A Unified Treatment for Anxiety 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，并且可能严重损害。在过去的十年里，我们对这些情绪障碍的本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和经常压力生活事件相互作用，导致情绪障碍。药物和心理治疗已被证明在短期内是有效的，但就结果而言，仍有很大的改进空间。有效的心理治疗，其中许多是在过去的五到十年里才开发出来的，已经非常明确地针对每一种IDSM-IV情绪障碍。这导致了过多的协议，阻碍了这些有效治疗方法的培训和传播。这个应用程序的目的是创建一个统一的心理方法的情绪障碍。为了开发这个统一协议（UP），我们将根据我们在现代学习理论、认知神经科学和情绪调节方面的先进知识，提炼出当前有效方法的主要成分。这使我们把注意力集中在前因认知重评、情绪回避和修改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，24名患者将接受治疗，手册将通过患者、治疗师、研究者和咨询师的反馈进行完善。还将制定依从性和能力评级，并将培训评分员可靠地管理这些评级。在第三阶段的试点研究中，40名主要诊断为主要情绪障碍（惊恐障碍伴或不伴广场恐怖症、社交恐惧症、强迫症、广泛性焦虑障碍、严重抑郁症，以及其他情绪障碍，如创伤后应激障碍和心境恶劣）的患者将被随机分配接受新开发的干预或12周的等待名单条件。治疗效果将在几个领域进行评估，包括情绪症状学和生活质量。如果成功，这将是迈向大规模治疗研究的第一步，验证统一的心理社会方法治疗情绪障碍。

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.