The prevalence of anxiety disorders, obsessive compulsive disorder (OCD), and posttraumatic stress disorder (PTSD) is comparable across younger and older adults, but older adults are under-referred, undertreated, and understudied. It is unclear whether existing psychological treatments are (equally) effective in older and younger adults, leaving a substantial treatment gap. This study examined whether treatment outcomes for anxiety, OCD, or PTSD differed between younger and older adults. RM ANOVA analyses were conducted in a sample of Dutch patients in generalized mental health care (N = 20,554). Age groups were categorized based on differences at which symptoms presentations emerge (i.e., 18–50 versus a group aged 51 years and older). Next, analyses were repeated based on the conventional retirement age (i.e., 18–64 versus a group aged 65 years and older). Findings showed statistically significant main effects of age group for PTSD and anxiety disorders, but not for OCD. However, the magnitude of the statistically significant effects did not reach the threshold for a small effect (ƞ2 =.007). Pre-treatment scores were lower in the older age groups. After controlling for pretreatment differences using propensity score matching, the main effects of age group were no longer statistically significant. The absence of age effects provides a first step in extending the evidence-base for the treatment of anxiety, OCD, and PTSD to older adults. We recommend clinicians working with older adults to adhere to the clinical guidelines established for younger adults with anxiety, OCD, and PTSD. This will remove treatment barriers for older adults.
Efficacious treatments for PTSD, conducted with primarily veteran samples, include Prolonged Exposure and Trauma Management Therapy, both of which appear effective when delivered in an intensive outpatient protocol (IOP). Both TMT-IOP and compressed prolonged exposure (CPE) are grounded in exposure therapy but TMT includes Virtual Reality (VR) assisted individual exposure therapy, and a group therapy component. The study compared the efficacy of these compressed treatments (TMT-IOP and CPE) in an all active-duty sample (n = 99). The results indicated that both interventions were equally effective, with significant decreases on primary measures of PTSD and results were maintained at 6-month follow-up (ps<.001 for the CAPS-5 and PCL-5). Remission of PTSD symptoms was achieved by 68% of patients who completed CPE and 67% of patients who completed TMT-IOP, a difference that was not significant (p > .05). There were no group differences on measures of anger, general anxiety, depression, and general functioning; both groups demonstrated statistically significant decreases at posttreatment (all ps<.05) and maintenance at 6-month follow-up. The results are discussed in terms of the feasibility and efficacy of conducting IOPs at military installations and the necessity of additional interventions for the successful PTSD treatment in military populations.
Background Anxiety disorders are highly prevalent, and many patients do not remit with first-line treatments. Eye Movement Desensitization and Reprocessing (EMDR) is effective for post-traumatic stress disorder (PTSD), but meta-analytic evidence on anxiety outcomes remains fragmented. Objective To synthesize meta-analyses of randomized controlled trials on the efficacy of EMDR in reducing anxiety symptoms. Methods Web of Science, PubMed, PsycINFO, and Scopus were searched from inception to April 2026 (PROSPERO CRD420261373395). Two reviewers independently selected studies, extracted data, and appraised quality with AMSTAR 2. Harmonized effect sizes were pooled using random-effects and multilevel second-order meta-analysis, and heterogeneity, moderators, small-study effects, and sensitivity analyses were examined. Result Eleven meta-analyses contributing 17 effect sizes were included; one was rated as high quality, one as moderate, three as low, and six as critically low. EMDR was associated with a moderate reduction in anxiety symptoms (g = −0.63, 95% CI [−0.82, −0.45]). Heterogeneity was substantial (I² = 74%) and largely explained by comparator type: effects were large against passive controls (g ≈ −1.01) but small against active psychological treatments (g = −0.36, 95% CI [−0.53, −0.18]). The 95% prediction interval reached approximately null effects. Most comparisons derived from PTSD samples. Results were consistent across sensitivity analyses, including analyses addressing overlap between meta-analyses. Conclusions The available evidence suggests that EMDR may reduce anxiety symptoms on average, but its advantage over active treatments appears small. Given the low methodological quality of most included meta-analyses, these findings are indirect and preliminary, and high-quality comparative trials in non-PTSD anxiety disorders are needed.
