2/2 YOGA FOR GENERALIZED ANXIETY DISORDER

2/2 瑜伽治疗广泛性焦虑症

• 批准号: 8504152
• 负责人: NAOMI M SIMON
• 金额: $ 37.19万
• 依托单位: MASSACHUSETTS GENERAL HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-07-01 至 2018-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8504152
• 关键词: Address; Aftercare; Anxiety; Applications Grants; Binding; Breathing Exercises; Clinical; Clinical Trials Data Monitoring Committees; Clinical assessments; Cognition; Cognitive; Cognitive Therapy; Collaborations; Committee Members; Communication; Data; Data Analyses; Data Set; Disease; Education; Ensure; Exercise; Future; Generalized Anxiety Disorder; Gold; Grant; Individual; Intervention; Lead; Mediating; Mediation; Mental disorders; National Institute of Mental Health; Patients; Phase; Posture; Procedures; Process; Public Health; Publications; Randomized; Randomized Controlled Trials; Recording of previous events; Research; Research Design; Research Personnel; Research Project Grants; Role; Safety; Site; Stress; Supervision; Symptoms; Testing; Time; Training; Treatment Efficacy; Ursidae Family; Work; Yoga; active control; arm; comparative efficacy; data management; economic cost; evidence base; follow-up; human subject; insight; meetings; member; mindfulness; mindfulness meditation; public health relevance; quality assurance; response; symposium; treatment duration; treatment response

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.

描述（由申请人提供）：广义焦虑症（GAD）是一种常见且令人衰弱的精神病病。这种疾病的定义特征令人担忧，这是一个面向未来和适应不良的认知过程。认知行为疗法（CBT）通常可有效治疗GAD，尤其是在与正念方法结合使用时。但是，CBT并未被广泛传播。相比之下，瑜伽被广泛实践以增强正念，减轻压力和减轻焦虑。但是，对于瑜伽的GAD效力以及这些策略与CBT相比，知之甚少。在当前的应用中，我们提出了一项为期五年的多站点研究，以检查针对患有GAD的患者的瑜伽，CBT和压力教育的比较疗效，这是一种先前使用的控制条件。我们建议将186例GAD患者随机，至12周的瑜伽，CBT或压力教育课程。独立的临床评估将在干预阶段，干预后和6个月的随访之前进行12疗程干预阶段之前进行。我们可以预测，与接受后治疗后接受压力教育的个人相比，随机接受瑜伽的个体和接受CBT的人的GAD反应和症状降低。此外，我们预测，接受瑜伽的个体的GAD症状的改善将与测试后接受CBT的人相提并论。我们的次要目的是检查瑜伽对GAD症状的长期治疗功效。我们假设瑜伽和CBT在6个月的随访中同样有效。我们的三级目的是检查和比较瑜伽和CBT治疗变化的机理。我们预测，瑜伽过程中的治疗变化是通过正念和交感神经激活变化来介导的，而CBT的变化是通过适应不良认知的变化来介导的。这项拟议的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理的重要理论问题。