Exploring social factors in the psychological treatment of anxiety and mood disorders

探索焦虑和情绪障碍心理治疗中的社会因素

• 批准号: 2105614
• 金额: --
• 依托单位: King's College London
• 依托单位国家: 英国
• 项目类别: Studentship
• 财政年份: 2018
• 资助国家: 英国
• 起止时间: 2018 至 无数据
• 项目状态: 已结题
• 来源: https://gtr.ukri.org/projects?ref=studentship-2105614
• 关键词: Exploring; social; factors; psychological; treatment

Anxiety and depression are highly prevalent and debilitating disorders, with huge economic and social costs. To address the large number of untreated individuals struggling with these disorders, the UK Improving Access to Psychological Therapy (IAPT) initiative was started in 2008. IAPT provides evidence-based psychological therapies for patients with anxiety and depression in a primary care setting. However, substantial variation in responses to these treatments is evident, with roughly 50% of patients not showing significant improvements in symptom levels following treatment. Little is known about the source of these individual differences, and even less is understood about outcomes in terms of changes in social functioning. Evidence currently suggests a need to tailor treatments around risk variables, in order to promote improvements in long-term outcomes and cost-effectiveness of the IAPT service.To date, the majority of research exploring predictors of psychological treatment response has only focused on clinical trials. Childhood trauma has been found to be a key risk factor in the development and persistence of psychological disorders, and in clinical trials has been shown to relate to psychological treatment outcomes. More recently, associations have been shown between childhood trauma and risk of relapse following treatment in IAPT. These associations may reflect negative biases regarding social situations. Genetic factors have also been found to provide important information when exploring predictors of psychological therapy outcomes. The aim of this research is to explore the social and genetic risk variables relevant to the outcomes of psychological treatments in IAPT. Specifically, it will (i) address whether social risk factors such as childhood trauma predict treatment response; (ii) extend the assessment of treatment response to include measures of social functioning; (iii) investigate psychosocial factors associated with the relationship between a history of childhood trauma and psychological treatment response; and (iv) incorporate genetic and social risk factors in the overall prediction of treatment response in IAPT.This project will involve large-scale prospective recruitment of IAPT service users using an online recruitment platform. This will enable greater communication with participants as well as online data collection at pre-treatment, post-treatment and follow-up, including demographic and social information. Collaborating with the NIHR-funded BioResource at the Institute of Psychiatry, Psychology and Neuroscience will enable the exploration of genome-wide polygenetic risk scores for anxiety, depression and risk of poor response to psychological treatment. Through this research, the potential to use social and genetic risk factors as predictors of the treatments that will be most beneficial to patients' outcomes in IAPT will be explored.

焦虑和抑郁是非常普遍和使人衰弱的疾病，具有巨大的经济和社会成本。为了解决大量未经治疗的患者与这些疾病作斗争的问题，英国于2008年启动了“改善获得心理治疗的机会”（IAPT）倡议。IAPT为初级保健环境中的焦虑和抑郁患者提供基于证据的心理治疗。然而，对这些治疗的反应存在明显的差异，大约50%的患者在治疗后症状水平没有显着改善。人们对这些个体差异的来源知之甚少，对社会功能变化的结果了解得更少。目前有证据表明，需要根据风险变量量身定制治疗方法，以促进IAPT服务的长期结果和成本效益的改善。迄今为止，大多数探索心理治疗反应预测因素的研究只集中在临床试验上。儿童创伤已被发现是心理障碍发展和持续存在的关键风险因素，并且在临床试验中已被证明与心理治疗结果有关。最近，儿童创伤与IAPT治疗后复发风险之间存在关联。这些关联可能反映了对社会情境的负面偏见。在探索心理治疗结果的预测因素时，遗传因素也被发现提供了重要的信息。本研究的目的是探讨与IAPT心理治疗结果相关的社会和遗传风险变量。具体而言，它将(i)解决社会风险因素，如儿童创伤是否预测治疗反应；扩大对治疗效果的评估，以包括社会功能的措施；（iii）调查与儿童创伤史和心理治疗反应之间关系相关的社会心理因素；（iv）将遗传和社会风险因素纳入IAPT治疗反应的总体预测。该项目将涉及通过在线招聘平台对IAPT服务用户进行大规模前瞻性招聘。这将有助于加强与参与者的沟通，并在治疗前、治疗后和随访期间在线收集数据，包括人口和社会信息。与美国国立卫生研究院资助的精神病学、心理学和神经科学研究所的生物资源合作，将能够探索焦虑、抑郁和心理治疗不良反应风险的全基因组多基因风险评分。通过这项研究，将探索利用社会和遗传风险因素作为预测治疗方法的潜力，这些治疗方法将对IAPT患者的预后最有利。