Anxiety in Older Veterans

Therapuetic Areas:Psychiatry / Psychology
Age Range:60 - Any
Start Date:December 5, 2018
End Date:June 1, 2020
Contact:Christine E Gould, PhD
Phone:(650) 493-5000

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Reducing Anxiety and Improving Functioning in Older Veterans

Anxiety leads to poor quality of life, avoidance of activities, decreased social engagement,
functional decline, and disability in older patients. This study will compare two
self-directed treatments delivered via DVD videos that can be viewed in one's own home. The
two treatments being compared are: psychoeducation, which refers to information and education
about anxiety, and a behavioral treatment program, called BREATHE (Breathing, Relaxation and
Education for Anxiety Treatment in the Home Environment). BREATHE teaches diaphragmatic
breathing and progressive muscle relaxation. Participants will be randomly assigned to either
treatment. The study is 12 weeks long. There are 4 weeks of treatment via DVD and 8 weeks of
follow-up. Participants will be asked questions about anxiety symptoms, mood, health and

Anxiety is pervasive, costly, and leads to behavioral avoidance, disability, and poor quality
of life. The proposed CDA-2 study will examine the efficacy of a brief psychosocial
intervention for anxiety in older Veterans with anxiety disorders. The psychosocial
intervention is called BREATHE (Breathing, Relaxation and Education for Anxiety Treatment in
the Home Environment) and teaches diaphragmatic breathing and progressive muscle relaxation
via DVD videos that can be viewed in Veterans' own homes. The BREATHE treatment includes
age-appropriate vignettes of anxiety-evoking situations. This project is aligned with older
adults' preference of psychotherapy to pharmacotherapy for treating anxiety. BREATHE is
expected to benefit older Veterans ( 60 years) by reducing anxiety and avoidance and thereby
increasing their engagement in activities and improving overall functioning. This aim will be
tested in a randomized control trial of DVD-based BREATHE compared with DVD-based
psychoeducation in 60 older Veterans with anxiety disorders (Generalized Anxiety Disorder,
Panic Disorder, Agoraphobia, Social Anxiety Disorder, and unspecified/other specified anxiety
disorder). The study is 12 weeks long with both treatments lasting 4 weeks followed by an 8
week follow-up period. It is hypothesized that BREATHE will result in a statistically and
clinically significant reduction of anxiety symptoms as measured with the Geriatric Anxiety
Scale compared with psychoeducation. Improvements in functioning (Activity Card Sort) are
expected for participants randomized to the BREATHE condition compared with those randomized
to psychoeducation. Hypotheses in will be addressed with mixed effects models.

Inclusion Criteria:

- Veterans aged 60 years or older.

- Meets criteria for an anxiety disorder (Generalized Anxiety Disorder, Social Anxiety
Disorder, Panic Disorder, Agoraphobia, Anxiety Disorder Unspecified, Anxiety Disorder
Other Specified).

- English-speaking.

Exclusion Criteria:

- Diagnosis of dementia or significant cognitive impairment as determined by a brief
cognitive screen.

- Diagnosis of serious mental illness (bipolar disorder, psychosis, schizophrenia),

- taking benzodiazepines more than once a week per self report.
We found this trial at
Palo Alto, California 94304
Principal Investigator: Christine E Gould, PhD
Phone: 650-493-5000
Palo Alto, CA
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