VISN 20 Northwest Network Mental Illness Research, Education and Clinical Center (MIRECC), United States; University of Washington School of Medicine, United States.
VA Puget Sound Healthcare System, United States.
Psychiatry Res. 2020 Nov;293:113394. doi: 10.1016/j.psychres.2020.113394. Epub 2020 Aug 17.
People in need of mental health treatment do not access care at high rates or in a timely manner, inclusive of Veterans at Department of Veteran's Affairs (VA) medical centers. Barriers to care have been identified, and one potential solution is the use of technology-based interventions within primary care. This study evaluated the Cognitive Anxiety Sensitivity Treatment (CAST), a previously developed computerized treatment that has shown efficacy in community samples for mental health symptoms including: anxiety, depression, post-traumatic stress, and suicidal ideation. VA primary care patients with elevated anxiety sensitivity (N = 25) were recruited to participate in a mixed-method open pilot to examine acceptability, usability, and preliminary effectiveness in a VA primary care setting. Participants completed an initial visit, that included the intervention, and a one-month follow-up. Veterans found CAST to be generally acceptable, with strong usability ratings. Qualitative analyses identified areas of strength and areas for improvement for use with VA primary care Veterans. Repeated measures ANCOVAs revealed significant effects for symptoms of anxiety, depression, traumatic-stress, and suicidal ideation. CAST could potentially have a large public health impact if deployed across VA medical centers as a first-step intervention for a range of mental health presenting concerns.
需要心理健康治疗的人无法以较高的比率或及时获得治疗,包括退伍军人事务部 (VA) 医疗中心的退伍军人。已经确定了护理障碍,一种潜在的解决方案是在初级保健中使用基于技术的干预措施。本研究评估了认知焦虑敏感治疗 (CAST),这是一种先前开发的计算机化治疗方法,已在社区样本中显示出对心理健康症状的疗效,包括:焦虑、抑郁、创伤后应激和自杀意念。VA 初级保健中焦虑敏感程度升高的患者 (N=25) 被招募参与混合方法开放试点研究,以在 VA 初级保健环境中检查可接受性、可用性和初步效果。参与者完成了初始访问,包括干预措施和一个月的随访。退伍军人认为 CAST 总体上是可以接受的,具有很强的可用性评分。定性分析确定了在与 VA 初级保健退伍军人一起使用时的优势和改进领域。重复测量方差分析显示,焦虑、抑郁、创伤后应激和自杀意念的症状有显著影响。如果在 VA 医疗中心广泛部署,作为一系列心理健康问题的第一步干预措施,CAST 可能会产生重大的公共卫生影响。