COGNITIVE MODEL OF PANIC DISORDER WITH AGORAPHOBIA

伴有广场恐惧症的恐慌症认知模型

• 批准号: 3386582
• 负责人: LARRY MICHELSON
• 金额: $ 28.07万
• 依托单位: PENNSYLVANIA STATE UNIVERSITY, THE
• 依托单位国家: 美国
• 财政年份: 1989
• 资助国家: 美国
• 起止时间: 1989-09-15 至 1992-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/3386582
• 关键词: behavior modification; chronic disease /disorder; clinical anxiety; cognition; human subject; human therapy evaluation; longitudinal human study; mental disorder diagnosis; mental disorders; psychological stressor; relapse /recurrence; relaxation; stress

The primary objective of this proposal is to conduct comparative outcome investigation of a highly promising treatment derived from the Cognitive Model of Panic (CMP) vs. applied Relaxation Training in the treatment of Panic Disorder with Agoraphobia (PDA). A comprehensive assessment battery will be administered at pre, mid, posttreatment and at 3, 6, 12, and 24-month follow-ups to monitor the treatments' efficacy, clinical significance and generalization. The mediating influence of stressful life events and individual differences will be examined. Longitudinal monitoring will delineate cognitive, behaviotal, physiological, and psychological adjustment, relapse and the emergence of any psychiatric disorders. Forty-eight patients, meeting DSM-III-R criteria for PDA, will be randomly assigned to the treatments. Protocol therapists, whose treatment integrity will be objectively monitored, will be counterbalanced across treatments. The role of self-directed exposure practice, marital adjustment, response profiles, concordance- disconcordance, need for interim treatment and booster sessions will be compared across conditions. Moreover, the clinical impact of the treatments will be examined by comparing treated patients to normative, non-phobic cohorts as well as using formal clinical significance testing. The proposed study will address critical conceptual, methodological and clinical-research issues regarding their short and long-term efficacy for this chronic and severe anxiety disorder, estimated to afflict 5-11 million Americans. Lyl+B cells are a unique subpopulation of critical importance in the development of autoimmunity, immunodeficiency and B cell malignancy. The goal of this grant is to investigate the immunoregulatory role of hyperdiploid Ly1+B cells obtained from the spleens of NZB mice. Immunoregulation will be investigated in cell transfer experiments in which hyperdiploid splenic Lyl+B cells will be transfused into unirradiated autoimmune and non-autoimmune recipients. Chromosome markers show that the only long-lived donor cells found in these recipients are hyperdiploid LYI+B cells. The effect of in vivo transferred LYI+B cells recipient antibody production both spontaneously produced autoantibody and antibody to exogenous antigens,and recipient B cells subpopulations will be assessed. Hyperdiploid Ly1+B cell hybridomas as well as purified Ly1+B cell will be studied for antibody specificity and VH gene family usage. These results will be compared with conventional peritoneal diploid Ly1+B cell V gene usage. Experiments will determine if diploid Ly1+B cells in young NZB mice develop into hyperdiploid Ly1+B cells genetically programmed fashion or in response to environmental stimuli. The splenic hyperdiploid Lyl+B cells offer a unique opportunity to study the development and function of a singular population of spontaneous occurring B cells. These cells can be used to investigate the role of Ly1+b cells in vivo by virtue of their selective growth advantage and abnormal chromosome markers which allow independent identification in human immune disorders such as rheumatoid artheitis, Leul+ B cells (human analog of Lyl+ B cells) are elevated. In addition, the malignant cell in many chronic lymohocytic leukemias has been identified as a Leu1+ B cell. Becaus this unique subulation of B cells is important in patients with autoimmunit and malignancy, the proposed studies of the role of the murine analog, Lyl- B cells, in immune regulation have important clinical relevance. An uhderitanding of the mechanism of immunoregulation by Lyl+B cells may lead to novel therapeutic intervention in disease.

该提案的主要目的是进行比较结果 对来自认知的高度有希望的治疗的研究 恐慌模型（CMP）与应用的放松训练 恐慌症的恐慌症（PDA）。全面的评估电池 将在前，中期，治疗后和3、6、12进行管理 24个月的随访，以监测治疗疗效的临床功效 意义和概括。压力的中介影响 将检查生活事件和个体差异。 纵向监测将描述认知，行为， 生理和心理调整，复发和出现 任何精神疾病。 48名患者，遇到DSM-III-R PDA的标准将随机分配给治疗。协议 治疗师的治疗完整性将受到客观监控，将 在治疗中保持平衡。自我指导的曝光作用 练习，婚姻调整，反应概况，一致性 - 脱节，需要临时治疗和助推器会议 在各种条件下进行比较。此外， 将通过将治疗患者与规范性治疗的患者进行比较，检查治疗 无恐怖的队列以及使用正式的临床意义测试。 拟议的研究将解决关键的概念，方法论和 有关其短期和长期疗效的临床研究问题 这种慢性和严重的焦虑症，估计受苦5-11 百万美国人。 LYL+B细胞是对关键重要性的独特亚群 自身免疫，免疫缺陷和B细胞恶性肿瘤的发展。这 这笔赠款的目标是调查 从NZB小鼠的脾脏获得的高二倍体LY1+B细胞。 免疫调节将在细胞转移实验中研究 哪种高二倍体脾脏Lyl+B细胞将被输送到 未经辐射的自身免疫和非自动免疫接收者。染色体标记 表明这些受体中唯一发现的供体细胞是 高二倍体LYI+B细胞。体内转移LYI+B细胞的效果 受体抗体生产自发产生自身抗体和 外源抗原和受体B细胞亚群的抗体将是 评估。高二倍体LY1+B细胞杂交瘤以及纯化的LY1+B细胞 将研究抗体特异性和VH基因家族使用情况。这些 结果将与常规腹膜二倍体LY1+B细胞V进行比较 基因用法。实验将确定年轻NZB中的二倍体LY1+B细胞是否 小鼠发展成高二倍体LY1+B细胞遗传编程的时尚 或针对环境刺激。脾脏高二倍体Lyl+B 细胞提供了研究的独特机会来研究的发展和功能 自发发生的B细胞的奇异种群。这些细胞 可用于研究Ly1+B细胞在体内的作用 他们的选择性增长优势和 异常染色体标记物，允许人类独立鉴定 免疫疾病，例如类风湿蛛网膜炎，leul+ B细胞（人类类似物 Lyl+ B细胞的升高。另外，许多人的恶性细胞 慢性淋巴细胞性白血病已被确定为LEU1+ B细胞。 becaus B细胞的这种独特的亚型在自身免疫患者中很重要 和恶性肿瘤，提出的关于鼠类似物的作用的研究lyl- 在免疫调节中，B细胞具有重要的临床相关性。一个 Lyl+B细胞免疫调节机理的uhderitanding可能会导致 对疾病的新型治疗干预。