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一项针对情绪困扰跨诊断风险的基于远程医疗认知行为疗法的团体干预单臂试点试验。

A One-Arm Pilot Trial of a Telehealth CBT-Based Group Intervention Targeting Transdiagnostic Risk for Emotional Distress.

作者信息

Flynt Sierra, Koscinski Brandon, Accorso Catherine, Knapp Ashley, Gorka Stephanie, Suhr Julie, Austin Megan, Allan Nicholas P

机构信息

Department of Psychology, Ohio University, Athens, OH, USA.

Feinberg School of Medicine, Northwestern University, Evanston, IL, USA.

出版信息

medRxiv. 2024 Apr 23:2024.04.23.24306218. doi: 10.1101/2024.04.23.24306218.

Abstract

The COVID-19 pandemic had a significant impact on mental health, straining an already overburdened healthcare system. A modular, transdiagnostic approach to treating psychopathology may be ideal to target common transdiagnostic risk factors for emotional distress and related disorders likely to be impacted by circumstances related to this once-in-a-lifetime environmental stressor. Anxiety sensitivity (AS), or fear of anxious arousal, intolerance of uncertainty (IU), or distress when confronted with uncertainty, and loneliness are three transdiagnostic risk factors impacted by the pandemic and robust predictors of emotional distress beyond that. We completed a pilot feasibility, acceptability, and utility trial of Coping Crew, our group, telehealth-delivered transdiagnostic treatment protocol in 17 participants who completed the intervention ( age = 22.00, = 4.46; 71% female). The intervention and study protocol were feasible to deliver and were rated as acceptable and useful to address intervention targets. Evidence was mixed regarding feasibility, acceptability, and usefulness of the mobile app component. Sixteen of 17 participants (94%) completed at least one survey a day on 80% of the days but only 6 participants (35%) completed at least 80% of the mobile app surveys delivered over the course of the intervention. Most participants rated use of the app as acceptable and relevant to psychological improvements made due to the intervention. Sizeable effect size reductions in transdiagnostic risk factors were found at post-intervention and maintained at 1- and 3-month follow-up, supporting next steps in the development of this modular transdiagnostic treatment.

摘要

新冠疫情对心理健康产生了重大影响,使本就不堪重负的医疗系统更加紧张。采用模块化、跨诊断的方法治疗精神病理学问题,可能是针对常见跨诊断风险因素的理想方式,这些因素会导致情绪困扰以及可能受到这一前所未有的环境压力源相关情况影响的相关障碍。焦虑敏感性(AS),即对焦虑唤醒的恐惧、不确定性不耐受(IU),即面对不确定性时的痛苦,以及孤独感是受疫情影响的三个跨诊断风险因素,也是除此之外情绪困扰的有力预测因素。我们对17名完成干预的参与者(年龄 = 22.00,标准差 = 4.46;71%为女性)进行了一项关于“应对小组”的初步可行性、可接受性和实用性试验,这是我们团队通过远程医疗提供的跨诊断治疗方案。干预措施和研究方案在实施上是可行的,并且在实现干预目标方面被评为可接受且有用。关于移动应用程序组件的可行性、可接受性和实用性,证据不一。17名参与者中有16名(94%)在80%的日子里每天至少完成一项调查,但在干预过程中,只有6名参与者(35%)完成了至少80%的移动应用程序调查。大多数参与者认为该应用程序的使用是可接受的,并且与因干预而取得的心理改善相关。在干预后发现跨诊断风险因素有显著的效应量降低,并且在1个月和3个月的随访中保持不变,这为这种模块化跨诊断治疗的进一步开发提供了支持。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3877/11071586/73099e0f151e/nihpp-2024.04.23.24306218v1-f0001.jpg

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