Frederick T. Schubert, Danielle M. Morabito, Norman B. Schmidt
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We hypothesized that CAST would be rated as highly acceptable, would significantly reduce anxiety sensitivity when compared to a control intervention, and would retain its mechanism of action on internalizing symptoms such that reductions in anxiety sensitivity (AS) would mediate reductions in symptoms of anxiety and depression. We recruited 73 participants in preexisting groups and groups consisting of individual participants to be randomly assigned to the CAST or control condition with assessments at pre-intervention, post-intervention, and 1-month follow-up. Multilevel linear mixed effect models were conducted to examine whether treatment condition predicts reductions in AS. Direct and indirect effects of intervention condition on internalizing symptoms through changes in AS were examined using regression and mediation models. Results suggest that this “Group CAST” is acceptable and efficacious in reducing AS. 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引用次数: 0
摘要
尽管传统的循证治疗在减少临床焦虑方面是有效的,但许多焦虑的个体从未接受过这种治疗。最近,开发了基于技术的简短干预措施,以克服与获取有关的障碍。尽管这些干预措施具有优势,但也面临着重大的可行性问题,并且未得到充分利用。调整数字干预措施,使其以有指导的小组形式进行管理,可以提高可行性和利用率。本研究旨在评估一种简短的认知焦虑敏感性治疗(CAST;Schmidt et al., 2014)在临床医生的指导下分组给药。我们假设CAST将被评为高度可接受的,与对照干预相比,它将显著降低焦虑敏感性,并将保留其对内化症状的作用机制,例如焦虑敏感性(as)的降低将介导焦虑和抑郁症状的减轻。我们招募了73名参与者,分别来自已存在组和由个体参与者组成的组,随机分配到CAST组或对照组,并在干预前、干预后和1个月的随访中进行评估。采用多水平线性混合效应模型来检验治疗条件是否能预测AS的减少。通过回归和中介模型检验干预条件对AS内化症状的直接和间接影响。结果表明,该“组CAST”在减少AS方面是可以接受和有效的。研究结果表明,与先前研究的CAST版本一样,CAST组可能通过减少AS来减少抑郁和焦虑。结果支持一种新的基于群体的框架,以改善简短数字心理健康治疗的应用。临床试验编号:bernct06817473。
Examining the efficacy of the computerized anxiety sensitivity treatment in a guided, group format: A randomized controlled trial
Although traditional evidence-based treatments are efficacious in reducing clinical anxiety, many anxious individuals never receive them. Recently, brief technology-based interventions have been developed to overcome access related barriers. Despite their advantages, these interventions also face significant feasibility issues and are underutilized. Adapting digital interventions to be administered in guided, group formats may improve viability and utilization. The current study aimed to evaluate feasibility, acceptability, and efficacy of a brief Cognitive Anxiety Sensitivity Treatment (CAST; Schmidt et al., 2014) administered in groups with the guidance of a clinician. We hypothesized that CAST would be rated as highly acceptable, would significantly reduce anxiety sensitivity when compared to a control intervention, and would retain its mechanism of action on internalizing symptoms such that reductions in anxiety sensitivity (AS) would mediate reductions in symptoms of anxiety and depression. We recruited 73 participants in preexisting groups and groups consisting of individual participants to be randomly assigned to the CAST or control condition with assessments at pre-intervention, post-intervention, and 1-month follow-up. Multilevel linear mixed effect models were conducted to examine whether treatment condition predicts reductions in AS. Direct and indirect effects of intervention condition on internalizing symptoms through changes in AS were examined using regression and mediation models. Results suggest that this “Group CAST” is acceptable and efficacious in reducing AS. Findings suggest Group CAST may reduce depression and anxiety via AS reductions, as with previously studied versions of CAST. Results support a new group-based framework for improving the application of brief digital mental health treatments.
期刊介绍:
The major focus of Behaviour Research and Therapy is an experimental psychopathology approach to understanding emotional and behavioral disorders and their prevention and treatment, using cognitive, behavioral, and psychophysiological (including neural) methods and models. This includes laboratory-based experimental studies with healthy, at risk and subclinical individuals that inform clinical application as well as studies with clinically severe samples. The following types of submissions are encouraged: theoretical reviews of mechanisms that contribute to psychopathology and that offer new treatment targets; tests of novel, mechanistically focused psychological interventions, especially ones that include theory-driven or experimentally-derived predictors, moderators and mediators; and innovations in dissemination and implementation of evidence-based practices into clinical practice in psychology and associated fields, especially those that target underlying mechanisms or focus on novel approaches to treatment delivery. In addition to traditional psychological disorders, the scope of the journal includes behavioural medicine (e.g., chronic pain). The journal will not consider manuscripts dealing primarily with measurement, psychometric analyses, and personality assessment.