2 - (OP24) Predictors and Moderators of Cognitive Behavioural Therapy Outcomes in Older Adults with Anxiety and Mood Disorders

Introduction: There is limited understanding of the factors that predict or moderate treatment response to cognitive behavioural therapy in older adults with depression and anxiety. This study aimed to examine predictors and moderators using a combined sample of participants from randomised controlled trials (RCT) examining the efficacy of CBT on anxiety and depression symptoms compared to a control condition.

Method: 220 participants aged 60–88 years (M = 67.79, SD = 5.87) previously participated in one of three and were randomised to either CBT or a control condition and completed demographic questionnaires, diagnostic assessments, and self-report symptom measures pre-, post-treatment, and at 6-month follow-up. Demographic, clinical, and process characteristics were examined for prediction and moderation of treatment outcomes across a range of diagnostic severity, comorbidity, and symptom severity measures.

Results: Demographic characteristics had limited predictive ability. Greater severity of disorders and greater comorbidity of disorders was associated with greater symptom reduction across both conditions, but particularly in CBT. Social anxiety disorder was associated with greater symptom reduction. Less frequent automatic negative thoughts at baseline predicted greater symptom reduction in the Control, but were also linked to symptom change over time. More frequent non-social activities predicted greater symptom change in CBT, whilst more frequent social activities predicted greater symptom change in both conditions. Social activity also moderated treatment effects. Those with more social activities received more benefit from Control, whilst frequency of social activity did not influence outcomes in CBT. No other variables predicted or moderated treatment effects.

Discussion: The findings from this study showed that prediction of CBT treatment response was linked to disorder severity, comorbidity, frequency of NATs, social and non-social activities. Interestingly, the frequency of social activities moderated treatment effects and suggest potential new fruitful therapeutic targets.