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: 8967180
• 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/8967180
• 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; 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; improved outcome; inclusion criteria; individualized medicine; meetings; symposium; symptomatic improvement; symptomatology; 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，为患有抑郁和焦虑障碍的退伍军人提供循证心理治疗，并完成相关研究项目，以更好地了解和改善患有这些障碍的退伍军人的临床结果。到目前为止，格罗斯博士已经撰写了43篇同行评议的出版物，并在国家和国际社会的会议上发表了32次会议演讲。格罗斯博士还担任过两次DVA功勋奖的联合调查员。近期和长期的职业目标：格罗斯博士的长期职业目标包括提高对患有抑郁症和焦虑症的退伍军人进行循证心理治疗的有效性、效率、传播和实施。与这些长期目标一致，格罗斯博士的DVA职业发展奖(CDA)建议对患有抑郁/焦虑障碍的退伍军人进行单一的统一跨诊断认知行为疗法(CBT)评估，以改善临床结果并减少共病，与基于证据的心理治疗控制条件下的行为激活治疗(BAT)相比。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还将在随机对照试验(RCT)中提供重要的培训，包括先进的方法、实施、统计评估和资质。专业课程、与导师的预定时间以及实践培训将被用来增强格罗斯博士在这些领域的背景。研究计划的相关性：CBT在治疗患有严重抑郁和焦虑症状的退伍军人方面非常有效。然而，CBT没有得到充分利用，很大程度上是因为跨障碍方案的复杂性和数量，以及应用这些方案所需的广泛培训。这些限制减少了退伍军人接受CBT的机会，导致较差的临床结果和生活质量。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，以改善获得护理的机会，方法是将现有的针对情绪问题的特定障碍CBT协议提炼成适用于绝大多数抑郁/焦虑障碍表现的统一CBT协议。研究计划的主要目的：拟议的CDA研究旨在：1)比较跨诊断CBT与BAT控制条件在减轻心理健康症状和提高生活质量方面的有效性，以及2)比较跨诊断CBT与BAT控制条件的可行性和可接受性。参与人群：拟议研究的参与者将包括96名患有抑郁/焦虑症的DVA患者。一般纳入标准包括：1)抑郁症/焦虑症的主要诊断；以及2)为参与研究提供知情同意的意愿和能力。要使用的程序：将完成跨诊断CBT和BAT控制条件的RCT。参与随机对照试验将包括完成：1)同意文件，2)摄入量评估，3)随机分配治疗条件，4)每周50分钟的个别心理治疗，为期12-16周，5)摄入量时症状和生活质量的自我报告评估，治疗后一周，以及6个月的随访。对退伍军人医疗保健的预期影响：如果成功，这项拟议的项目将通过这一新的跨诊断CBT方案最终改善循证CBT的获得和可用性，从而降低DVA抑郁症/焦虑症患者的症状、共病，并改善生活质量和康复。