An RCT of Acceptance-based Behavior Therapy for GAD

基于接受的行为疗法治疗广泛性焦虑症的随机对照试验

• 批准号: 7579876
• 负责人: LIZABETH ROEMER
• 金额: $ 43.94万
• 依托单位: UNIVERSITY OF MASSACHUSETTS BOSTON
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-03-01 至 2012-02-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7579876
• 关键词: Address; Anxiety; Anxiety Disorders; Area; Behavior Therapy; Behavioral; Chronic Disease; Client; Climacteric; Cognitive; Combined Modality Therapy; Comorbidity; Compassion; Disease; Effectiveness; Elements; Emotions; Fright; Future; Generalized Anxiety Disorder; Health; Health Care Costs; Impairment; Individual; Intervention; Measures; Mediating; Minority; Mood Disorders; Pharmaceutical Preparations; Population; Quality of life; Randomized; Randomized Controlled Trials; Recruitment Activity; Relaxation; Research; Role; Self Perception; Symptoms; Treatment Efficacy; Water; Work; active method; base; clinically significant; cost; depression; design; ethnic minority population; follow up assessment; follow-up; functional disability; health care service utilization; meetings; mindfulness; primary outcome; psychosocial; response; secondary outcome; theories; treatment effect; trial comparing

DESCRIPTION (provided by applicant): Generalized anxiety disorder (GAD) is a chronic disorder that has been associated with significant psychosocial impairment, as well as health-care utilization/cost. Further, it is a highly comorbid disorder, and has been posited to be the basic anxiety disorder, which increases vulnerability for other anxiety and mood disorders. Despite the significant health impact of this disorder, it is currently the anxiety disorder for which existing treatments have demonstrated the least effectiveness. Cognitive-behavioral treatments have demonstrated the most efficacy to date; yet studies commonly find that less than half those treated meet criteria for high end state functioning after a follow-up period, indicating that more efficacious treatments are needed. In addition, very few studies have addressed the effect of treatment on quality of life and functioning or assessed gains over a long follow-up period. Current theory and research in the area of worry and GAD highlights the role of cognitive/experiential avoidance in this disorder, suggesting that an integrative treatment that combines elements of traditional cognitive-behavioral approaches with mindfulness/acceptance-based elements from other behavioral treatments may be beneficial with this population. Recent pilot work suggests that an acceptance-based behavior therapy specifically designed to target presenting problems in GAD results in significant reductions in symptomatology and increases in quality of life and that these changes are significantly greater than changes that occur over a waitlist period. The current application aims to further investigate the efficacy of this intervention by comparing it to Applied Relaxation, an intervention with demonstrated efficacy in treating GAD. We will randomly assign 126 individuals who meet criteria for GAD (as well as comorbid disorders, providing GAD is principal) to receive one of these two treatments. We will examine whether acceptance-based behavior therapy leads to significantly greater reductions in symptoms and increases in quality of life and functioning at post and across 24 months of follow up assessments. We will also determine the proportion of individuals who meet high end state functioning in each treatment, and we will explore whether treatment effects are comparable among ethnic minority individuals (who we will make considerable efforts to recruit) and non-minority individuals. Finally, we will explore whether treatment effects are due to proposed mechanisms of change (experiential acceptance, mindfulness) as well as potential predictors of response among either or both treatments. Findings will have important implications in terms of determining maximally efficacious interventions for GAD and guiding future research in this area.

描述（由申请人提供）：广义焦虑症（GAD）是一种慢性疾病，与重大的社会心理障碍以及医疗保健利用/成本有关。此外，这是一种高度合并症，并被认为是基本焦虑症，它增加了其他焦虑和情绪障碍的脆弱性。尽管这种疾病对健康产生了重大影响，但目前正是现有治疗的焦虑症表现出最小的有效性。认知行为治疗表明迄今为止的功效最大。然而，研究通常发现，在随访期之后，经过治疗的人数不到一半符合高端状态功能的标准，这表明需要更有效的治疗方法。此外，很少有研究能够解决治疗对生活质量以及在漫长的随访期内的影响或评估收益的影响。当前的忧虑和GAD领域的理论和研究突出了认知/体验式回避在这种疾病中的作用，这表明将传统认知行为方法的要素与其他行为治疗中基于正念/接受的元素结合在一起的综合治疗可能对人群有益。最近的试点工作表明，一种基于接受的行为疗法专门设计用于针对GAD中的问题，导致症状学和生活质量的增加显着降低，并且这些变化明显大于候补名单时期发生的变化。当前的应用旨在通过将其与应用放松的效果进行进一步研究，这是一种在治疗GAD方面具有功效的干预措施。我们将随机分配符合GAD标准的126个人（以及合并症，提供GAD是校长），以接受这两种治疗方法之一。我们将研究基于接受的行为疗法是否会导致症状的减少以及在后续24个月的随访评估中的生活质量和生活质量的提高。我们还将确定在每种治疗中符合高端状态功能的个人的比例，我们将探讨治疗效果是否在少数族裔个人（我们将大力努力招募）和非少数人的个人中是否具有可比性。最后，我们将探讨治疗效果是否是由于提出的变化机制（经验验收，正念）以及两种处理之间反应的潜在预测指标。在确定GAD的最大有效干预措施方面，发现将具有重要的含义，并指导该领域的未来研究。