<clinical_study>
  <!-- This xml conforms to an XML Schema at:
    https://clinicaltrials.gov/ct2/html/images/info/public.xsd -->
  <required_header>
    <download_date>ClinicalTrials.gov processed this data on September 20, 2023</download_date>
    <link_text>Link to the current ClinicalTrials.gov record.</link_text>
    <url>https://clinicaltrials.gov/ct2/show/NCT01681329</url>
  </required_header>
  <id_info>
    <org_study_id>MOP-82771-12-04</org_study_id>
    <nct_id>NCT01681329</nct_id>
  </id_info>
  <brief_title>Cognitive-Behavioral Treatment and Interpretation Modification Training for Adults With Generalized Anxiety Disorder</brief_title>
  <acronym>CBT+IMT-GAD</acronym>
  <official_title>Improving Outcomes for Adults With Generalized Anxiety Disorder: Combining Cognitive-Behavioral Treatment and Interpretation Modification Training</official_title>
  <sponsors>
    <lead_sponsor>
      <agency>Concordia University, Montreal</agency>
      <agency_class>Other</agency_class>
    </lead_sponsor>
    <collaborator>
      <agency>Hopital du Sacre-Coeur de Montreal</agency>
      <agency_class>Other</agency_class>
    </collaborator>
    <collaborator>
      <agency>Université du Québec à Trois-Rivières</agency>
      <agency_class>Other</agency_class>
    </collaborator>
    <collaborator>
      <agency>Université de Sherbrooke</agency>
      <agency_class>Other</agency_class>
    </collaborator>
    <collaborator>
      <agency>Toronto Metropolitan University</agency>
      <agency_class>Other</agency_class>
    </collaborator>
    <collaborator>
      <agency>Brown University</agency>
      <agency_class>Other</agency_class>
    </collaborator>
  </sponsors>
  <source>Concordia University, Montreal</source>
  <oversight_info>
    <has_dmc>No</has_dmc>
  </oversight_info>
  <brief_summary>
    <textblock>
      Generalized Anxiety Disorder (GAD) is a condition characterized by chronic and excessive&#xD;
      worry and anxiety. Our group has developed a cognitive-behavioural treatment (CBT) for GAD&#xD;
      that has been tested in four previous clinical trials. The findings show that 60 to 70% of&#xD;
      affected individuals attain GAD remission and that 50 to 55% achieve high endstate&#xD;
      functioning following the treatment. Although these numbers are encouraging, there remain a&#xD;
      considerable proportion of individuals who do not fully benefit from treatment. In our most&#xD;
      recent CIHR-funded treatment study, we assessed the impact of information processing on the&#xD;
      efficacy of CBT for GAD. Our findings show: a) that the tendency to negatively interpret&#xD;
      ambiguous information at pre-treatment was associated with greater GAD symptoms at&#xD;
      post-treatment; and b) that patients who were less successful at changing their negative&#xD;
      interpretation style were also less responsive to CBT. Given that computerized interpretation&#xD;
      modification training has been shown to be effective for decreasing the negative&#xD;
      interpretation style of anxious individuals, the goal of the current proposal is to determine&#xD;
      whether such training can augment the efficacy of CBT for adults with GAD. A total of 138&#xD;
      individuals with a primary diagnosis of GAD will be randomly allocated to one of two&#xD;
      conditions: a) CBT plus interpretation modification training or b) CBT plus non-active&#xD;
      training. CBT will consist of 14 weekly sessions, with interpretation modification training&#xD;
      (or non-active training) administered prior to each session. Measures of GAD symptoms,&#xD;
      psychopathology, cognitive vulnerability, and interpretation style will be administered at&#xD;
      pre-, mid-, and post-treatment, as well as at 6- and 12-month follow-ups. The proposed study&#xD;
      will provide information about the efficacy, clinical usefulness, and mechanisms of&#xD;
      interpretation modification training in combination with CBT.&#xD;
    </textblock>
  </brief_summary>
  <detailed_description>
    <textblock>
      Generalized Anxiety Disorder (GAD) is characterized by excessive and uncontrollable worry and&#xD;
      anxiety. In Canada, the point prevalence of GAD is 3 to 4%, and the personal and social costs&#xD;
