1/2-Yoga For Generalized Anxiety Disorder

描述（由申请人提供）：广泛性焦虑症（GAD）是一种常见的和衰弱的精神疾病。这种障碍的定义特征是令人担忧，这是一种面向未来的适应不良的认知过程。认知行为疗法（CBT）通常对治疗GAD有效，特别是当与正念方法相结合时。然而，CBT并没有得到广泛传播。相比之下，瑜伽被广泛用于增强正念，减轻压力和缓解焦虑。然而，关于瑜伽对GAD的疗效以及这些策略与CBT的比较知之甚少。在当前的应用中，我们提出了一项为期五年的多地点研究，以检查瑜伽，CBT和压力教育（以前采用的对照条件）对GAD患者的比较疗效。我们建议将186名GAD患者随机分为12周的瑜伽，CBT或压力教育课程。将在12个疗程干预阶段之前、治疗中期、干预后和6个月随访时进行独立临床评估。我们预测随机接受瑜伽和接受CBT的个体比接受压力教育的个体在治疗后更大的GAD反应和症状减轻。此外，我们预测，接受瑜伽的个人GAD症状的改善将与接受CBT的人在测试后相当。我们的第二个目的是检查瑜伽对GAD症状的长期治疗效果。我们假设瑜伽和CBT在6个月的随访中同样有效。我们的第三个目的是检查和比较瑜伽和CBT治疗变化的机制。我们预测，瑜伽过程中的治疗变化是通过正念的变化和交感神经激活的变化介导的，而CBT的变化是通过适应不良认知的变化介导的。这项研究的结果对瑜伽的实践具有重要的临床意义，并将回答有关治疗变化机制的重要理论问题。

DESCRIPTION (provided by applicant): Generalized anxiety disorder (GAD) is a common and debilitating psychiatric condition. The defining feature of this disorder is worrying, which is a future-oriented and maladaptive cognitive process. Cognitive behavioral therapy (CBT) is generally effective for treating GAD, especially when combined with mindfulness approaches. However, CBT is not widely disseminated. In contrast, yoga is widely practiced to enhance mindfulness, reduce stress, and alleviate anxiety. However, little is known about the efficacy of yoga for GAD and how these strategies compare to CBT. In the current application, we propose a five-year multi-site study to examine the comparative efficacy of yoga, CBT, and stress education, a previously employed control condition, for patients with GAD. We propose to randomize 186 patients with GAD to 12-weekly yoga, CBT, or stress education sessions. Independent clinical assessments will occur before the 12-session intervention phase, at mid- treatment, after the intervention, and at 6-month follow-up. We predict greater GAD response and symptom reduction in individuals randomized to receive yoga and those who receive CBT than individuals who receive stress education at post-treatment. Moreover, we predict that the improvement in GAD symptoms in individuals receiving yoga will be comparable to those receiving CBT at post-test. Our secondary aim is to examine the long-term treatment efficacy of yoga on GAD symptoms. We hypothesize that yoga and CBT are equally effective at the 6-month follow-up. Our tertiary aim is to examine and compare the mechanism of treatment changes in yoga and CBT. We predict that treatment changes during yoga are mediated via changes in mindfulness and changes in sympathetic activation, whereas changes in CBT are mediated via changes in maladaptive cognitions. The results of this proposed study have important clinical implications for the practice of yoga and will answer important theoretical questions about the mechanism of treatment change.