Implementation of Transdx Group for POTS

University of Colorado, Denver16 enrolled

Overview

The proposed intervention is focused on developing and implementing a psychological approach incorporated into a group-based outpatient intervention for pediatric autonomic dysfunction. The investigators hypothesize that their intervention will result in improvements in the transdiagnostic mechanisms specifically targeted by components of their intervention including sleep, information processing, and youth/parent experiential avoidance.

Study Type

INTERVENTIONAL

Allocation

Purpose

TREATMENT

Masking

NONE

Enrollment

Conditions

Dysautonomia Anxiety Depression

Interventions

Transdiagnostic Group-Based TreatmentBEHAVIORAL

10 week 90-minute weekly therapy sessions including both the adolescent and caregiver. Treatment will consist of psychoeducation about dysautonomia, motivational interviewing techniques to promote readiness for change, support around lifestyle and behavioral changes, core CBT components (e.g., relaxation training, linking thoughts, feelings, and behaviors, minimizing catastrophizing thoughts, cognitive coping, and exposure), and components of ACT aiming to increase cognitive flexibility (e.g., mindfulness, experiential avoidance, values, cognitive defusion, committed action), and relapse prevention and maintenance. Most sessions will involve homework assigned to the adolescent and their parent/legal guardian(s) to encourage practice at home.

Eligibility

Sex: ALLMin age: 13 YearsMax age: 18 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: * Adolescent participants must be 1. between the ages of 13-18 years old, 2. english speaking, and 3. have been diagnosed with autonomic dysfunction, dysautonomia, orthostatic intolerance, and/or POTS. * Participants must also: 1. endorse symptoms of autonomic dysfunction on the COMPASS 31 (measures are described below), and show 2. moderate functional impairment, and/or 3. some psychiatric symptoms in the domains of anxiety and/or depression. * FDI scores must be greater than 12 (see Kashikar-Zuck et al., 2011 for an empirical rationale). * Must have attended at least one day of school per week during the past month. * On the measures of anxiety (SCARED) and depression (CDI), the adolescent's scale score must be above the "average" range based on T scores (CDI) or within the "clinical" range (SCARED). * Each participant must have at least one English-speaking parent/legal guardian who can provide informed consent for the adolescent, as well as participate in the study. * Each adolescent and their parent/legal guardian(s) must be English-speaking. Exclusion Criteria: * Adolescent participants; 1. wards of the state, 2. endorse active homicidal or suicidal ideation, 3. have an intellectual disability, a pervasive developmental disability or significant developmental delay, 4. endorse an active substance use disorder, and 5. are currently participating in individual or group psychotherapy. 6. do not have in-network health insurance that covers Health and Behavior interventions, or 7. are unable to self-pay. * Parent/legal guardian(s) are 1. unwilling to participate in the study, 2. are non-English speaking, or 3. have an intellectual disability, a pervasive developmental disability or significant developmental delay, and/or 4. do not have legal custody of the adolescent participant.

Locations (1)

Children's Hospital Colorado

Aurora, Colorado, United States

Outcomes

Primary Outcomes

Change in Composite Autonomic Symptom Score (self-report)

This is a 31 item self-report measure developed to assess autonomic symptoms (e.g., dizziness, orthostatic intolerance, nausea, sweating).

Time frame: Baseline, 10 weeks, and 6-months

Change in Functional Disability Inventory (caregiver and self-report)

This is a measure that evaluates children's difficulty in physical and psychosocial functioning due to their physical health. The instrument consists of 15 items that assess self-perceptions of activity limitations during the past 2 weeks.

Time frame: Baseline, 10 weeks, and 6-months

Change in Children's Depression Inventory (caregiver and self-report)

This is a 27-item self-report measure designed to assess cognitive, behavioral, and affective symptoms of depression.

Time frame: Baseline, 10 weeks, and 6-months

Change in Screen for Childhood Anxiety Related Emotional Disorders (caregiver and self-report)

This measure is used to screen for childhood anxiety disorders including general anxiety disorder, separation anxiety disorder, panic disorder and social phobia. In addition, it assesses symptoms related to school refusal. The SCARED consists of 41 items.

Time frame: Baseline, 10 weeks, and 6-months

Change in Transdiagnostic Youth/Parent Questionnaire

Our team developed these comprehensive questionnaires to assess transdiagnostic mechanisms in the present study. These questionnaires comprise full measures and/or subscales drawn from several well-validated and psychometrically-sound measures that are available as part of the public domain and/or that were provided for open access by the developers of the measure, and that have been previously designed and validated to measure each of the mechanisms of interest. These mechanisms include emotion regulation, experiential avoidance, sleep, peer acceptance/rejection, parenting, and information processing.

Data from ClinicalTrials.gov

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