      of GAD are well documented. Over the past decade, new cognitive-behavioural treatments have&#xD;
      been developed for GAD. Our group has also developed a cognitive-behavioural treatment (CBT)&#xD;
      protocol for GAD, which focuses on intolerance of uncertainty. There are now four published&#xD;
      randomized clinical trials of the treatment, with results suggesting that it is more&#xD;
      efficacious than wait-list control, supportive therapy, and applied relaxation. Although&#xD;
      these results are encouraging, 30 to 40% of affected individuals do not attain diagnostic&#xD;
      remission and 45 to 50% do not achieve high endstate functioning at post-treatment.&#xD;
&#xD;
      In an effort to augment the efficacy of the treatment protocol for GAD, we have recently&#xD;
      examined a broad range of demographic and clinical variables that might predict a limited&#xD;
      response to treatment. The results of our analyses suggest that a particular type of&#xD;
      cognitive bias plays a key role in determining treatment response. Specifically, patients&#xD;
      with a particularly negative interpretation style (i.e., the tendency to negatively interpret&#xD;
      ambiguous information) have a greater probability of not attaining remission following CBT&#xD;
      (they also show less improvement on other indicators of treatment outcome). In addition,&#xD;
      change in interpretation style appears to mediate change in GAD symptoms over the course of&#xD;
      CBT. Thus, the data suggest that treatment efficacy could be increased by adding training&#xD;
      strategies that specifically address negatively biased interpretations of ambiguous&#xD;
      information. Recently, a number of experimental investigations have shown that the tendency&#xD;
      to negatively interpret ambiguous information can be decreased using computerized&#xD;
      interpretation modification training. In fact, the data show that such changes can be&#xD;
      maintained over time, can generalize to new situations, and can lead to corresponding changes&#xD;
      in GAD symptoms and anxiety proneness. Thus, it appears that computerized interpretation&#xD;
      modification training has the potential to increase the efficacy of current CBT protocols by&#xD;
      directly targeting and decreasing the tendency to negatively interpret ambiguous information.&#xD;
&#xD;
      The proposed randomized clinical trial addresses the following question: Can computerized&#xD;
      interpretation modification training augment the efficacy of CBT for GAD? A total of 138&#xD;
      individuals with a primary diagnosis of GAD will be randomly allocated to one of two&#xD;
      conditions: a) CBT plus interpretation modification training (CBT+IMT) or b) CBT plus&#xD;
      non-active training (CBT+NA). CBT will consist of 14 weekly 50-minute sessions targeting&#xD;
      intolerance of uncertainty via procedures such as problem-solving training and imaginal&#xD;
      exposure. Participants randomized to the experimental condition will receive 10 minutes of&#xD;
      computerized interpretation modification training prior to each CBT session. In&#xD;
      interpretation modification training, respondents learn to endorse benign combinations and&#xD;
      reject negative combinations of sentences and words, thus promoting new associative learning.&#xD;
      Participants in the control condition will receive 10 minutes of non-active training, in&#xD;
      which each sentence is paired with a word that is unrelated to the sentence or a word that is&#xD;
      related to a non-threatening (and typically peripheral) aspect of the sentence. Measures of&#xD;
      GAD symptoms, psychopathology, cognitive vulnerability, and interpretation style will be&#xD;
      administered at pre-, mid-, and post-treatment, as well as at 6- and 12-month follow-ups. The&#xD;
      proposed study will provide information about the efficacy, clinical usefulness, and&#xD;
      mechanisms of interpretation modification training in combination with CBT. Given previous&#xD;
      findings on the key role of negative interpretation style in anxiety, the proposed study has&#xD;
      the potential to increase our understanding and ability to treat individuals with GAD.&#xD;
    </textblock>
  </detailed_description>
  <overall_status>Completed</overall_status>
