Emotion Regulation Therapy for Generalized Anxiety

描述（由申请人提供）：广泛性焦虑障碍（GAD）的特征是过度的、无法控制的担忧和显著的中枢神经系统觉醒。它是普遍的、慢性的，并与显著的功能损害相关（现在被认为与重度抑郁症相当）。认知行为疗法（CBT）治疗广泛性焦虑症已经证明了一定程度的疗效，但与CBT治疗其他焦虑和情绪障碍相比，结果令人失望。通常情况下，只有一半接受cbt治疗的患者能达到高终状态功能。显然需要对广泛性焦虑症进行更有效的社会心理治疗。目前可用的广泛性焦虑症的治疗方法可能没有取得令人满意的结果，因为它们没有充分针对广泛性焦虑症的基本困难。也就是说，他们试图平息过度的担忧和安静的躯体唤醒，但没有有效地解决这些症状。他们没有问，“为什么广泛性焦虑症患者认为担忧是一种管理情绪困扰的“有吸引力的”策略？”我们用情绪调节的方法来解决这个问题。我们小组对广泛性焦虑症患者的情绪失调进行了广泛的初步研究，结果表明，广泛性焦虑症患者在经历比其他人更强烈的厌恶情绪时，无法识别、描述或接受他们的情绪体验，对消极情绪和积极情绪的反应都不适应，而且当消极情绪出现时，他们感觉自己无法修复。此外，与没有广泛性焦虑症的人相比，他们在调节实验诱发的负面情绪方面表现出更大的困难。担心可能是一种战略性的努力，以避免恐惧和无法控制的情绪体验。因此，这项探索性研究拨款申请将开发和操作一种治疗广泛性焦虑症的方法，该方法将认知行为程序与提高患者情绪调节技能的技术相结合。该手册最初将由一组专家组成的专家小组在CBT、以情绪为中心的心理治疗方法、心理治疗整合和情绪调节方面进行开发，并将在公开临床试验和小规模随机临床试验中进一步发展。在这项工作中产生的数据将作为后续拨款申请的基础，以进一步评估这种情绪调节方法治疗广泛性焦虑症的效用。相关性：广泛性焦虑症是一种常见的精神健康问题，与严重的痛苦和损害有关。然而，目前的心理治疗方法并没有达到最佳效果，这可能是因为他们没有关注广泛性焦虑症的一个重要部分，即无法调节一个人的情绪体验。该应用程序将开发和测试一种手动治疗，该治疗结合了当前最好的认知行为程序和旨在帮助广泛性焦虑症患者更好地调节他们的情绪体验的技术。新开发的治疗方法将在一系列小型研究中进行评估。

DESCRIPTION (provided by applicant): Generalized Anxiety Disorder (GAD) is characterized by excessive, uncontrollable worry and significant central nervous system arousal. It is prevalent, chronic, and associated with significant functional impairment (now recognized as comparable to major depressive disorder). Cognitive-behavioral therapies (CBT) for GAD have demonstrated a degree of efficacy, but results have been disappointing when compared to CBT for other anxiety and mood disorders. Typically, only half of CBT-treated patients achieve high end-state functioning. More efficacious psychosocial treatments for GAD are clearly needed. Currently available treatments for GAD may have achieved less than satisfactory outcomes because they have not adequately targeted the essential difficulties that underlie GAD. That is, they have attempted to quell excessive worry and quiet somatic arousal but have not addressed these symptoms functionally. They have not asked, "Why does the person with GAD find worry an "appealing" strategy for managing emotional distress?" We take an emotional regulation approach to this question. Extensive preliminary research by our group on emotion dysregulation in GAD suggests that, while experiencing emotions as more intensely aversive than other people, persons with GAD are unable to identify, describe or accept their emotional experience, react maladaptively to both negative and positive emotions, and feel less able to repair negative moods when they occur. Furthermore, they demonstrate greater difficulties regulating experimentally induced negative emotions than persons without GAD. Worry may be a strategic effort to avoid feared and unmanageable emotional experience. Therefore, this exploratory research grant application will develop and manualize an approach to the treatment of GAD that integrates cognitive-behavioral procedures with techniques to increase patients' emotional regulation skills. The manual will be initially developed with the input of a panel of scientists expert in CBT, emotion-focused approaches to psychotherapy, psychotherapy integration, and emotion regulation and will be further developed in an open clinical trial and a small-scale randomized clinical trial. Data generated in this effort will serve as the basis for later grant applications to further evaluate the utility of this emotion regulation approach to treatment of GAD. Relevance: GAD is a common mental health problem associated with significant distress and impairment. However, current psychotherapeutic procedures have been less than optimally effective, and this may be because they have not focused on an important part of GAD, the inability to regulate one's emotional experience. This application will develop and test a manualized therapy that combines the best of current cognitive-behavioral procedures with techniques designed to help persons with GAD better regulate their emotional experience. The newly developed treatment will be evaluated in a series of small studies.