UCLA

Treatments for GAD are less efficacious than those for other anxiety disorders, and individuals in relationships characterized by distress are less likely to respond to standard GAD treatments, which suggest dyadic treatment of GAD may be beneficial to individuals in distressed relationships. This dissertation presents and conducts preliminary tests of an acceptance- and mindfulness-based dyadic treatment for GAD based on the principles of Integrative Behavioral Couple Therapy (IBCT). This dissertation first examined to what extent in-person and online IBCT reduced GAD symptoms; moderate effect sizes as compared to waitlist control were found for the online version of IBCT (the OurRelationship program). Because this program targeted relationship satisfaction in general, it would be useful for the GAD-focused modifications to specifically aim at altering aspects of couples' relationships that are associated with GAD. The next study examined associations between specific interpersonal behaviors in the dyadic context and GAD symptoms. Negative communication behaviors were found to be associated with GAD symptoms across four diverse samples, and in one sample, communication mediated the association between relationship satisfaction and GAD symptoms. Therefore, the third paper described an initial attempt at modifying the online OurRelationship program for couples to specifically address the needs of individuals with GAD and their partners. Two detailed case studies of couples who completed this IBCT-GAD intervention suggested that it was a credible treatment; both couples increased in relationship satisfaction, and one partner with GAD experienced clinically significant improvements in her symptoms. Quantitative and qualitative analysis suggested that improved GAD symptoms were associated with reductions in the partner's tendency to facilitate GAD-related behavior. Future data collection will provide additional information about the efficacy of the IBCT-GAD intervention and the mechanisms by which it operates.