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不确定感容忍度行为实验:广泛性焦虑障碍成人的随机临床试验。

Behavioral Experiments for Intolerance of Uncertainty: A Randomized Clinical Trial for Adults With Generalized Anxiety Disorder.

机构信息

Université du Québec en Outaouais.

Ottawa Institute of Cognitive Behavioural Therapy.

出版信息

Behav Ther. 2022 Nov;53(6):1147-1160. doi: 10.1016/j.beth.2022.05.003. Epub 2022 May 27.

DOI:10.1016/j.beth.2022.05.003
PMID:36229113
Abstract

Sophisticated multicomponent treatments for adults with generalized anxiety disorder (GAD) have been developed over the past three decades. Although these comprehensive treatments have produced encouraging results, they appear to be less efficacious than treatments for other anxiety disorders. The goal of this randomized controlled trial is to test a newly developed, highly focused treatment for adults with GAD: Behavioral Experiments for Intolerance of Uncertainty. Sixty (60) participants (51 women, 9 men), with a mean age of 34.60 years (range: 19 to 67 years), were randomized to either treatment (n = 30) or wait-list control (n = 30). Treatment consisted of 12 weekly 1-hour sessions in which participants learned to use behavioral experiments to test their catastrophic beliefs about uncertainty. Assessments were conducted at pre-, mid- and postcondition, and at 6- and 12-month follow-up. The primary outcome was the severity of GAD, and secondary outcomes were worry, depression, somatic anxiety, and intolerance of uncertainty. Using growth curve modeling, we found that (1) the treatment group was superior to the wait-list group in terms of change from pre- to posttest on all outcomes; (2) the combined sample (once wait-listed participants received treatment) evidenced large and significant decreases on all outcomes; and (3) treatment gains were either maintained or increased over the 12-month follow-up period of the study. The new treatment is a promising treatment option for adults with GAD considering that it may be as efficacious as more comprehensive evidence-based psychological treatments for GAD.

摘要

在过去的三十年中,已经开发出了针对广泛性焦虑症(GAD)成年人的复杂多组分治疗方法。尽管这些综合治疗方法取得了令人鼓舞的结果,但它们似乎不如其他焦虑症的治疗方法有效。本随机对照试验的目的是测试一种新开发的、针对 GAD 成人的高度集中治疗方法:对不确定性的不耐受行为实验。共有 60 名(51 名女性,9 名男性)参与者,平均年龄为 34.60 岁(范围:19 至 67 岁),随机分为治疗组(n=30)或等待名单对照组(n=30)。治疗包括 12 次每周 1 小时的课程,参与者在这些课程中学习使用行为实验来检验他们对不确定性的灾难性信念。评估在治疗前、中期和后期进行,并在治疗后 6 个月和 12 个月进行随访。主要结果是 GAD 的严重程度,次要结果是担忧、抑郁、躯体焦虑和对不确定性的不耐受。使用增长曲线模型,我们发现:(1)治疗组在所有结果上的变化都优于等待名单组,从治疗前到治疗后;(2)综合样本(一旦等待名单参与者接受治疗)在所有结果上都显示出显著的大幅下降;(3)治疗效果在研究的 12 个月随访期间保持或增加。考虑到这种新的治疗方法可能与更全面的基于证据的 GAD 心理治疗一样有效,因此它是 GAD 成人的一种有前途的治疗选择。

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