Grant: Doctoral Award - Frederick Banting and Charles Best Canada Graduate Scholarships

Generalized anxiety disorder (GAD) is a common mental disorder characterized by chronic, excessive worry that causes marked distress and impairment in everyday life, but current psychological treatments for GAD demonstrate limited effectiveness. Therefore, it is vitally important to refine treatment methods in order to improve outcomes for Canadians with GAD and reduce related healthcare costs. Anxiety disorders are often treated with exposure therapy, in which the patient is exposed to feared objects or situations for prolonged periods. This is thought to produce gradual desensitization to feared objects or situations and therefore reduce anxiety. However, because worry concerns situations that have not yet occurred, exposure therapy must be adapted for GAD treatment. Imaginal exposure is a common exposure therapy adaptation that requires the patient to vividly imagine his/her most distressing worry coming true in real life. Patients are asked to create a script describing the feared scenario as if it were occurring presently, record the script read aloud, and then listen to the recording repeatedly while imagining the scenario until anxiety abates An alternate procedure, written exposure, also requires a written worry script. However, instead of creating an audio recording, patients are asked to write a new script daily and to delve deeper into the scenario each time. Written exposure is a newer procedure and has demonstrated promise in early research, but it has not been compared with imaginal exposure to determine whether one method is more effective. While many therapists are familiar with imaginal exposure, written exposure is a recent development with which few therapists are familiar. However, written exposure is a simple procedural adaptation that can easily be implemented, if proven superior. Ultimately, application of the findings of this research may improve mental health services for Canadians with GAD and reduce related healthcare costs.