There is an established relationship between anxiety and asthma, which is associated with poor health outcomes. Most previous cognitive behavior therapies (CBT) have focused on comorbid panic disorder whereas anxiety related to asthma may rather be illness-specific. The feasibility of an online CBT targeting avoidance behavior in anxiety related to asthma was evaluated, using a pretest-posttest design. Thirty participants with self-reported anxiety related to asthma were offered an eight-week treatment with therapist support. Mean adherence was good (80% of content), and most participants (89%) reported adequate relief after treatment. Catastrophizing about asthma (CAS), assessed at 2 months after treatment, improved significantly with a large effect size (Cohen's d = 1.52). All secondary outcomes, including asthma control, avoidance behavior, fear of asthma symptoms and quality of life, improved significantly with moderate to large effect sizes (d: 0.40–1.44). All improvements were stable at 4 months follow up. Weekly ratings showed that a decrease in avoidance behavior predicted a decrease in CAS the following week throughout the treatment period. We conclude that CBT targeting avoidance behavior is a feasible treatment for anxiety related to asthma. The results justify investigation of efficacy and mechanisms of change in a randomized controlled trial.

ClinicalTrials.gov, ID: NCT03486756.

焦虑和哮喘之间存在既定的关系，这与不良的健康结果有关。大多数以前的认知行为疗法 (CBT) 都集中在合并症的恐慌症上，而与哮喘相关的焦虑可能是特定于疾病的。使用前测-后测设计评估了针对与哮喘相关的焦虑中的回避行为的在线 CBT 的可行性。三十名自我报告的与哮喘有关的焦虑的参与者在治疗师的支持下接受了为期八周的治疗。平均依从性良好（内容的 80%），大多数参与者（89%）报告治疗后充分缓解。治疗后 2 个月时评估的哮喘灾难性 (CAS) 显着改善，效果显着（Cohen's d = 1.52）。所有次要结果，包括哮喘控制、回避行为、对哮喘症状的恐惧和生活质量，均显着改善，效应大小为中到大 ( d : 0.40–1.44)。所有改善在 4 个月的随访中保持稳定。每周评级显示，在整个治疗期间，回避行为的减少预示着接下来一周 CAS 的减少。我们得出结论，针对回避行为的 CBT 是治疗与哮喘相关的焦虑的可行方法。结果证明在随机对照试验中研究疗效和变化机制是合理的。

ClinicalTrials.gov，ID：NCT03486756。