Generalized Anxiety Disorder (GAD) is characterized by excessive, uncontrollable worry (Barlow, et al., 1986) leading to medical over-utilization, poor perceived health, low ratings of quality of life, and impairment at work that result in a significant economic and public health impact (Ballenger et al., 2001;Hoffman et al., 2008;Wittchen, 2002). Lifetime prevalence of GAD is high (5.7%, Kessler et al., 2005;8.5% in primary care setting, Roy-Byrne &Wager, 2004). Although efficacious psychosocial and pharmacological treatments for GAD exist (for a reviews see Nutt, et al., 2002), the majority of these individuals do not access our most effective treatments (Collins et al., 2004) and treatment-seeking delays are longest for this condition relative to other anxiety and mood disorders (i.e., 14 years from the time of onset;Kessler et al., 1998). The substantial delays in treatment seeking, failure to access evidence-based treatments and overutilization of medical services, result in prolonged personal and economic costs. Thus, there is a significant unmet need for the development of efficient and cost-effective treatments that have the potential to be widely accessible to individuals with GAD. The current proposal directly responds to the NIMH priorities for evaluating user-friendly interventions and non- traditional delivery methods to increase access to evidence-based interventions. We will evaluate the efficacy of a 12-week computer-delivered home-based treatment program for GAD. Treatment will comprise a combination of two interventions shown to be efficacious in the treatment of GAD. The Attention Modification Program (AMP) is a computerized program designed to facilitate attention disengagement from threatening stimuli (Amir et al., 2009). Applied Relaxation (AR) is a behavioral, skills-based intervention where individuals learn ways to reduce the physiological cues associated with anxiety and worry (Vst, 1987;Siev &Chambless, 2007). Following the recommended guidelines of the NIMH Workgroup on Psychosocial Intervention Development (Hollon et al., 2002), we review evidence suggesting that both treatments are ideal candidates for the efficient, economical, and widespread transportation of evidence-based treatments for GAD. This proposal has the potential for a significant public health impact by evaluating a new method for delivering evidence-based interventions for hard-to-reach populations through the use of innovative technologies.

Public Health Relevance

Generalized anxiety disorder (GAD) is a prevalent and debilitating psychiatric condition associated with low rates of accessing evidence-based treatments that result in prolonged personal and economic costs. Thus, there is a significant unmet need for development of efficient and cost-effective treatments that are widely accessible to individuals suffering with this condition. The current proposal aims to address these issues by evaluating the feasibility and effectiveness of a computer-delivered home- based treatment program for GAD that comprises a combination of two interventions shown to be efficacious in the treatment of GAD (i.e., attention training and applied relaxation).

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Research Project (R01)
Project #
5R01MH087623-05
Application #
8650333
Study Section
Mental Health Services in Non-Specialty Settings (SRNS)
Program Officer
Pearson, Jane L
Project Start
2010-06-11
Project End
2015-03-31
Budget Start
2014-06-02
Budget End
2015-03-31
Support Year
5
Fiscal Year
2014
Total Cost
$329,962
Indirect Cost
$99,808
Name
San Diego State University
Department
Psychology
Type
Schools of Arts and Sciences
DUNS #
073371346
City
San Diego
State
CA
Country
United States
Zip Code
92182
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McGeary, John E; Meadows, Sydney P; Amir, Nader et al. (2014) Computer-delivered, home-based, attentional retraining reduces drinking behavior in heavy drinkers. Psychol Addict Behav 28:559-62
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