A Unified Treatment for Anxiety Disorders

描述(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，可以是严重的损害。在过去的十年里，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，往往是应激的生活事件导致情绪障碍。药物和心理治疗在短期内都被证明是有效的，但在结果方面仍有很大的改善空间。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，非常专门针对每一种IDSM-IV情绪障碍。这导致了过多的方案，阻碍了这些有效治疗的培训和传播。此应用程序的目的是创建一种统一的心理方法来治疗情绪障碍。为了开发这个统一的方案(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不断发展的知识，提炼出当前有效方法的主要成分。这导致我们将重点放在先前的认知重新评估、情绪回避和改变情绪驱动的行动倾向作为治疗任何情绪障碍的基本方法上。因此，研究的第一阶段将侧重于治疗的开发和方案的编写。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、调查员和顾问的反馈进行完善。还将制定遵守和能力评级，并对评分员进行培训，使其能够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(伴或不伴广场恐怖症、社交恐惧症、强迫症、广泛性焦虑症和严重抑郁障碍，以及其他情绪障碍，如创伤后应激障碍和恶劣心境障碍，如果有的话)的患者将被随机分配接受新开发的干预或进入12周的等待名单条件。治疗成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，该研究验证了对情绪障碍采取统一的心理社会方法。

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.