Attention Training and Relaxation for GAD: Testing the Efficacy of Home-Delivery

GAD 的注意力训练和放松：测试送货上门的效果

• 批准号: 7988092
• 负责人: NADER AMIR
• 金额: $ 34.76万
• 依托单位: SAN DIEGO STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-06-11 至 2015-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7988092
• 关键词: Address; Aftercare; Anxiety; Attention; Behavioral; Burn injury; Characteristics; Clinical; Computers; Controlled Clinical Trials; Cues; Data; Development; Diagnostic; Economics; Educational process of instructing; Effectiveness; Evidence based intervention; Evidence based treatment; Failure; Generalized Anxiety Disorder; Guidelines; Health; Health Priorities; Home environment; Impairment; Individual; Intervention; Interviewer; Learning; Literature; Measures; Medical; Methods; Modification; Monitor; Mood Disorders; National Institute of Mental Health; Participant; Patient Self-Report; Pharmacological Treatment; Physiological; Population; Prevalence; Public Health; Quality of life; Randomized; Relative (related person); Relaxation; Relaxation Therapy; Reporting; Research Priority; Services; Stimulus; Symptoms; Testing; Time; Training; Translating; Transportation; Treatment outcome; United States Health Resources and Services Administration; Work; active method; base; clinically significant; computerized; cost; design; economic cost; effective therapy; efficacy testing; follow-up; innovation; innovative technologies; meetings; primary care setting; primary outcome; programs; psychosocial; public health relevance; skills; therapy design; therapy development; treatment effect; treatment program; treatment response; user-friendly

DESCRIPTION (provided by applicant): Generalized Anxiety Disorder (GAD) is characterized by excessive, uncontrollable worry (Barlow, et al., 1986) leading to medical over-utilization, poor perceived health, low ratings of quality of life, and impairment at work that result in a significant economic and public health impact (Ballenger et al., 2001; Hoffman et al., 2008; Wittchen, 2002). Lifetime prevalence of GAD is high (5.7%, Kessler et al., 2005; 8.5% in primary care setting, Roy-Byrne & Wager, 2004). Although efficacious psychosocial and pharmacological treatments for GAD exist (for a reviews see Nutt, et al., 2002), the majority of these individuals do not access our most effective treatments (Collins et al., 2004) and treatment-seeking delays are longest for this condition relative to other anxiety and mood disorders (i.e., 14 years from the time of onset; Kessler et al., 1998). The substantial delays in treatment seeking, failure to access evidence-based treatments and overutilization of medical services, result in prolonged personal and economic costs. Thus, there is a significant unmet need for the development of efficient and cost-effective treatments that have the potential to be widely accessible to individuals with GAD. The current proposal directly responds to the NIMH priorities for evaluating user-friendly interventions and non- traditional delivery methods to increase access to evidence-based interventions. We will evaluate the efficacy of a 12-week computer-delivered home-based treatment program for GAD. Treatment will comprise a combination of two interventions shown to be efficacious in the treatment of GAD. The Attention Modification Program (AMP) is a computerized program designed to facilitate attention disengagement from threatening stimuli (Amir et al., 2009). Applied Relaxation (AR) is a behavioral, skills-based intervention where individuals learn ways to reduce the physiological cues associated with anxiety and worry (Vst, 1987; Siev & Chambless, 2007). Following the recommended guidelines of the NIMH Workgroup on Psychosocial Intervention Development (Hollon et al., 2002), we review evidence suggesting that both treatments are ideal candidates for the efficient, economical, and widespread transportation of evidence-based treatments for GAD. This proposal has the potential for a significant public health impact by evaluating a new method for delivering evidence-based interventions for hard-to-reach populations through the use of innovative technologies. PUBLIC HEALTH RELEVANCE: Generalized anxiety disorder (GAD) is a prevalent and debilitating psychiatric condition associated with low rates of accessing evidence-based treatments that result in prolonged personal and economic costs. Thus, there is a significant unmet need for development of efficient and cost-effective treatments that are widely accessible to individuals suffering with this condition. The current proposal aims to address these issues by evaluating the feasibility and effectiveness of a computer-delivered home- based treatment program for GAD that comprises a combination of two interventions shown to be efficacious in the treatment of GAD (i.e., attention training and applied relaxation).

描述（由申请人提供）：广义焦虑症（GAD）的特征是过度，无法控制的忧虑（Barlow等，1986）导致医疗过度利用，感知不良的健康，生活质量低的生活质量和工作障碍的评级以及在工作中产生了重大的经济和公共健康影响（Ballenger等人，2001年，2001年； Hoffman等人，2002年； 2008年）。 GAD的终生患病率很高（5.7％，Kessler等，2005；在初级保健环境中8.5％，Roy-Byrne＆Wager，2004）。尽管存在有效的GAD心理社会和药理学治疗（有关评论，请参见Nutt等，2002），但这些人中的大多数无法获得我们最有效的治疗方法（Collins等，2004）和寻求治疗的延迟是此条件相对于其他焦虑和情绪障碍的最长时间（即，从其他焦虑和情绪障碍（即，距离Onser of On Senser of Onsel of Onsel exsler exsler exsler exsler; Kess et sess ets and sess and；寻求治疗，无法获得基于证据的治疗以及对医疗服务过度利用的实质性延迟，导致了长期的个人和经济成本。因此，有很大的未满足需要开发有效且具有成本效益的治疗方法，这些治疗有可能被GAD的个体广泛使用。当前的提案直接响应了NIMH的优先级，以评估用户友好的干预措施和非传统交付方法，以增加获得基于证据的干预措施的机会。我们将评估为GAD提供12周的基于计算机的家庭治疗计划的功效。治疗将包括两种干预措施的组合，这些干预措施在治疗GAD方面有效。注意修改程序（AMP）是一个计算机化程序，旨在促进威胁刺激的注意力（Amir等，2009）。应用放松（AR）是一种基于行为，基于技能的干预措施，个人学习减少与焦虑和忧虑相关的生理线索的方法（VST，1987； Siev＆Chambless，2007）。遵循NIMH工作组的推荐指南（Hollon等，2002），我们回顾了证据，表明这两种治疗方法都是高效，经济和广泛运输GAD的理想候选者。该提案通过评估一种新方法来通过使用创新技术来为难以到达的人群提供基于证据的干预措施，从而产生重大的公共卫生影响。 公共卫生相关性：普遍的焦虑症（GAD）是一种普遍且令人衰弱的精神病疾病，与较低的循证治疗率相关，导致个人和经济成本延长。因此，有很大的未满足需要开发有效且具有成本效益的治疗方法，这些治疗可被患有这种情况的人广泛使用。当前的提案旨在通过评估GAD的计算机基于家庭基础治疗计划的可行性和有效性来解决这些问题，该计划包括两种干预措施，这些干预措施在治疗GAD方面有效（即注意培训和应用放松）。