Information Processing Training for Social Phobia in Primary Care

描述（由申请人提供）：社交恐惧症（SP）在所有精神疾病中发病率排名第二，并与严重损害相关。焦虑症患者更有可能向普通内科医生寻求治疗，而不是心理健康专家。然而，只有不到三分之一的焦虑症初级保健患者得到适当的护理。在接受治疗的患者中，许多患者没有反应。计算机信息处理训练是一种很有前途的焦虑障碍干预手段，它牢固地建立在认知理论和实证研究的基础上。计算机信息处理训练程序直接针对与SP相关的注意和解释偏差。这些程序可以提高焦虑障碍心理治疗的成本效益和可及性。这条研究路线的长期目标是将基础精神病理学研究的发现转化为创新的治疗方法，这些治疗方法是可接受的，并且易于在现实世界中传播。第二个长期目标是为患有焦虑症的初级保健人群开发基于经验的治疗方法。本研究的具体目的是通过比较一种创新干预，即注意和解释修正（AIM）与安慰剂条件，来确定初级保健环境中信息处理训练的可接受性、可行性和初步效果。可接受性将主要通过定性访谈来确定。可行性将根据完成状态和其他定性数据来确定。初步疗效将用效应量来估计。具体来说，假设与安慰剂相比，通过访谈、自我报告和行为测量评估，完成AIM的参与者将体验到社交焦虑症状的减轻。最近，社交恐惧症的患病率估计很高，在所有精神疾病中排名第二。社交恐惧症对个人健康造成严重损害，对社会造成经济负担。由于大多数焦虑症患者都在初级保健中寻求治疗，因此评估初级保健中社交恐惧症的创新治疗方法的研究可能会降低医疗保健的成本和利用率。

DESCRIPTION (provided by applicant): Social Phobia (SP) ranks second in prevalence among all psychiatric disorders and is associated with significant impairment. Anxiety disorder patients are more likely to seek treatment from general medical physicians than mental health specialists. However, less than one third of primary care patients with anxiety disorders receive appropriate care. Of those who do receive treatment, many patients do not respond. Computerized information processing training is a promising intervention for anxiety disorders that is firmly based in cognitive theory and empirical findings. Computerized information processing training procedures directly target attention and interpretation biases associated with SP. These procedures may improve the cost-effectiveness and accessibility of psychological treatments for anxiety disorders. The long-term goal of this line of research is to translate findings from basic psychopathology research into innovative treatments that are acceptable and easily disseminated in real world settings. The second long-term objective is to develop empirically based treatments for primary care populations with anxiety disorders. The specific aims of the study are to determine the acceptability, feasibility, and preliminary efficacy of information processing training in a primary care setting by comparing an innovative intervention, Attention and Interpretation Modification (AIM), to a placebo condition. Acceptability will be determined primarily from qualitative interviews. Feasibility will be determined by completer status and other qualitative data. Preliminary efficacy will be estimated with effect sizes. Specifically, it is hypothesized that participants completing AIM will experience a reduction in social anxiety symptoms, as assessed by interview, self-report, and behavioral measures, compared to placebo. Relevance to Public Health Recent prevalence estimates of Social Phobia are high, ranking second among all psychiatric disorders. Social Phobia results in significant impairment to~ the individual and in economic burden to society. Because most individuals with anxiety disorders seek treatment in primary care, research evaluating innovative treatments for Social Phobia in primary care will potentially reduce health care costs and utilization.