Efficacy Evaluation of a Unified Transdiagnostic Treatment for Anxiety Disorders

描述(由申请人提供)：焦虑症是一种常见的、慢性的、昂贵的、对生活质量造成损害的疾病，在世界上每一个进行过调查的国家中，焦虑症比任何其他类别的疾病更普遍。在过去的十年中，人们对焦虑和相关情绪障碍的本质的了解不断加深，揭示了这些障碍在病因和潜在结构上的共性取代了差异。同时，对现有的针对这些疾病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程序，其中包括一种创新的情绪障碍跨诊断治疗(UP)统一协议，该协议现在已经开发出来。如果有效，UP可能代表着一种更有效的策略，它将使未另行规定的共病(NOS)和亚定义阈值焦虑症的治疗意义变得毫无意义。我们现在建议对一组异质性焦虑症患者的UP的疗效进行评估，方法是通过与现有基于证据的SDP进行严格比较，并以等待名单控制条件为基准，使用统计等价性和优越性分析。其他目标包括确定停用治疗后UP相对于比较条件的持久性，以及确定治疗对障碍特定症状与高阶气质变量的不同影响。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表明的那样调节长期结果，以及这种作用机制是否在不同的治疗方案中有所不同。 公共卫生相关性：这项研究通过评估一种新的、有前景的跨诊断治疗策略来解决一个重要的公共卫生问题，以治疗常见和致残性精神障碍，特别是焦虑症。这些信息将回答有关治疗变化机制的重要理论问题，并可能导致一些最普遍的精神障碍的更有效、更具成本效益和更容易传播的治疗策略。

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. PUBLIC HEALTH RELEVANCE: This study addresses an important public health issue by evaluating a novel and promising new transdiagnostic treatment strategy for common and disabling mental disorders, specifically the anxiety disorders. This information will answer important theoretical questions about the mechanism of treatment change, and might lead to more efficacious, cost-effective, and easily disseminable treatment strategies for some of the most prevalent mental disorders.