Efficacy of Group Transdiagnostic Cognitive Behavior Therapy in Adolescents with Comorbid Headache and Anxiety Disorder

Abstract

Introduction Headache is a common complaint among adolescents and is associated with several comorbid conditions particularly anxiety and depression. Transdiagnostic cognitive behavior therapy (TCBT) is an alternative approach to third wave CBT. It attempts to address multiple diagnoses at the same time while focusing on shared pathology and common processes (McEvoy et al., 2009). Aim To develop a group transdiagnostic cognitive behavior therapy intervention module for adolescents with comorbid headache and anxiety disorder and to evaluate the module in terms of feasibility, acceptance and efficacy. Method A TCBT intervention module for headache and anxiety disorder for use with adolescents was developed. Fifteen adolescents diagnosed with comorbid headache and anxiety disorder were recruited from the outpatient psychiatric clinic at AIIMS, New Delhi. Baseline, mid-and post- intervention assessments was done on Youth Self Report, M.I.N.I KID, Anxiety Disorders Interview Schedule, STAI – Y, CDI – 2, Headache Diary, Headache Impact Test (HIT) and Global Assessment Scale for Children (CGAS). TCBT was carried out over a period of 12 weeks with one group session per week for each of the three groups. Results 85% participants showed clinically significant improvement as rated on scores on STAI-Y, HIT and CGAS. Qualitative interpretation of headache diary showed significant decrease in the frequency, intensity and duration of headache for all participants. Conclusion TCBT module was found to be feasible, acceptable and efficacious leading to significant symptom reduction. Discussion Possible benefits of TCBT as pertaining to the Indian context along with barriers are further discussed.