Transdiagnostic Psychotherapy for Veterans with Mood and Anxiety Disorders

对患有情绪和焦虑症的退伍军人进行跨诊断心理治疗

• 批准号: 8813485
• 负责人: Daniel F. Gros
• 金额: --
• 依托单位: RALPH H JOHNSON VA MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-01-01 至 2018-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8813485
• 关键词: Address; Aftercare; Anxiety; Anxiety Disorders; Appointment; Area; Award; Behavior Therapy; Behavioral; Client satisfaction; Clinical; Clinical Trials; Cognitive Therapy; Comorbidity; Competence; Consent; Consultations; Depressive disorder; Diagnosis; Disease; Documentation; Dropout; Effectiveness; Emotional; Evaluation; Feedback; Focus Groups; Fright; Goals; Health Services Accessibility; Healthcare; Improve Access; Individual; Informed Consent; Intake; International; Intervention; Interview; K-Series Research Career Programs; Lead; Medical center; Mental Depression; Mental Health; Mentors; Mentorship; Methodology; Mood Disorders; Outcome; Panic; Participant; Patient Self-Report; Patients; Peer Review; Population; Procedures; Protocols documentation; Provider; Psychologist; Psychotherapy; Publications; Quality of Care; Quality of life; Questionnaires; Randomized Controlled Trials; Recovery; Research; Research Personnel; Research Project Grants; Schedule; Societies; Stress; Supervision; Symptoms; Testing; Time; Training; Veterans; Work; base; career; comparative efficacy; cost; cost effective; depressive symptoms; design; evidence base; experience; falls; flexibility; follow-up; improved; inclusion criteria; individualized medicine; meetings; public health relevance; symposium; therapy design; willingness

DESCRIPTION (provided by applicant): Research background: Over the past four years, Dr. Gros has worked as a Department of Veteran Affairs (DVA) Staff Psychologist, providing evidence-based psychotherapies to Veterans with depressive and anxiety disorders and completing related research projects to better understand and improve clinical outcomes in Veterans with these disorders. To date, Dr. Gros has authored 43 peer-reviewed publications and 32 conference presentations at meetings of national and international societies. Dr. Gros has also served as Co- Investigator on two DVA Merit Awards. Immediate and Long-Term Career Goals: Dr. Gros' long-term career goals involve improving the effectiveness, efficiency, dissemination, and implementation of evidence-based psychotherapy for Veterans with depressive and anxiety disorders. Consistent with these long-term goals, Dr. Gros' DVA Career Development Award (CDA) proposes to evaluate a single unified transdiagnostic cognitive behavioral therapy (CBT) in Veterans with depressive/anxiety disorders to improve clinical outcomes and reduce comorbidity as compared to an evidence-based psychotherapy control condition of behavioral activation treatment (BAT). Primary Aims in Career and Mentorship Plan: In order to accomplish these goals, Dr. Gros' CDA also will provide vital trainings in randomized controlled trials (RCTs), including advanced methodology, implementation, statistical evaluation, and grantsmanship. Specialized coursework, scheduled time with mentors, and hands-on trainings will be used to enhance Dr. Gros' background in each of these areas. Relevance of Research Plan: CBT is robustly effective in treating Veterans with severe symptoms of depression and anxiety. However, CBT is underutilized due in large part to the complexity and number of protocols across disorders, as well as extensive training needed to apply them. These limitations have reduced Veterans' access to CBT, resulting in poorer clinical outcomes and quality of life. To address these concerns, world renowned experts in the CBT field have been calling for a new transdiagnostic approach to treatment in order to improve access to care by distilling the existing disorder-specific CBT protocols for emotional problems into an unified CBT protocol for the great majority of depressive/anxiety disorder presentations. Primary Aims in Research Plan: The proposed CDA research aims to: 1) compare the efficacy of transdiagnostic CBT on reducing mental health symptoms and improving quality of life to the BAT control condition, and 2) compare the feasibility and acceptability of the transdiagnostic CBT to the BAT control condition. Participant population: The participants of the proposed study will include 96 DVA patients with depressive/anxiety disorders. General inclusion criteria includes: 1) a principal diagnosis of a depressive/anxiety disorder; and 2) a willingness and competence to provide informed consent for research participation. Procedures to be used: A RCT of the transdiagnostic CBT and BAT control condition will be completed. Participation in the RCT will involve completion of: 1) consent documentation, 2) intake assessment, 3) random assignment to treatment condition, 4) weekly 50 minute appointments of individual psychotherapy for 12-16 weeks, and 5) self-report assessments of symptomatology and quality life at intake, one week post-treatment, and 6-month follow-up. Anticipated Impacts on Veterans Health Care: If successful, this proposed project will lead to reduced symptomatology, comorbidity, and improved quality of life and recovery in DVA patients with depressive/anxiety disorders by eventually improving access to and availability of evidence-based CBT through this new transdiagnostic CBT protocol.

