Date of Award




Document Type


Degree Name

Doctor of Philosophy (PhD)


Department of Psychology


Clinical Psychology

Content Description

1 online resource (xi, 158 pages) : illustrations (some color)

Dissertation/Thesis Chair

John Forsyth

Committee Members

Mitch Earleywine, Michelle Craske


Anxiety Disorders, Cognitive Behavioral Therapy, Effectiveness, Hispanics, Primary Care, Hispanic Americans, Anxiety disorders, Depression, Mental, Cognitive therapy

Subject Categories

Clinical Psychology | Psychology


The proportion of Hispanics in psychosocial treatment outcome research is limited. To our knowledge, no randomized clinical trials have investigated the effectiveness of cognitive-behavioral therapy in adult Hispanics with anxiety disorders. This is important because Hispanics are among the fastest growing minority group in the U. S., and as a group, they evidence pervasive and persistent anxiety disorders. The growth of the Hispanic population has taken place while social service systems are ill prepared to address the needs of these individuals. In this study, we addressed this gap in the literature by evaluating the difference in clinical effectiveness of cognitive behavioral therapy (CBT) for Hispanic relative to White adults with one or more of the four common anxiety disorders (panic disorder, post-traumatic stress disorder, generalized anxiety disorder, and social anxiety disorder). Participants (N = 279) included treatment seeking patients (Hispanics = 53, Whites = 226) from 13 primary care clinics (each clinic linked to one of the 4 study sites: University of California, Los Angeles; University of California, San Diego; University of Washington; University of Arkansas for Medical Sciences). A particular interest of the present study was to examine differences in treatment response among Hispanics and Whites following CBT for anxiety disorders and to identify predictors of treatment response among Hispanics. A secondary aim was to investigate the relationship between acculturation and mental health in the Hispanic sample and whether this relationship was moderated by levels of social support. Assessed outcomes included symptom-based and physical and mental health functioning measures. Results showed that CBT improved symptom severity (i.e., ASI, BSI, PHQ-9) and mental health functioning (i.e., SF-12) in both samples. Data also suggested that marital dissatisfaction and lesser social support before receiving CBT treatment for anxiety predicted greater anxiety sensitivity and distress at the 6-month follow-up among Hispanics. Unexpectedly, a limited proportion of significant associations between acculturation and greater symptom severity were found in the Hispanic sample. Outcomes are discussed in terms of addressing the issue of whether empirically supported treatments (in this case, CBT for anxiety disorders) can be generalized for use with Hispanics in the U.S.