behavioral treatment of generalized anxiety disorder广泛性焦虑症的认知行为治疗课件

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1、CognitiveBehavioralTreatmentofGeneralizedAnxietyDisorderTheoriginalversionoftheseslideswasprovidedbyMichaelW.Otto,Ph.D.withsupportfromNIMHExcellenceinTrainingAwardattheCenterforAnxietyandRelatedDisordersatBostonUniversity(R25MH08478)UseofthisSlideSetPresentationinformationislis

2、tedinthenotessectionbelowtheslide(inPowerPointnormalviewingmode).Abibliographyforthisslidesetisprovidedbelowinthenotesectionforthisslide.Referencesarealsoprovidedinnotesectionsforselectsubsequentslides.SlideSetOutlineTreatmentoutcomefindingsPerspectivesacrossmetaanalysesTreatmen

3、tmodelsSimilarities(overdifferences)ElementsoftreatmentWhatisaccomplishedinsessionFuturedirectionsGeneralizedAnxietyDisorder:DiagnosticConsiderationsPervasiveworryandchronicarousalResidualcategoryofpanicdisorderinDSM-IIISpheresofworryinDSM-III-RandchronicarousalExcessiveandunco

4、ntrollableworryand3of6symptomsinDSM-IVrestless,keyedup,onedgeeasilyfatigueddifficultiesconcentratingirritabilitymuscletensionsleepdisturbanceCorePatternsinGADUncontrollableworryFutureorientationNegativecognitivebiasesSomaticarousalRoleandtaskinefficiencyInterpersonalaversiveness

5、(unbalancedrelationships)GAD:CoreTreatmentElementsInformationAppliedRelaxationCognitiveRestructuring(probabilityestimates,copingestimates)Cue-ControlledWorry(worrytimes+problemsolving)WorryExposure(includingexistentialtopics)MindfulnessMeta-Analyses:5PerspectivesAllRandomizedTri

6、als(pre-post)Norton&Price,2007Placebo-ControlledTrials(controlledeffectsize)Hofmann&Smits,2008ElementsofTreatment(controlledeffectsize)Gouldetal.,2004DifferentialEfficacy(pre-post)Siev&Chambless,2007Gouldetal.,2004EffectivenessTrials(pre-post)Stewart&Chambless,2009Meta-Analysiso

7、fRandomizedAnxietyTrialsofCBT(withinES)Norton&Price,2007,JNMDEffectSize(d)Hofmann&Smits(2008)Meta-AnalysisMeta-analysisofwell-controlledtrialsofCBTforanxietyInclusioncriteria:RandomassignmenttoeitherCBTorplaceboThepsychologicalplacebohadtoinvolveinterventionstocontrolfornonspeci

8、ficfactors(e.g.,regularcontactwithatherapist,re