  <start_date>September 2012</start_date>
  <completion_date type="Actual">June 2018</completion_date>
  <primary_completion_date type="Actual">June 2018</primary_completion_date>
  <phase>N/A</phase>
  <study_type>Interventional</study_type>
  <has_expanded_access>No</has_expanded_access>
  <study_design_info>
    <allocation>Randomized</allocation>
    <intervention_model>Parallel Assignment</intervention_model>
    <primary_purpose>Treatment</primary_purpose>
    <masking>Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)</masking>
  </study_design_info>
  <primary_outcome>
    <measure>Change from baseline in severity of GAD symptoms assessed by structured interview</measure>
    <time_frame>Post-treatment (14 weeks)</time_frame>
    <description>Clinician's Severity Rating (CSR) scale of Anxiety Disorders Interview Schedule for DSM-IV (ADIS-IV)</description>
  </primary_outcome>
  <primary_outcome>
    <measure>Change from baseline in severity of GAD symptoms</measure>
    <time_frame>Post-treatment (14 weeks)</time_frame>
    <description>Worry and Anxiety Questionnaire (WAQ)</description>
  </primary_outcome>
  <primary_outcome>
    <measure>Change from baseline in severity of worry</measure>
    <time_frame>Post-treatment (14 weeks)</time_frame>
    <description>Penn State Worry Questionnaire (PSWQ)</description>
  </primary_outcome>
  <secondary_outcome>
    <measure>Change from baseline in somatic anxiety</measure>
    <time_frame>Post-treatment (14 weeks)</time_frame>
    <description>Beck Anxiety Inventory (BAI)</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Change from baseline in depressive symptoms</measure>
    <time_frame>Post-treatment (14 weeks)</time_frame>
    <description>Beck Depression Inventory, 2nd edition (BDI-II)</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Change from baseline in hostile attitudes</measure>
    <time_frame>Post-treatment (14 weeks)</time_frame>
    <description>Aggression Questionnaire, Hostility subscale (AQ-Host)</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Change from baseline in intolerance of uncertainty</measure>
    <time_frame>Post-treatment (14 weeks)</time_frame>
    <description>Intolerance of Uncertainty Scale (IUS)</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Change from baseline in beliefs about worry</measure>
    <time_frame>Post-treatment (14 weeks)</time_frame>
    <description>Why Worry, 2nd edition (WW-II)</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Change from baseline in problem orientation</measure>
    <time_frame>Post-treatment (14 weeks)</time_frame>
    <description>Negative Problem Orientation Questionnaire (NPOQ)</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Change from baseline in cognitive avoidance</measure>
    <time_frame>Post-treatment (14 weeks)</time_frame>
    <description>Cognitive Avoidance Questionnaire (CAQ)</description>
  </secondary_outcome>
  <other_outcome>
    <measure>Change from baseline in interpretation of scrambled sentences</measure>
    <time_frame>Post-treatment (14 weeks)</time_frame>
    <description>Scrambled Sentence Task for GAD (SST-GAD)</description>
  </other_outcome>
  <other_outcome>
    <measure>Change from baseline in interpretation of ambiguous scenarios</measure>
    <time_frame>Post-treatment (14 weeks)</time_frame>
    <description>Ambiguous/Unambiguous Situations Diary, Extended version (AUSD-Ext)</description>
  </other_outcome>
  <other_outcome>
    <measure>Change from baseline in interpretation of ambiguous pictures</measure>
    <time_frame>Post-treatment (14 weeks)</time_frame>
    <description>Affective Picture Rating Task (APRT)</description>
  </other_outcome>
  <number_of_arms>2</number_of_arms>
  <enrollment type="Actual">79</enrollment>
  <condition>Generalized Anxiety Disorder</condition>
  <arm_group>
    <arm_group_label>Cognitive-behavioral therapy with interpretation training</arm_group_label>
    <arm_group_type>Experimental</arm_group_type>
    <description>14 sessions of cognitive-behavioral therapy combined with computerized interpretation modification training</description>
  </arm_group>
  <arm_group>
    <arm_group_label>Cognitive-behavioral therapy with non-active training</arm_group_label>
    <arm_group_type>Active Comparator</arm_group_type>
