This K23 Mentored Patient-Oriented Career Development Award application is to request support for Dr. Dalrymple's development as an independent investigator specializing in combined treatment trials (psychotherapy plus pharmacotherapy) for patients with complicated presentations of depression. The short- term goal of this award is to develop and evaluate the feasibility and acceptability of a psychosocial intervention to augment pharmacotherapy for patients with comorbid Major Depressive Disorder (MDD) and Social Anxiety Disorder (SAD), as this comorbidity pattern is highly prevalent yet undertreated in routine psychiatric settings. The training goals of this application include: 1) obtain further experience in treating this population by developing an integrated behavioral treatment;2) receive training in the development of psychosocial interventions for MDD;3) obtain training in the pharmacological treatment of MDD and SAD to prepare for future combined treatment trials;4) develop skills in the implementation of treatment research in routine practice settings;5) receive formal training in advanced longitudinal data analytic methods as applied to clinical trials;6) expand grant writing and manuscript preparation skills;and 7) obtain further knowledge of ethical and multicultural issues related to treatment outcome research. These goals will be accomplished through mentorship provided by Drs. Zimmerman and Miller as well as other consultant mentors, completion of coursework, seminars, and clinical experiences, and implementation of the proposed research project. The 5- year research plan will include the development of a psychosocial treatment integrating behavioral and acceptance-based techniques to augment pharmacotherapy for patients with comorbid MDD-SAD, called Depression and Social Anxiety Treatment (DASAT). The goals of this research project are to: 1) develop a treatment manual for DASAT by conducting an initial open trial (n=20);2) conduct a randomized controlled pilot study comparing pharmacotherapy-as-usual (PAU;n=15) to pharmacotherapy-as-usual plus DASAT (PAU+DASAT;n=15), to examine the feasibility and acceptability of the intervention;3) develop a therapist training program;4) develop and test therapist adherence and competence scales;and 5) refine DASAT and study procedures to prepare for a larger clinical trial.
The proposed project will result in substantial public health benefit because it will be developed for and tested in a routine practice setting, where the prevalence of comorbid Major Depressive Disorder and Social Anxiety Disorder is highest and improved treatments for it are needed. In addition, the treatment will target overall functioning and quality of life as well as symptoms, and will be designed to augment pharmacotherapy, further increasing its public health impact.
|Dalrymple, Kristy; Martinez, Jennifer; Tepe, Elizabeth et al. (2013) A clinically useful social anxiety disorder outcome scale. Compr Psychiatry 54:758-65|
|Kelly, Megan M; Dalrymple, Kristy; Zimmerman, Mark et al. (2013) A comparison study of body dysmorphic disorder versus social phobia. Psychiatry Res 205:109-16|
|Zimmerman, Mark; Young, Diane; Chelminski, Iwona et al. (2012) Overcoming the problem of diagnostic heterogeneity in applying measurement-based care in clinical practice: the concept of psychiatric vital signs. Compr Psychiatry 53:117-24|
|Zimmerman, Mark; Galione, Janine N; Chelminski, Iwona et al. (2011) Psychiatric diagnoses in patients who screen positive on the Mood Disorder Questionnaire: Implications for using the scale as a case-finding instrument for bipolar disorder. Psychiatry Res 185:444-9|
|Dalrymple, Kristy L; Zimmerman, Mark (2011) Treatment-seeking for social anxiety disorder in a general outpatient psychiatry setting. Psychiatry Res 187:375-81|
|Zimmerman, Mark; Galione, Janine N; Ruggero, Camilo J et al. (2011) Are screening scales for bipolar disorder good enough to be used in clinical practice? Compr Psychiatry 52:600-6|
|Dalrymple, Kristy L; Zimmerman, Mark (2011) Age of onset of social anxiety disorder in depressed outpatients. J Anxiety Disord 25:131-7|
|Dalrymple, Kristy L; Galione, Janine; Hrabosky, Joshua et al. (2011) Diagnosing social anxiety disorder in the presence of obesity: implications for a proposed change in DSM-5. Depress Anxiety 28:377-82|
|O'Brien, Erin M; Chelminski, Iwona; Young, Diane et al. (2011) Severe insomnia is associated with more severe presentation and greater functional deficits in depression. J Psychiatr Res 45:1101-5|
|Zimmerman, Mark; Galione, Janine N; Ruggero, Camilo J et al. (2010) Overdiagnosis of bipolar disorder and disability payments. J Nerv Ment Dis 198:452-4|
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