Efficacy Evaluation of a Unified Transdiagnostic Treatment for Anxiety Disorders

焦虑症统一跨诊断治疗的疗效评估

• 批准号: 8207886
• 负责人: David H. Barlow
• 金额: $ 58.61万
• 依托单位: BOSTON UNIVERSITY (CHARLES RIVER CAMPUS)
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-12-24 至 2015-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8207886
• 关键词: Acute; Address; Aftercare; Anxiety; Anxiety Disorders; Behavior; Benchmarking; Categories; Chronic; Comorbidity; Country; DSM-IV; Data; Depressive disorder; Diagnosis; Diagnostic; Disease; Emotional disorder; Epidemiologic Studies; Etiology; Individual; Knowledge; Lead; Light; Mediating; Mediator of activation protein; Mental disorders; Nature; Neurotic Disorders; Outcome; Outcome Measure; Patients; Pattern; Pharmacological Treatment; Phase; Prevalence; Procedures; Process; Protocols documentation; Public Health; Quality of life; Regulation; Relative (related person); Robin bird; Sampling; Selective Serotonin Reuptake Inhibitor; Severities; Specific qualifier value; Structure; Surveys; Symptoms; Time; Training; Treatment Efficacy; Treatment Protocols; Treatment outcome; Waiting Lists; active method; base; cost effective; efficacy evaluation; evidence base; follow-up; improved; indexing; innovation; novel; psychologic; public health relevance; treatment effect; treatment response; treatment strategy

DESCRIPTION (provided by applicant): Anxiety disorders are common, chronic, costly, debilitating to quality of life, and are more prevalent than any other class of disorders in every country in the world where surveys have been taken. Deepening understanding of the nature of anxiety and related emotional disorders during the last decade has revealed that commonalities in etiology and latent structure among these disorders supersedes differences. At the same time, examination of extant single diagnosis psychological treatment protocols (SDPs) for these disorders underscores mechanistic similarities. These findings suggested the possibility of distilling a set of psychological procedures that would comprise an innovative Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP), and this protocol has now been developed. If efficacious, the UP may represent a more efficient and possibly more effective strategy which would render treatment implications of comorbidity, not otherwise specified (NOS) and subdefinitional threshold anxiety disorder conditions moot. We now propose an evaluation of the efficacy of the UP in a group of patients with heterogeneous anxiety disorders by way of rigorous comparisons to existing evidence based SDPs benchmarked against a wait list control condition, using both statistical equivalence and superiority analyses. Additional aims include determining the durability of the UP relative to comparison conditions after treatment discontinuation, and ascertaining the differential impact of treatments on disorder specific symptoms vs. higher-order temperamental variables. Further analyses will indicate if changes in these higher order temperamental variables mediate long-term outcome as preliminary data suggests, and if this mechanism of action differs among treatments. PUBLIC HEALTH RELEVANCE: This study addresses an important public health issue by evaluating a novel and promising new transdiagnostic treatment strategy for common and disabling mental disorders, specifically the anxiety disorders. This information will answer important theoretical questions about the mechanism of treatment change, and might lead to more efficacious, cost-effective, and easily disseminable treatment strategies for some of the most prevalent mental disorders.

描述（由申请人提供）：焦虑症是常见的、慢性的、昂贵的、降低生活质量的疾病，并且在进行调查的世界上每个国家都比任何其他类型的疾病更为普遍。过去十年对焦虑和相关情绪障碍本质的深入了解表明，这些疾病在病因学和潜在结构上的共性取代了差异。与此同时，对这些疾病的现有单一诊断心理治疗方案（SDP）的检查强调了机制上的相似性。这些发现表明有可能提炼出一套心理程序，其中包括一个创新的情绪障碍跨诊断治疗统一方案（UP），并且该方案现已开发出来。如果有效，UP可能代表一种更有效且可能更有效的策略，这将使共病、未另行指定的（NOS）和亚定义阈值焦虑症病症的治疗意义变得毫无意义。现在，我们建议通过与以等待名单控制条件为基准的现有基于证据的 SDP 进行严格比较，使用统计等效性和优越性分析来评估 UP 在一组异质性焦虑症患者中的疗效。其他目标包括确定治疗停止后相对于比较条件的 UP 的持久性，并确定治疗对疾病特定症状与高阶气质变量的差异影响。进一步的分析将表明这些高阶气质变量的变化是否如初步数据所表明的那样介导长期结果，以及这种作用机制在治疗之间是否有所不同。 公共卫生相关性：本研究通过评估针对常见和致残性精神障碍（特别是焦虑症）的一种新颖且有前景的跨诊断治疗策略，解决了一个重要的公共卫生问题。这些信息将回答有关治疗改变机制的重要理论问题，并可能为一些最流行的精神障碍制定更有效、更具成本效益且易于传播的治疗策略。