Anxiety Disorders Clinical Trial
Official title:
Phase 3 of The Development of A Unified Treatment for Anxiety Disorders
The purpose of this study is to develop a new psychological therapy for a variety of different types of emotional disorders. The study will compare symptoms and functioning of clients who receive the treatment with those who do not, and will include a number of assessments before, during, and after treatment. We predict that patients receiving active treatment will show improved functioning relative to wait-list control.
Emotional disorders, specifically anxiety disorders and depression, are common, chronic,
costly, and debilitating to quality of life (Barlow, 2002). Best estimates from various
epidemiological studies place the one year prevalence of any anxiety disorder for individuals
over 18 at 11.8%, and the one year prevalence of any mood disorder 5.1% (Narrow, Rae, Robins,
& Regier, 2002). Lifetime rates are higher. We understand the nature and causes of anxiety
and unipolar mood disorders (major depressive disorder and dysthymia) somewhat better than 10
years ago, with evidence pointing to generalized biological and psychological vulnerabilities
interacting with specific learning and, sometimes, stressful triggering life events as
etiological factors (Barlow, 2002; Brown, Chorpita, & Barlow, 1998). Pharmacological and
psychological treatments have been proven effective, at least in the short term, but most
studies have ignored the effects of treatment on broad-based patterns of comorbidity that
accompany these disorders. Most comorbid disorders are usually additional emotional disorders
(Brown, Campbell, Lehman, Grisham, & Mancill, 2001). More importantly, treatment outcomes
have been less than satisfactory or ineffective for up to 50% of patients, even for the
principal disorder (Nathan & Gorman, 2002). A common pharmacological treatment exists for
many emotional disorders, which is selective serotonin re-uptake inhibitors (SSRIs) and
closely related compounds. Effective psychological treatments, on the other hand, have been
developed to be very specific to each DSM-IV diagnostic category. The purpose of this
proposal is to create a unified psychological approach to the emotional disorders. To do,
this we will take advantage of recent advances in our understanding of the nature of
emotional disorders, as well as emerging knowledge of the process of regulation and change in
emotional behavior, in order to distill and refine basic principles of successful
psychological treatments. It is expected that this approach will simplify training and
dissemination, possibly improve efficacy, and perhaps also shed further light on the nature
of emotional disorders. Thus, the specific aims of this proposal are to:
1. Develop and refine a unified psychological treatment for anxiety and non-bipolar mood
disorders derived from distilling the major ingredients of current effective approaches
in light of advancing knowledge of emotion regulation and modification.
2. Revise and develop methods of evaluating adherence and outcome utilizing this new
treatment protocol, focusing not only on symptom reduction but also quality of life and
adaptive functioning.
3. Treat a small number of patients with heterogeneous DSM-IV mood and anxiety diagnoses
with this new protocol with the purpose of making appropriate modifications for a
subsequent pilot study.
4. Conduct a pilot study testing this unified treatment in comparison to a wait-list
control condition in order to determine credibility and efficacy in terms of both
symptomatic functioning and quality of life, and relating these outcomes to those from
more disorder specific treatments.
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