A Unified Treatment for Anxiety Disorders

焦虑症的统一治疗

• 批准号: 7048228
• 负责人: David H. Barlow
• 金额: $ 19.38万
• 依托单位: BOSTON UNIVERSITY (CHARLES RIVER CAMPUS)
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-09-26 至 2008-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7048228
• 关键词: agoraphobia; anxiety disorders; behavioral /social science research tag; clinical research; combination therapy; comorbidity; functional ability; handbook; human subject; human therapy evaluation; interview; major depression; mental health epidemiology; obsessive compulsive disorder; outcomes research; panic disorder; posttraumatic stress disorder; psychological adaptation; psychotherapy; quality of life; questionnaires; therapy compliance; therapy design /development

DESCRIPTION (provided by applicant): Emotional disorders, particularly anxiety disorders and depression are common, chronic, costly, and can be severely impairing. We have developed increased understanding of the nature and causes of these emotional disorders during the past decade with evidence pointing to very similar biological and psychological vulnerabilities that interact with specific learning and, often, stressful life events to cause emotional disorders. Treatments, both drug and psychological, have been proven effective in the short term, but leave plenty of room for improvement in terms of outcome. Effective psychological treatments, many of which have been developed only in the past five to ten years, have been targeted very specifically to each IDSM-IV emotional disorder. This has resulted in a plethora of protocols, that has retarded training and dissemination of these efficacious treatments. The purpose of this application is to create a unified psychological approach to emotional disorders. To develop this unified protocol (UP) we will distill the major ingredients of current efficacious approaches in light of our advancing knowledge of modern learning theory and cognitive neuroscience and emotion regulation. This has led us to a focus on antecedent cognitive reappraisal, emotional avoidance, and modifying emotion driven action tendencies as basic approaches in the treatment of any emotional disorder. Thus, the first phase of the study will focus on treatment development and protocol writing. In the second phase of the study twenty-four patients will be treated and the manual will be refined through patient, therapist, investigator and consultant feedback. Adherence and competency ratings will also be developed and raters will be trained to reliably administer them. In the third phase, the pilot study, forty patients with a principal diagnosis of the major emotional disorders (panic disorder with or without agoraphobia, social phobia, obsessive compulsive disorder, generalized anxiety disorder, and major depressive disorder, as well as other emotional disorders if they are available, such as post-traumatic stress disorder and dysthymia) will be randomly assigned to receive the newly developed intervention or to a twelve-week wait list condition. Therapeutic gains will be assessed in several domains, including emotional symptomatology, and quality of life. If successful, this will be the first step towards a large scale treatment study validating a unified psychosocial approach to the emotional disorders.

描述（由申请人提供）：情绪障碍，特别是焦虑症和抑郁症是常见的，慢性的，昂贵的，并可能严重损害。在过去的十年中，我们对这些情绪障碍的性质和原因有了更多的了解，有证据表明，非常相似的生物和心理脆弱性与特定的学习相互作用，并且经常与压力生活事件相互作用，导致情绪障碍。药物和心理治疗在短期内已被证明是有效的，但在结果方面仍有很大的改进空间。有效的心理治疗，其中许多是在过去五到十年才开发出来的，已经非常具体地针对每一种IDSM-IV情绪障碍。这导致了过多的协议，这阻碍了这些有效治疗的培训和传播。这个应用程序的目的是创建一个统一的心理方法来治疗情绪障碍。为了开发这个统一的协议（UP），我们将根据我们对现代学习理论和认知神经科学以及情绪调节的先进知识，提取当前有效方法的主要成分。这使我们把重点放在先前的认知重新评价、情绪回避和改变情绪驱动的行为倾向上，作为治疗任何情绪障碍的基本方法。因此，研究的第一阶段将侧重于治疗开发和方案编写。在研究的第二阶段，将对24名患者进行治疗，并通过患者、治疗师、研究者和顾问的反馈对手册进行完善。还将制定遵守率和能力评级，并培训评级人员以可靠地管理这些评级。在第三阶段，试点研究，40例主要诊断为主要情绪障碍的患者（有或没有广场恐怖症的惊恐障碍、社交恐怖症、强迫症、广泛性焦虑症和重度抑郁症，以及其他情绪障碍（如果有的话），如创伤后应激障碍和心境恶劣）将被随机分配接受新开发的干预措施或等待12周的条件。治疗收益将在几个领域进行评估，包括情感障碍学和生活质量。如果成功，这将是大规模治疗研究的第一步，验证情绪障碍的统一心理社会方法。