    <description>14 sessions of cognitive-behavioral therapy combined with computerized non-active training</description>
  </arm_group>
  <intervention>
    <intervention_type>Behavioral</intervention_type>
    <intervention_name>Cognitive-behavioral therapy</intervention_name>
    <description>Cognitive-behavioral therapy addressing intolerance of uncertainty, positive beliefs about worry, negative problem orientation, and cognitive avoidance</description>
    <arm_group_label>Cognitive-behavioral therapy with interpretation training</arm_group_label>
    <arm_group_label>Cognitive-behavioral therapy with non-active training</arm_group_label>
    <other_name>Intolerance of uncertainty treatment</other_name>
  </intervention>
  <intervention>
    <intervention_type>Other</intervention_type>
    <intervention_name>Interpretation training</intervention_name>
    <description>Computerized interpretation training using Word-Sentence Association Paradigm</description>
    <arm_group_label>Cognitive-behavioral therapy with interpretation training</arm_group_label>
    <other_name>Cognitive bias modification for interpretations</other_name>
  </intervention>
  <eligibility>
    <criteria>
      <textblock>
        Inclusion Criteria:&#xD;
&#xD;
          -  Principal diagnosis of GAD&#xD;
&#xD;
          -  Willingness to keep medication status stable while participating in the study&#xD;
&#xD;
          -  Willingness to undergo randomization&#xD;
&#xD;
        Exclusion Criteria:&#xD;
&#xD;
          -  Change in medication type or dose in 12 weeks before study entry&#xD;
&#xD;
          -  Use of herbal products known to have CNS effects in the 2 weeks before study entry&#xD;
&#xD;
          -  Evidence of suicidal intent&#xD;
&#xD;
          -  Evidence of current substance abuse&#xD;
&#xD;
          -  Evidence of current or past schizophrenia, bipolar disorder or organic mental disorder&#xD;
&#xD;
          -  Current participation in other trials&#xD;
&#xD;
          -  Concurrent psychotherapy during treatment phase of trial&#xD;
&#xD;
          -  Evidence of anxiety symptoms due to a general medical condition&#xD;
      </textblock>
    </criteria>
    <gender>All</gender>
    <minimum_age>18 Years</minimum_age>
    <maximum_age>N/A</maximum_age>
    <healthy_volunteers>No</healthy_volunteers>
  </eligibility>
  <overall_official>
    <last_name>Michel J. Dugas, Ph.D.</last_name>
    <role>Principal Investigator</role>
    <affiliation>Concordia University, Montreal</affiliation>
  </overall_official>
  <location>
    <facility>
      <name>Hôpital du Sacré-Coeur de Montréal, Clinique des troubles anxieux</name>
      <address>
        <city>Montréal</city>
        <state>Quebec</state>
        <zip>H3M 3A9</zip>
        <country>Canada</country>
      </address>
    </facility>
  </location>
  <location_countries>
    <country>Canada</country>
  </location_countries>
  <verification_date>July 2018</verification_date>
  <study_first_submitted>September 5, 2012</study_first_submitted>
  <study_first_submitted_qc>September 5, 2012</study_first_submitted_qc>
  <study_first_posted type="Estimate">September 7, 2012</study_first_posted>
  <last_update_submitted>July 19, 2018</last_update_submitted>
  <last_update_submitted_qc>July 19, 2018</last_update_submitted_qc>
  <last_update_posted type="Actual">July 20, 2018</last_update_posted>
  <responsible_party>
    <responsible_party_type>Principal Investigator</responsible_party_type>
    <investigator_affiliation>Concordia University, Montreal</investigator_affiliation>
    <investigator_full_name>Michel J Dugas, Ph.D.</investigator_full_name>
    <investigator_title>Professor of Psychology</investigator_title>
  </responsible_party>
  <keyword>Cognitive-behavioral therapy</keyword>
  <keyword>Interpretation modification training</keyword>
  <keyword>Randomized clinical trial</keyword>
  <keyword>Adults</keyword>
  <condition_browse>
    <!-- CAUTION:  The following MeSH terms are assigned with an imperfect algorithm            -->
    <mesh_term>Anxiety Disorders</mesh_term>
  </condition_browse>
  <!-- Results have not yet been posted for this study                                          -->
</clinical_study>


download date: ClinicalTrials.gov processed this data on September 20, 2023
link text: Link to the current ClinicalTrials.gov record.
