Positive and negative affect change following psychotherapeutic treatment for anxiety-related disorders: A systematic review and meta-analysis.

Anxiety-related disorders feature elevated negative affect (NA), and in some cases, diminished positive affect (PA). It remains unclear how well extant psychotherapies for anxiety-related disorders improve PA versus NA. We systematically searched the Cochrane Central Register of Controlled Trials, PubMed, PsychInfo, and Web of Science databases. Records included studies involving (1) patients with a principal or co-principal diagnosis of at least one anxiety-related disorder (i.e., generalized anxiety, social anxiety, panic, agoraphobia, health anxiety, specific phobia, obsessive-compulsive disorder, or posttraumatic stress disorder), and (2) pre- and post-treatment PA and NA scores or a change index between pre- and post-treatment PA and NA scores. Effect sizes were calculated for meta-analyses. Fourteen studies with 1001 adults with an anxiety-related disorder were included. Psychotherapeutic interventions included cognitive behavioral, present-centered, and imagery-based approaches. Treatments reduced NA (g = −0.90; 95%CI [−1.19, −0.61]) to a greater extent than they improved PA (g = 0.27; 95%CI [0.05, 0.59]), Z = −5.26, p <.001. The limited number of studies available precluded analyses of the relationship between changes in affect and symptoms. Results should be considered with caution given the small number and heterogeneity of included studies. Current psychotherapeutic interventions for anxiety-related disorders may not improve PA and NA to comparable levels. • Systematic review and meta-analysis of the effect of psychotherapies on affective change for anxiety-related disorders. • There is a large effect of improvement in negative affect (g = −0.90). • There is a small effect of improvement in positive affect (g = 0.27). • Extant psychotherapies for anxiety-related disorders repair negative affect to a greater extent than positive affect. [ABSTRACT FROM AUTHOR]