CBT Augmentation of Paroxetine for Social Anxiety

CBT 增强帕罗西汀治疗社交焦虑

• 批准号: 7126443
• 负责人: RICHARD G HEIMBERG
• 金额: $ 29.76万
• 依托单位: TEMPLE UNIV OF THE COMMONWEALTH
• 依托单位国家: 美国
• 财政年份: 2003
• 资助国家: 美国
• 起止时间: 2003-08-15 至 2008-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7126443
• 关键词: behavior prediction; behavioral /social science research tag; clinical anxiety; clinical research; cognitive behavior therapy; combination therapy; fear; functional ability; human subject; human therapy evaluation; mental disorder chemotherapy; neuropharmacology; paroxetine; patient oriented research; psychological tests; quality of life; relapse /recurrence; sign /symptom; social psychology

DESCRIPTION (provided by applicant): Social anxiety disorder is a prevalent, chronic and disabling condition. Paroxetine has received FDA approval on the basis of its acute efficacy for this disorder, but much about longer-term management remains uncertain. There are virtually no data regarding next steps in treatment despite evidence that most patients who receive acute paroxetine therapy still exhibit significant residual symptoms. Furthermore, there are also no data regarding methods for minimizing relapse when medication is discontinued despite evidence that relapse rates in such circumstances are high. Cognitive-behavioral therapy (CBT) is a good candidate for augmenting paroxetine response and reducing relapse after medication discontinuation as it has been shown to be an effective treatment in its own right and often associated with lesser relapse than medication alone. Although CBT has been found to be useful in these circumstances for depression and panic disorder, there have been no similar studies in social anxiety disorder. This application will examine the ability of CBT to augment acute paroxetine response and reduce relapse following paroxetine discontinuation in social anxiety disorder. It will also examine the degree of residual symptoms and disability as well as rates of remission and improvements in quality of life in response to paroxetine alone or with the addition of CBT. Predictors of acute response and relapse after treatment is discontinued will also be explored. To achieve these ends, two hundred fifty patients will receive 12 weeks of open treatment with paroxetine. Patients showing at least some benefit will be randomized to continued paroxetine with or without CBT for 16 additional weeks. All treatment will then be tapered and patients will be followed for 24 additional weeks. Overall, this study should provide important information about the augmentation of paroxetine treatment for patients with social anxiety disorder, effective methods for reducing relapse, and who may benefit from paroxetine treatment or relapse when medication is withdrawn. It will also increase understanding of the interplay of psychosocial and pharmacological treatment methods and psychological and biological factors in patients' total response to treatment.

描述(申请人提供)：社交焦虑症是一种普遍、慢性和致残的疾病。帕罗西汀因其对这种疾病的急性疗效而获得FDA的批准，但关于长期治疗的许多问题仍不确定。尽管有证据表明，大多数接受急性帕罗西汀治疗的患者仍然表现出明显的残留症状，但几乎没有关于下一步治疗的数据。此外，尽管有证据表明在这种情况下复发率很高，但也没有关于在停药时将复发降至最低的方法的数据。认知行为疗法(CBT)是增强帕罗西汀反应和减少停药后复发的一个很好的候选方案，因为它本身被证明是一种有效的治疗方法，而且往往比单独用药复发率低。尽管CBT被发现在这些情况下对抑郁症和恐慌症有用，但还没有关于社交焦虑症的类似研究。这项应用将检验CBT在帕罗西汀停止治疗社交焦虑症后增强急性帕罗西汀反应和减少复发的能力。它还将检查帕罗西汀单独或加用CBT后残留症状和残疾的程度以及缓解率和生活质量的改善。还将探索在停止治疗后急性反应和复发的预测因素。为了达到这些目的，250名患者将接受为期12周的帕罗西汀开放治疗。显示至少有一些益处的患者将被随机分成两组，继续服用帕罗西汀加或不加CBT治疗16周。然后，所有治疗都将逐渐减少，患者将再接受24周的随访。总体而言，这项研究应该为社交焦虑障碍患者加强帕罗西汀治疗提供重要信息，减少复发的有效方法，以及谁可能受益于帕罗西汀治疗或在停药时复发。它还将增加对心理社会和药物治疗方法以及心理和生物因素在患者对治疗的总反应中的相互作用的了解。

项目成果

Clarifying the Behavioral Economics of Social Anxiety Disorder: Effects of Interpersonal Problems and Symptom Severity on Generosity.

澄清社交焦虑症的行为经济学：人际问题和症状严重程度对慷慨的影响。

• DOI: 10.1177/2167702615578128
• 发表时间: 2016
• 期刊: Clinical psychological science : a journal of the Association for Psychological Science
• 作者: Rodebaugh,ThomasL;Heimberg,RichardG;Taylor,KristinP;Lenze,EricJ
• 通讯作者: Lenze,EricJ

The moderated effects of video feedback for social anxiety disorder.

• DOI: 10.1016/j.janxdis.2010.04.007
• 发表时间: 2010-10
• 期刊: JOURNAL OF ANXIETY DISORDERS
• 影响因子: 10.3
• 作者: Rodebaugh, Thomas L.;Heimberg, Richard G.;Schultz, Luke T.;Blackmore, Michelle
• 通讯作者: Blackmore, Michelle

Does centrality in a cross-sectional network suggest intervention targets for social anxiety disorder?

• DOI: 10.1037/ccp0000336
• 发表时间: 2018-10
• 期刊: Journal of consulting and clinical psychology
• 影响因子: 5.9
• 作者: Rodebaugh TL;Tonge NA;Piccirillo ML;Fried E;Horenstein A;Morrison AS;Goldin P;Gross JJ;Lim MH;Fernandez KC;Blanco C;Schneier FR;Bogdan R;Thompson RJ;Heimberg RG
• 通讯作者: Heimberg RG

Psychometric evaluation of the Fear of Positive Evaluation Scale in patients with social anxiety disorder.

社交焦虑症患者对阳性评估量表的恐惧的心理测量评估。

• DOI: 10.1037/a0025723
• 发表时间: 2012-06
• 期刊: PSYCHOLOGICAL ASSESSMENT
• 影响因子: 3.6
• 作者: Weeks, Justin W.;Heimberg, Richard G.;Rodebaugh, Thomas L.;Goldin, Philippe R.;Gross, James J.
• 通讯作者: Gross, James J.