url: https://clinicaltrials.gov/ct2/show/NCT01681329
org study id: MOP-82771-12-04
nct id: NCT01681329
lead sponsor: 
collaborator: 
collaborator: 
collaborator: 
collaborator: 
collaborator: 
has dmc: No
Generalized Anxiety Disorder (GAD) is a condition characterized by chronic and excessive
      worry and anxiety. Our group has developed a cognitive-behavioural treatment (CBT) for GAD
      that has been tested in four previous clinical trials. The findings show that 60 to 70% of
      affected individuals attain GAD remission and that 50 to 55% achieve high endstate
      functioning following the treatment. Although these numbers are encouraging, there remain a
      considerable proportion of individuals who do not fully benefit from treatment. In our most
      recent CIHR-funded treatment study, we assessed the impact of information processing on the
      efficacy of CBT for GAD. Our findings show: a) that the tendency to negatively interpret
      ambiguous information at pre-treatment was associated with greater GAD symptoms at
      post-treatment; and b) that patients who were less successful at changing their negative
      interpretation style were also less responsive to CBT. Given that computerized interpretation
      modification training has been shown to be effective for decreasing the negative
      interpretation style of anxious individuals, the goal of the current proposal is to determine
      whether such training can augment the efficacy of CBT for adults with GAD. A total of 138
      individuals with a primary diagnosis of GAD will be randomly allocated to one of two
      conditions: a) CBT plus interpretation modification training or b) CBT plus non-active
      training. CBT will consist of 14 weekly sessions, with interpretation modification training
      (or non-active training) administered prior to each session. Measures of GAD symptoms,
      psychopathology, cognitive vulnerability, and interpretation style will be administered at
      pre-, mid-, and post-treatment, as well as at 6- and 12-month follow-ups. The proposed study
      will provide information about the efficacy, clinical usefulness, and mechanisms of
      interpretation modification training in combination with CBT.
Generalized Anxiety Disorder (GAD) is characterized by excessive and uncontrollable worry and
      anxiety. In Canada, the point prevalence of GAD is 3 to 4%, and the personal and social costs
      of GAD are well documented. Over the past decade, new cognitive-behavioural treatments have
      been developed for GAD. Our group has also developed a cognitive-behavioural treatment (CBT)
      protocol for GAD, which focuses on intolerance of uncertainty. There are now four published
      randomized clinical trials of the treatment, with results suggesting that it is more
      efficacious than wait-list control, supportive therapy, and applied relaxation. Although
      these results are encouraging, 30 to 40% of affected individuals do not attain diagnostic
      remission and 45 to 50% do not achieve high endstate functioning at post-treatment.

      In an effort to augment the efficacy of the treatment protocol for GAD, we have recently
      examined a broad range of demographic and clinical variables that might predict a limited
      response to treatment. The results of our analyses suggest that a particular type of
      cognitive bias plays a key role in determining treatment response. Specifically, patients
      with a particularly negative interpretation style (i.e., the tendency to negatively interpret
      ambiguous information) have a greater probability of not attaining remission following CBT
      (they also show less improvement on other indicators of treatment outcome). In addition,
      change in interpretation style appears to mediate change in GAD symptoms over the course of
      CBT. Thus, the data suggest that treatment efficacy could be increased by adding training
      strategies that specifically address negatively biased interpretations of ambiguous
      information. Recently, a number of experimental investigations have shown that the tendency
      to negatively interpret ambiguous information can be decreased using computerized
      interpretation modification training. In fact, the data show that such changes can be
      maintained over time, can generalize to new situations, and can lead to corresponding changes
      in GAD symptoms and anxiety proneness. Thus, it appears that computerized interpretation
      modification training has the potential to increase the efficacy of current CBT protocols by
      directly targeting and decreasing the tendency to negatively interpret ambiguous information.

      The proposed randomized clinical trial addresses the following question: Can computerized
      interpretation modification training augment the efficacy of CBT for GAD? A total of 138
      individuals with a primary diagnosis of GAD will be randomly allocated to one of two
      conditions: a) CBT plus interpretation modification training (CBT+IMT) or b) CBT plus
      non-active training (CBT+NA). CBT will consist of 14 weekly 50-minute sessions targeting
      intolerance of uncertainty via procedures such as problem-solving training and imaginal
      exposure. Participants randomized to the experimental condition will receive 10 minutes of
      computerized interpretation modification training prior to each CBT session. In
      interpretation modification training, respondents learn to endorse benign combinations and
      reject negative combinations of sentences and words, thus promoting new associative learning.
