A randomized controlled trial of emotion regulation therapy for generalized anxiety disorder with and without co-occurring depression.
A randomized controlled trial of emotion regulation therapy for generalized anxiety disorder with and without co-occurring depression.
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DOI：
10.1037/ccp0000289
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发表时间：
2018-03
影响因子：
5.9
通讯作者：
Heimberg RG
中科院分区：
文献类型：
--
作者：
Mennin DS;Fresco DM;O'Toole MS;Heimberg RG
广泛性焦虑症（GAD）和重性抑郁症（MDD），特别是当它们同时发生时，与次优治疗反应相关。这些障碍的一个共同特征是消极的自我参照处理（NSRP;即，焦虑、沉思），这影响了治疗结果。情绪调节疗法（ERT）将情感科学的原理与传统和当代的认知行为治疗相结合，通过针对动机和调节机制以及行为后果来识别和修改NSRP的功能性质。.基于令人鼓舞的开放试验结果，53例初步诊断为GAD的患者（43%合并MDD）被随机分配接受ERT（n = 28）或改良的注意力控制条件（MAC，n = 25）立即治疗。与MAC患者相比，ERT患者在GAD和MDD、担忧、沉思、共病疾病严重程度、功能障碍、生活质量以及反映正念注意力、元认知和总体情绪调节的假设机制等临床指标方面表现出统计学和临床意义上的改善，所有这些均表现出对主要结局的介导作用。ERT的这种优效性超过了中等效应量，大多数结局超过了大效应的常规。急性治疗结束后，治疗效果维持了9个月。总体而言，ERT导致GAD和MDD的高终末状态功能发生率较高，并维持至随访期。研究结果为ERT的有效性和假设机制提供了令人鼓舞的支持，并为改善我们对复杂临床疾病（如GAD伴MDD）的理解和治疗指明了富有成效的方向。
Generalized anxiety disorder (GAD) and major depression (MDD), especially when they co-occur, are associated with suboptimal treatment response. One common feature of these disorders is negative self-referential processing (NSRP; i.e., worry, rumination), which worsens treatment outcome. Emotion Regulation Therapy (ERT) integrates principles from affect science with traditional and contemporary cognitive behavioral treatments to identify and modify the functional nature of NSRP by targeting motivational and regulatory mechanisms, as well as behavioral consequences. . Building on encouraging open trial findings, 53 patients with a primary diagnosis of GAD (43% with comorbid MDD) were randomly assigned to immediate treatment with ERT (n = 28) or a modified attention control condition (MAC, n = 25). ERT patients, as compared to MAC patients, evidenced statistically and clinically meaningful improvement on clinical indicators of GAD and MDD, worry, rumination, comorbid disorder severity, functional impairment, quality of life, as well as hypothesized mechanisms reflecting mindful attentional, metacognitive, and overall emotion regulation, which all demonstrated mediation of primary outcomes. This superiority of ERT exceeded medium effect sizes with most outcomes surpassing conventions for a large effect. Treatment effects were maintained for nine months following the end of acute treatment. Overall, ERT resulted in high rates of high endstate functioning for both GAD and MDD that were maintained into the follow-up period. Findings provide encouraging support for the efficacy and hypothesized mechanisms underlying ERT and point to fruitful directions for improving our understanding and treatment of complex clinical conditions such as GAD with co-occurring MDD.
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不耐受性作为普遍焦虑症的认知行为治疗计划中忧虑的减少介体。
影响因子：
10.3
作者：
Bomyea, J.;Ramsawh, H.;Ball, T. M.;Taylor, C. T.;Paulus, M. P.;Lang, A. J.;Stein, M. B.
通讯作者：
Stein, M. B.
影响因子：
3.7
作者：
Fresco, David M.;Moore, Michael T.;Williams, J. Mark G.
通讯作者：
Williams, J. Mark G.
影响因子：
4
作者：
Andreescu, Carmen;Sheu, Lei K.;Tudorascu, Dana;Walker, Sarah;Aizenstein, Howard
通讯作者：
Aizenstein, Howard
影响因子：
25.8
作者：
Barlow, David H.;Farchione, Todd J.;Cassiello-Robbins, Clair
通讯作者：
Cassiello-Robbins, Clair
影响因子：
10.3
作者：
Evans, Susan;Ferrando, Stephen;Haglin, Dean
通讯作者：
Haglin, Dean