自主神经处理治疗（ADAPT）试验的改变：一种减少关节过度活动症焦虑的新型靶向治疗方法。

Altering Dynamics of Autonomic Processing Therapy (ADAPT) trial: a novel, targeted treatment for reducing anxiety in joint hypermobility.

机构信息

Department of Neuroscience, Brighton and Sussex Medical School, University of Sussex, Falmer, UK.

Sussex Partnership NHS Foundation Trust, Worthing, UK.

出版信息

Trials. 2021 Sep 21;22(1):645. doi: 10.1186/s13063-021-05555-4.

DOI:10.1186/s13063-021-05555-4

PMID:34548065

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8453027/

Abstract

BACKGROUND

Hypermobility is a poorly recognised and understood musculoskeletal disorder thought to affect around 20% of the population. Hypermobility is associated with reduced physiological and psychological functioning and quality of life and is a known risk factor for the development of an anxiety disorder. To date, no evidence-based, targeted treatment for anxiety in the context of hypermobility exists. The present intervention (ADAPT-Altering Dynamics of Autonomic Processing Therapy) is a novel therapy combining bio-behavioural training with cognitive approaches from clinical health psychology targeting the catastrophisation of internal sensations, with aim to improve autonomic trait prediction error.

METHOD

Eighty individuals with diagnosed hypermobility will be recruited and the efficacy of ADAPT to treat anxiety will be compared to an Emotion-Focused Supportive Therapy (EFST) comparator therapy in a randomised controlled trial. The primary treatment target will be post therapy score on the Beck Anxiety Inventory, and secondary outcomes will also be considered in relation to interoception, depression, alexithymia, social and work adjustment, panic symptoms and dissociation. Due to COVID restrictions, the intervention will be moved to online delivery and qualitative assessment of treatment tolerance to online therapy will also be assessed.

DISCUSSION

Online delivery of an intervention targeting anxiety would improve the quality of life for those experiencing anxiety disorder and help to reduce the £11.7 billion that anxiety disorders cost the UK economy annually.

TRIAL REGISTRATION

World Health Organization ISRCTN17018615 . Registered on 20th February 2019; trial protocol version 2.

摘要

背景

过度活动是一种尚未被充分认识和理解的肌肉骨骼疾病，据估计影响了约 20%的人群。过度活动与生理和心理功能下降以及生活质量降低有关，是焦虑障碍发展的已知风险因素。迄今为止，针对过度活动人群的焦虑症，尚无基于证据的靶向治疗方法。目前的干预措施（ADAPT-改变自主加工治疗）是一种新型治疗方法，结合了生物行为训练和临床健康心理学的认知方法，针对内部感觉的灾难化，旨在改善自主预测误差。

方法

将招募 80 名确诊为过度活动的个体，并在一项随机对照试验中比较 ADAPT 治疗焦虑症的效果与情绪聚焦支持性治疗（EFST）对照治疗的效果。主要治疗目标将是贝克焦虑量表的治疗后评分，次要结局也将与内感受、抑郁、述情障碍、社会和工作调整、惊恐症状和分离有关。由于 COVID-19 的限制，干预措施将转移到在线提供，还将评估对在线治疗的治疗耐受性的定性评估。