Enhancing Anxiety Treatment with Strategies from Behavioral Neuroscience Research

通过行为神经科学研究的策略加强焦虑治疗

• 批准号: 8525667
• 负责人: Cynthia Lancaster
• 金额: $ 3.75万
• 依托单位: UNIVERSITY OF TEXAS AT AUSTIN
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-08-01 至 2016-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8525667
• 关键词: Aftercare; Anxiety; Anxiety Disorders; Behavioral; Development; Disease; Effectiveness; Exposure to; Extinction (Psychology); Fright; Goals; Intervention; Lead; Measures; Neurosciences Research; Participant; Patient Self-Report; Patients; Phobic anxiety disorder; Pilot Projects; Play Therapy; Population; Post-Traumatic Stress Disorders; Procedures; Randomized; Recovery; Relative (related person); Research; Research Design; Research Project Grants; Residual state; Retrieval; Role; Sampling; Specific Phobia; Stimulus; Symptoms; Techniques; Testing; Translating; United States; Update; analog; attenuation; base; comparative efficacy; conditioning; cost effective; design; effective therapy; efficacy testing; follow-up; indexing; novel; public health relevance; theories; therapy design

DESCRIPTION (provided by applicant): The overarching objective of this project is to determine whether two fear attenuation techniques from behavioral neuroscience research can be translated to augment exposure therapy for anxiety disorders. Specifically, we will test the techniques of fear retrieval and compound extinction. Conducting a brief fear retrieval trial prior to extinction enhances fear reduction through the reconsolidation update mechanism. Conducting compound extinction, in which multiple feared stimuli are confronted simultaneously, enhances fear reduction through the error-correction mechanism. Study 1 (an analogue study) will test both the singular and interactive effects of fear retrieval and compound extinction for enhancing exposure therapy for specific phobia. Study 1 will use a 2 x 2 design, with fear retrieval (yes or no) and compound extinction (yes or no) as the two between-subjects factors. Participants (N=120) with arachnophobia or ophidiophobia will be randomized to one of four groups: (1) exposure as usual (no augmentation), (2) exposure with fear retrieval, (3) exposure with compound extinction, and (4) exposure with fear retrieval and compound extinction. Behavioral and self-report measures will be used to assess the impact of the fear retrieval and compound extinction augmentations on renewal and spontaneous recovery of fear at post-treatment and one-week follow- up (controlling for baseline fear level). The aim of study 2 is to test the feasibility of integrating the most effective treatment augmentation strategy that emerges from study 1 (fear retrieval and/or compound extinction) into prolonged exposure therapy (PE) for posttraumatic stress disorder (PTSD). To provide a preliminary test comparing the efficacy of PE with augmented PE, we will employ an alternating treatments design40 in which each participant receives both interventions. Participants (N=5) will receive 10 sessions of exposure therapy for PTSD, and will be randomized to one of the two treatment conditions (PE or augmented PE) for each session. PTSD symptoms will be assessed at the start of each, weekly session and one week after the last session. Change in PTSD symptoms from the start of a given session to one week later will provide an assessment of the effectiveness of each session of therapy. Since exposure therapy plays a central role in most manualized treatments for anxiety disorders, findings from these two studies could inform the development of more potent exposure therapies across the full spectrum of anxiety disorders.

描述（由申请人提供）：本项目的总体目标是确定行为神经科学研究中的两种恐惧衰减技术是否可以转化为增强焦虑症的暴露疗法。具体来说，我们将测试恐惧恢复和复合灭绝的技术。进行一个简短的恐惧恢复试验， 灭绝通过重新整合更新机制增强了恐惧减少。进行复合灭绝，其中多个恐惧刺激同时面临，通过纠错机制增强恐惧减少。研究1（模拟研究）将测试单一和交互作用的恐惧检索和化合物灭绝，以加强特定恐惧症的暴露治疗。研究1将使用2 × 2设计，将恐惧回忆（是或否）和复合消退（是或否）作为两个受试者间因素。患有蜘蛛恐惧症或蛇恐惧症的受试者（N=120）将被随机分配到四组之一：（1）照常暴露（无增强），（2）暴露与恐惧恢复，（3）暴露与复合消退，以及（4）暴露与恐惧恢复和复合消退。将使用行为和自我报告测量来评估恐惧恢复和复合消退增强对治疗后和一周随访时恐惧的更新和自发恢复的影响（控制基线恐惧水平）。研究2的目的是测试的可行性，整合最有效的治疗增强策略，出现从研究1（恐惧检索和/或化合物灭绝）到长期暴露治疗（PE）的创伤后应激障碍（PTSD）。为了提供一个初步的测试，比较PE与增强PE的疗效，我们将采用交替治疗设计40，其中每个参与者接受两种干预措施。参与者（N=5）将接受10次PTSD暴露治疗，每次治疗将随机分配至两种治疗条件（PE或增强PE）之一。PTSD症状将在每周一次会议开始时和最后一次会议后一周进行评估。从一个给定的会话开始到一周后的PTSD症状的变化将提供对每个会话治疗有效性的评估。由于暴露疗法在大多数焦虑症的手动治疗中起着核心作用，这两项研究的结果可以为开发更有效的暴露疗法提供信息。