描述（由申请人提供）： 研究背景：在过去的四年里，格罗斯博士一直担任退伍军人事务部（DVA）的工作人员心理学家，为患有抑郁症和焦虑症的退伍军人提供循证心理治疗，并完成相关的研究项目，以更好地了解和改善患有这些疾病的退伍军人的临床结果。迄今为止，格罗斯博士已撰写了43篇同行评审的出版物，并在国家和国际学会会议上发表了32篇会议演讲。格罗斯博士还担任过两次DVA优异奖的共同研究员。近期和长期职业目标：Gros博士的长期职业目标涉及提高抑郁症和焦虑症退伍军人循证心理治疗的有效性，效率，传播和实施。与这些长期目标相一致，Gros博士的DVA职业发展奖（CDA）建议评估患有抑郁症/焦虑症的退伍军人的单一统一跨诊断认知行为疗法（CBT），以改善临床结果并减少与行为激活治疗（BAT）的循证心理治疗控制条件相比的并发症。职业生涯和导师计划的主要目标：为了实现这些目标，Gros博士的CDA还将提供随机对照试验（RCT）的重要培训，包括先进的方法学，实施，统计评估和granitarian。专门的课程，与导师的预定时间，和动手培训将用于提高博士格罗斯在每个这些领域的背景。研究计划的相关性：CBT在治疗有严重抑郁和焦虑症状的退伍军人方面非常有效。然而，CBT未得到充分利用，这在很大程度上是由于跨疾病的协议的复杂性和数量，以及应用它们所需的广泛培训。这些限制减少了退伍军人接受CBT的机会，导致临床结果和生活质量较差。为了解决这些问题，CBT领域的世界知名专家一直在呼吁一种新的跨诊断治疗方法，以通过将现有的针对情绪问题的疾病特定CBT协议提炼为针对绝大多数抑郁/焦虑症的统一CBT协议来改善护理。研究计划的主要目的：拟议的CDA研究旨在：1）将跨诊断CBT在减少心理健康症状和改善生活质量方面的疗效与BAT对照条件进行比较; 2）将跨诊断CBT的可行性和可接受性与BAT对照条件进行比较。受试者人群：拟定研究的受试者将包括96名患有抑郁/焦虑障碍的DVA患者。一般入选标准包括：1）抑郁/焦虑障碍的主要诊断;和2）提供参与研究的知情同意的意愿和能力。将使用的程序：将完成跨诊断CBT和BAT对照条件的RCT。参与RCT将涉及完成：1）知情同意文件，2）摄入评估，3）随机分配治疗条件，4）每周50分钟的个体心理治疗预约，持续12-16周，以及5）摄入时、治疗后1周和6个月随访时的自我报告评估。对退伍军人医疗保健的预期影响：如果成功的话，这个拟议的项目将通过最终改善循证CBT的获得和可用性，减少抑郁/焦虑症DVA患者的抑郁症，合并症，改善生活质量和恢复通过这个新的transdiagnosis CBT协议。