More Power to the Executive? A Preliminary Test of CBT Plus Executive Skills Training for Treatment of Late-Life GAD

One hypothesized reason for the lower rates of cognitive behavior therapy (CBT) response among older as compared to younger anxiety patients is that they are more likely to show age-related deficits in executive skills, which are complex cognitive skills involved in the regulation of negative affect. Following an 8-week baseline period, this pilot study tested CBT augmented with an executive skills training program, Attention Process Training II (Sohlberg et al., 2001 and Sohlberg and Mateer, 2001) against standard CBT in a small sample of 8 older adults with generalized anxiety disorder (comorbidity allowed) and low scores on executive skills tests. Those who received the augmented version (CBT/APT) evidenced more improvement on executive skills and a weekly process measure of worry than those who received CBT. All of the participants in CBT/APT, as compared to half the participants in CBT, met criteria for response, and more in CBT/APT met criteria for high endstate functioning at posttreatment and follow-up. It may be fruitful to test the intervention in a larger sample, and to continue to investigate the role of executive skills in CBT outcome and anxiety treatment.