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基于计算机的家庭广泛性焦虑障碍治疗的可行性和推广:一项随机临床试验。

Feasibility and dissemination of a computerized home-based treatment for Generalized Anxiety Disorder: A randomized clinical trial.

机构信息

Joint Doctoral Program in Clinical Psychology, San Diego State University and University of California, San Diego, San Diego, CA, USA; Center for Understanding and Treating Anxiety (CUTA), San Diego State University, San Diego, CA, USA.

Center for Understanding and Treating Anxiety (CUTA), San Diego State University, San Diego, CA, USA.

出版信息

Behav Res Ther. 2019 Sep;120:103446. doi: 10.1016/j.brat.2019.103446. Epub 2019 Jul 26.

Abstract

Generalized Anxiety Disorder (GAD) is a prevalent, impairing, and undertreated psychiatric disorder. We examined if a home-based computerized treatment program can feasibly be delivered and successfully treat GAD symptoms. Using a randomized control trial, we compared three active groups receiving computerized sequenced Attention Bias Modification (ABM) followed by Applied Relaxation psychoeducation (AR-pe), the reversed sequence of AR-pe and ABM, and a simultaneous ABM and AR-pe group to an assessment only control group. The participants comprised 169 adults with a diagnosis of GAD. We asked participants to complete as many as twenty-four 30-min sessions of an at-home computerized treatment program over 12 weeks. The control group received 24 brief assessment questionnaires as well as assessments of attention bias. Results from intent-to-treat analyses show faster rate of improvement for symptoms of anxiety as measured by the Hamilton Anxiety Rating Scale (HAM-A) over time in groups that received active training in contrast to the clinical monitoring (CM) control group. Follow-up analyses revealed that both sequenced groups improved in anxiety when compared to the control group, while the simultaneous group did not outperform the control group. Results suggest that sequenced delivery of ABM and AR, may be a viable home-based treatment option for individuals with GAD who have limited access to resources or are otherwise unable to seek available treatments that require engagement outside of the home. TRIAL REGISTRATION: clinicaltrial. gov Identifier: NCT00602563.

摘要

广泛性焦虑障碍(GAD)是一种普遍存在、致残且治疗不足的精神障碍。我们研究了一种基于家庭的计算机化治疗方案是否可行,并能否成功治疗 GAD 症状。我们采用随机对照试验,将三种主动组进行比较,分别为接受计算机化序列注意偏向矫正(ABM)后进行应用放松心理教育(AR-pe)、AR-pe 和 ABM 顺序相反、ABM 和 AR-pe 同时进行,与仅评估对照组进行比较。参与者包括 169 名被诊断为 GAD 的成年人。我们要求参与者在 12 周内完成多达 24 次 30 分钟的家庭计算机化治疗方案。对照组接受了 24 次简短的评估问卷以及注意力偏差评估。意向治疗分析的结果表明,与临床监测(CM)对照组相比,接受主动训练的组在汉密尔顿焦虑量表(HAM-A)测量的焦虑症状上随时间的改善速度更快。随访分析显示,与对照组相比,两个序列组的焦虑症状都有所改善,而同时组并未优于对照组。结果表明,ABM 和 AR 的序列交付可能是一种可行的基于家庭的治疗选择,适用于资源有限或无法寻求其他需要在家外参与的现有治疗方法的 GAD 患者。试验注册:clinicaltrial.gov 标识符:NCT00602563。

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