A RCT of a Transdiagnostic Internet-Delivered Treatment for Three Anxiety Disorders Examination of Support Roles and Disorder-Specific Outcomes 英文参考文献.docVIP
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A RCT of a Transdiagnostic Internet-Delivered Treatment for Three Anxiety Disorders Examination of Support Roles and Disorder-Specific Outcomes 英文参考文献
ARCTofaTransdiagnosticInternet-DeliveredTreatment
forThreeAnxietyDisorders:ExaminationofSupport
RolesandDisorder-SpecificOutcomes
LukeJohnston1*,NickolaiTitov2,GavinAndrews1,JaySpence2,BlakeF.Dear2
1CRUfAD,SchoolofPsychiatry,UniversityofNewSouthWalesatStVincent’sHospital,Sydney,Australia,2eCentreClinic,DepartmentofPsychology,CentreforEmotional
Health,MacquarieUniversity,Sydney,Australia
Abstract
Background:Anxietydisorderssharecommonvulnerabilitiesandsymptoms.Disorder-specifictreatmentisefficacious,but
few access evidence-based care. Administering transdiagnostic cognitive-behavioral therapy via the internet (iCBT) may
increaseaccesstoevidence-basedtreatment,witharecentrandomizedcontrolledtrial(RCT)providingpreliminarysupport
forthisapproach.Thisstudyextendsthosefindingsandaimstoanswerthreequestions:IsatransdiagnosticiCBTprogram
foranxietydisordersefficaciousandacceptable?Doesitresultinchangeforspecificdisorders?Cangoodclinicaloutcomes
beobtainedwhenguidanceisprovidedviaaCoachratherthanaClinician?
Method: RCT (N=131) comparing three groups: Clinician-supported (CL) vs. Coach-supported (CO) vs. waitlist control
(Control).IndividualsmetDSM-IVcriteriaforaprincipaldiagnosisofgeneralizedanxietydisorder(GAD),socialphobia(SP)or
panic disorder with or without agoraphobia (Pan/Ag). Treatment consisted of an 8-lesson/10 week iCBT program with
weeklycontactfromaClinicianorCoach,andfollow-upat3-monthspost-treatment.
Results:Outcomesforthepooledtreatmentgroups(CL+CO)weresuperiortotheControlgrouponmeasuresofanxiety,
depressionanddisability,wereassociatedwithmediumtolargeeffectsizes(Cohen’sd=.76–1.44)(responserate=89–
100%),andweremaintainedatfollow-up.Significantreductionswerefoundondisorder-specificoutcomesforeachofthe
targetdiagnoses,andwereassociatedwithlargeeffectsizes.COparticipantsachievedsimilaroutcomestoCLparticipants
atpost-treatment,yethadsignificantlylowersymptomseverityscoresongeneralanxiety,panic-disorder,depressionand
disabilityatfollow-up(d=.45–.46).Seventy-fourp
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