Efficacy Evaluation of a Unified Transdiagnostic Treatment for Anxiety Disorders

描述（由申请人提供）：焦虑症是常见的，慢性的，昂贵的，使生活质量下降的，并且在世界上每个进行调查的国家比任何其他类型的疾病更普遍。在过去十年中，对焦虑和相关情绪障碍本质的深入理解揭示了这些疾病在病因和潜在结构上的共性取代了差异。同时，对这些疾病现有的单一诊断心理治疗方案（sdp）的检查强调了机制上的相似性。这些发现表明，有可能提炼出一套心理治疗程序，这些程序将构成一份创新的《情绪障碍跨诊断治疗统一协议》（UP），该协议现在已经开发出来。如果有效，UP可能代表了一种更有效的策略，这将使合并症的治疗意义变得更有效，没有其他规定（NOS）和亚定义阈值焦虑障碍条件变得没有意义。现在，我们建议对一组异质性焦虑症患者的疗效进行评估，方法是与现有的基于证据的sdp进行严格比较，以等待名单控制条件为基准，使用统计等效性和优势分析。其他目标包括确定治疗停止后相对于比较条件的UP的持久性，并确定治疗对障碍特定症状与高阶气质变量的差异影响。进一步的分析将表明，这些高阶气质变量的变化是否如初步数据所显示的那样调节了长期结果，以及这种作用机制是否在不同的治疗中有所不同。

DESCRIPTION (provided by applicant): Anxiety disorders are common, chronic, costly, debilitating to quality of life, and are more prevalent than any other class of disorders in every country in the world where surveys have been taken. Deepening understanding of the nature of anxiety and related emotional disorders during the last decade has revealed that commonalities in etiology and latent structure among these disorders supersedes differences. At the same time, examination of extant single diagnosis psychological treatment protocols (SDPs) for these disorders underscores mechanistic similarities. These findings suggested the possibility of distilling a set of psychological procedures that would comprise an innovative Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP), and this protocol has now been developed. If efficacious, the UP may represent a more efficient and possibly more effective strategy which would render treatment implications of comorbidity, not otherwise specified (NOS) and subdefinitional threshold anxiety disorder conditions moot. We now propose an evaluation of the efficacy of the UP in a group of patients with heterogeneous anxiety disorders by way of rigorous comparisons to existing evidence based SDPs benchmarked against a wait list control condition, using both statistical equivalence and superiority analyses. Additional aims include determining the durability of the UP relative to comparison conditions after treatment discontinuation, and ascertaining the differential impact of treatments on disorder specific symptoms vs. higher-order temperamental variables. Further analyses will indicate if changes in these higher order temperamental variables mediate long-term outcome as preliminary data suggests, and if this mechanism of action differs among treatments.