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结果比较 对源自认知的一种非常有前途的治疗方法的研究 恐慌模型 (CMP) 与应用放松训练治疗 恐慌症与广场恐惧症（PDA）。全面评估电池 将在治疗前、治疗中、治疗后以及 3、6、12 和 24 个月的随访以监测治疗效果、临床情况 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、心理调整、复发和出现 任何精神疾病。 48 名患者，符合 DSM-III-R PDA 的标准，将被随机分配给治疗。协议 治疗师的治疗完整性将受到客观监测， 不同治疗方法之间可以相互平衡。自我定向曝光的作用 实践、婚姻调整、反应概况、索引- 不一致，需要临时治疗和加强治疗 不同条件下的比较。此外，临床影响 将通过将接受治疗的患者与正常患者进行比较来检查治疗， 非恐惧症群体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、方法和 关于其短期和长期疗效的临床研究问题 这种慢性且严重的焦虑症，估计会影响 5-11 人 百万美国人。 Lyl+B 细胞是在细胞生物学中至关重要的独特亚群 自身免疫、免疫缺陷和 B 细胞恶性肿瘤的发展。这 这笔赠款的目的是研究免疫调节作用 从 NZB 小鼠脾脏获得的超二倍体 Ly1+B 细胞。 将在细胞转移实验中研究免疫调节 超二倍体脾Lyl+B细胞将被输注到 未受辐射的自身免疫和非自身免疫接受者。染色体标记 表明在这些受体中发现的唯一长寿的供体细胞是 超二倍体 LYI+B 细胞。体内转移LYI+B细胞的效果 受体抗体的产生既自发产生自身抗体， 外源抗原的抗体和受体 B 细胞亚群将 评估。超二倍体 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基因家族的使用。这些 结果将与常规腹膜二倍体Ly1+B细胞V进行比较 基因的使用。实验将确定年轻 NZB 中是否存在二倍体 Ly1+B 细胞 小鼠发育成超二倍体 Ly1+B 细胞的基因编程方式 或对环境刺激作出反应。脾超二倍体 Lyl+B 细胞提供了研究发育和功能的独特机会 自发产生的单一 B 细胞群。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 允许在人类中独立识别的异常染色体标记 免疫疾病，如类风湿性关节炎、Leul+ B 细胞（人类类似物） Lyl+ B 细胞）升高。此外，许多细胞中的恶性细胞 慢性淋巴细胞白血病已被确定为 Leu1+ B 细胞。因为 这种独特的 B 细胞亚型对于自身免疫患者非常重要 和恶性肿瘤，拟对小鼠类似物 Lyl- 的作用进行研究 B细胞，在免疫调节中具有重要的临床意义。一个 理解Lyl+B细胞的免疫调节机制可能会导致 疾病的新治疗干预。