Brief Enhanced Anxiety Sensitivity Treatment: A Pilot Study

项目摘要 焦虑敏感度升高的退伍军人可能会在以下情况下遭受不成比例和不必要的痛苦。 2019冠状病毒病疫情。除了情绪上的痛苦，这可能会表现在功能障碍。 应对这一潜在危机需要传播针对风险因素的干预措施， 焦虑和功能障碍，而不会使已经征税的心理健康服务管道过载。 焦虑敏感性，或对焦虑感觉的恐惧，是一种加剧焦虑的跨诊断风险因素， 导致功能障碍，并增加焦虑和功能之间的关系的强度 损伤因此，焦虑敏感性是一个理想的目标，以恢复功能的退伍军人与报告 功能障碍我们小组的初步数据表明， COVID-19是常见的，持久的，并通过焦虑敏感性水平预测，这表明迫切需要 介入此外，有强有力的证据表明，焦虑敏感性是可塑性使用认知行为 治疗技术，即使是在简短的，一个会话的干预提供。我们的小组已经展示了一个简短的- 会话干预是有效的，并且被参与者评为可接受。远程保健的使用增加 退伍军人医疗保健管理局的移动的应用程序为这一简短的证据提供了机会- 应广泛传播基于基础的干预措施。拟议中的研究将是第一个适应和测试简报 增强焦虑敏感性治疗（BEAST）用于焦虑升高的退伍军人的功能障碍 灵敏度BEAST包括一次会议干预，包括关于 焦虑，识别和挑战关于焦虑感觉的常见适应不良想法，以及 内感受性暴露来证明焦虑的良性本质。BEAST还包括为期两周的 生态瞬时干预成分，旨在提供生态有效的实践机会 在一次会议中获得的技能。这项可行性和可接受性试验的拟议目标是 1）调整BEAST，使其通过远程医疗和移动的应用程序与利益相关者和中心合作提供 移动的应用研究资源和服务，2）试点测试干预的可接受性， 可行性RR&D Small Projects in Rehabilitation Research（SPiRE） RFA RX-22-003。我们的目标是退伍军人的功能障碍，焦虑敏感性升高， 在焦虑症患者中的发现。这项试点试验的结果将提供必要的证明 BEAST及其组成部件的可接受性、可行性和可用性。这将使我们能够 尽快进行一项充分的随机对照试验，以证明BEAST的疗效，然后 传播试验传播一个简短的焦虑敏感性干预将代表一个重大的进步 用于治疗引起焦虑和相关病症以及损伤的跨诊断成分 并可能产生巨大的公共卫生影响。

Project Summary Veterans with elevated anxiety sensitivity are likely to suffer disproportionately and unnecessarily following the COVID-19 pandemic. Beyond the emotional suffering, this will likely manifest in functional impairment. Addressing this potential crisis requires dissemination of interventions targeting risk factors that maintain anxiety and functional impairment without overloading an already taxed mental health services pipeline. Anxiety sensitivity, or fear of anxiety sensations, is a transdiagnostic risk factor that exacerbates anxiety, results in functional impairment, and increases the strength of the relation between anxiety and functional impairment. Thus, anxiety sensitivity is an ideal target to restore functioning in Veterans with reporting functional impairment. Preliminary data by our group has demonstrated that functional impairment due to COVID-19 is common, enduring, and is predicted by levels of anxiety sensitivity, suggesting a critical need to intervene. Further, there is robust evidence that anxiety sensitivity is malleable using cognitive-behavioral therapy techniques, even when delivered in brief, one-session interventions. Our group has shown brief one- session interventions are efficacious and rated as acceptable by participants. The increased use of telehealth and mobile apps in the Veterans Healthcare Administration provides an opportunity for this brief evidence- based intervention to be disseminated broadly. The proposed study will be the first to adapt and test Brief Enhanced Anxiety Sensitivity Treatment (BEAST) for functional impairment in Veterans with elevated anxiety sensitivity. BEAST comprises a one-session intervention including psychoeducation about the nature of anxiety, identification and challenging of common maladaptive thoughts about anxiety sensations, and interoceptive exposure to demonstrate the benign nature of anxiety. BEAST also includes a two-week ecological momentary intervention component designed to provide ecologically valid opportunities to practice the skills acquired during the one session. The proposed aims in this pilot feasibility and acceptability trial are to 1) adapt BEAST to be delivered via telehealth and a mobile app working with stakeholders and the Center for Mobile Applications Research Resources & Services and 2) pilot test the intervention for acceptability and feasibility. This application is directly responsive to RR&D Small Projects in Rehabilitation Research (SPiRE) RFA RX-22-003. We target functional impairment in Veterans with elevated anxiety sensitivity, a common finding in people with anxiety disorders. Findings from this pilot trial will provide the necessary demonstration of acceptability, feasibility, and usability of BEAST and its constituent components. This will allow us to expeditiously conduct a fully powered randomized control trial to demonstrate efficacy of BEAST and then a dissemination trial. Disseminating a brief anxiety sensitivity intervention would represent a significant advance for treatment of a transdiagnostic component underlying anxiety and related conditions as well as impairment and could yield tremendous public health impact.