms questionnaires, including the State Trait Anxiety Inventory (STAI-7), Penn State Worry Questionnaire (PSWQ), and Beck Depression Inventory (BDI-II). Control participants (N = 44) completed these measures at baseline.
Participants with GAD had significantly greater muscle tension (p < .001) and GI distress (p < .001) compared to control participants without GAD. Reductions in worry, depression, and trait anxiety did not precede changes in muscle tension (range of effect size (r): .05-.12). Reductions in both depression (p = 0.04) and trait anxiety (p < 0.01) preceded reductions in GI distress. Reductions in worry did not precede reductions in GI distress (p = 0.25).
These data provide preliminary evidence for the temporal effect of reductions in psychological symptoms on reductions in GI distress in GAD, highlighting the potential of psychotherapy to improve physical outcomes.
广泛性焦虑障碍（GAD）的特征部分包括肌肉紧张和胃肠道（GI）不适等身体症状。迄今为止，很少有研究探讨与 GAD 相关的心理症状变化如何影响身体症状。本研究调查了在心理治疗过程中，担忧、焦虑和抑郁的减少是否先于肌肉紧张和 GI 不适的变化。
85 名患有 GAD 的参与者完成了 20 周的情绪调节治疗（ERT），此外还在治疗前、治疗中和治疗后进行了评估。他们完成了一份身体症状问卷，评估肌肉紧张和 GI 不适。参与者还完成了心理症状问卷，包括状态特质焦虑量表（STAI-7）、宾夕法尼亚州担忧问卷（PSWQ）和贝克抑郁量表（BDI-II）。对照组（N=44）在基线时完成了这些测量。
与没有 GAD 的对照组参与者相比，患有 GAD 的参与者的肌肉紧张（p<0.001）和 GI 不适（p<0.001）明显更大。担忧、抑郁和特质焦虑的减少并没有先于肌肉紧张的变化（效应大小范围（r）：0.05-0.12）。抑郁（p=0.04）和特质焦虑（p<0.01）的减少先于 GI 不适的减少。担忧的减少并没有先于 GI 不适的减少（p=0.25）。
这些数据初步提供了证据表明，在 GAD 中，心理症状减少对 GI 不适减少的时间效应，突出了心理治疗改善身体结果的潜力。