      Participants in the control condition will receive 10 minutes of non-active training, in
      which each sentence is paired with a word that is unrelated to the sentence or a word that is
      related to a non-threatening (and typically peripheral) aspect of the sentence. Measures of
      GAD symptoms, psychopathology, cognitive vulnerability, and interpretation style will be
      administered at pre-, mid-, and post-treatment, as well as at 6- and 12-month follow-ups. The
      proposed study will provide information about the efficacy, clinical usefulness, and
      mechanisms of interpretation modification training in combination with CBT. Given previous
      findings on the key role of negative interpretation style in anxiety, the proposed study has
      the potential to increase our understanding and ability to treat individuals with GAD.
allocation: Randomized
intervention model: Parallel Assignment
primary purpose: Treatment
masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
measure: Change from baseline in severity of GAD symptoms assessed by structured interview
time frame: Post-treatment (14 weeks)
description: Clinician's Severity Rating (CSR) scale of Anxiety Disorders Interview Schedule for DSM-IV (ADIS-IV)
measure: Change from baseline in severity of GAD symptoms
time frame: Post-treatment (14 weeks)
description: Worry and Anxiety Questionnaire (WAQ)
measure: Change from baseline in severity of worry
time frame: Post-treatment (14 weeks)
description: Penn State Worry Questionnaire (PSWQ)
measure: Change from baseline in somatic anxiety
time frame: Post-treatment (14 weeks)
description: Beck Anxiety Inventory (BAI)
measure: Change from baseline in depressive symptoms
time frame: Post-treatment (14 weeks)
description: Beck Depression Inventory, 2nd edition (BDI-II)
measure: Change from baseline in hostile attitudes
time frame: Post-treatment (14 weeks)
description: Aggression Questionnaire, Hostility subscale (AQ-Host)
measure: Change from baseline in intolerance of uncertainty
time frame: Post-treatment (14 weeks)
description: Intolerance of Uncertainty Scale (IUS)
measure: Change from baseline in beliefs about worry
time frame: Post-treatment (14 weeks)
description: Why Worry, 2nd edition (WW-II)
measure: Change from baseline in problem orientation
time frame: Post-treatment (14 weeks)
description: Negative Problem Orientation Questionnaire (NPOQ)
measure: Change from baseline in cognitive avoidance
time frame: Post-treatment (14 weeks)
description: Cognitive Avoidance Questionnaire (CAQ)
measure: Change from baseline in interpretation of scrambled sentences
time frame: Post-treatment (14 weeks)
description: Scrambled Sentence Task for GAD (SST-GAD)
measure: Change from baseline in interpretation of ambiguous scenarios
time frame: Post-treatment (14 weeks)
description: Ambiguous/Unambiguous Situations Diary, Extended version (AUSD-Ext)
measure: Change from baseline in interpretation of ambiguous pictures
time frame: Post-treatment (14 weeks)
description: Affective Picture Rating Task (APRT)
arm group label: Cognitive-behavioral therapy with interpretation training
arm group type: Experimental
description: 14 sessions of cognitive-behavioral therapy combined with computerized interpretation modification training
arm group label: Cognitive-behavioral therapy with non-active training
arm group type: Active Comparator
description: 14 sessions of cognitive-behavioral therapy combined with computerized non-active training
intervention type: Behavioral
intervention name: Cognitive-behavioral therapy
description: Cognitive-behavioral therapy addressing intolerance of uncertainty, positive beliefs about worry, negative problem orientation, and cognitive avoidance
arm group label: Cognitive-behavioral therapy with interpretation training
arm group label: Cognitive-behavioral therapy with non-active training
other name: Intolerance of uncertainty treatment
intervention type: Other
intervention name: Interpretation training
description: Computerized interpretation training using Word-Sentence Association Paradigm
arm group label: Cognitive-behavioral therapy with interpretation training
other name: Cognitive bias modification for interpretations
criteria: 
gender: All
minimum age: 18 Years
maximum age: N/A
healthy volunteers: No
last name: Michel J. Dugas, Ph.D.
role: Principal Investigator
affiliation: Concordia University, Montreal
facility: 
country: Canada
responsible party type: Principal Investigator
investigator affiliation: Concordia University, Montreal
investigator full name: Michel J Dugas, Ph.D.
investigator title: Professor of Psychology
mesh term: Anxiety Disorders