|
跨诊断认知行为团体治疗对情绪障碍患者的疗效研究
|
Abstract:
目的:评估跨诊断认知行为团体治疗对情绪障碍患者的疗效,为方案的临床应用提供价值依据。方法:对存在焦虑、抑郁情绪困扰的患者(包括符合精神障碍诊断与统计手册第5版,焦虑障碍、抑郁障碍等诊断)23例进行为期8周的认知行为团体治疗。在治疗前和治疗后分别对患者进行认知情绪调节量表(CERQ)、正念五因素量表(FFMQ)以及总体焦虑水平和总体抑郁水平测评。结果:23例患者治疗8周后总体焦虑水平(11.48 ± 3.42 VS 6.26 ± 3.67)和总体抑郁水平(10.35 ± 3.90 VS 5.00 ± 3.36)降低。治疗前后,认知情绪调节量表各维度量表评分结果显示:自我责难、沉思、灾难化三个维度得分显著降低且有统计学意义(P < 0.05);重新评价维度得分显著升高且有统计学意义(P < 0.05);接受、积极关注、重新计划、理性分析、责难他人等维度得分差异无统计学意义(P > 0.05)。治疗前后,正念五因素量表评分结果显示,不反应维度分值显著升高且有统计学意义(P < 0.05),观察、描述、有觉知地行动、不评判维度量表得分无统计学意义(P < 0.05)。结论:跨诊断认知行为团体治疗对情绪障碍患者的情绪调节有较好的治疗效果。
Objective: to evaluate the efficacy of trans-diagnostic cognitive behavioral group therapy for pa-tients with emotional disorders, and to provide valuable evidence for the clinical application of the protocol. Methods: twenty-three patients with anxiety and depression were treated with cognitive behavioral group therapy for 8 weeks. The patients were diagnosed as anxiety and depression ac-cording to the 5th edition of Diagnostic and Statistical Manual of mental disorders (DSM-5). Before and after treatment, the patients were assessed with the cognitive emotion regulation scale (CERQ), the five-factor mindfulness scale (FFMQ), the general anxiety level and the general depression level. Results: after 8 weeks of treatment, the total anxiety level (11.48 ± 3.42 VS 6.26 ± 3.67) and the to-tal depression level (10.35 ± 3.90 VS 5.00 ± 3.36) of the 23 patients were decreased. Before and af-ter treatment, the scores of each dimension of the cognitive emotion regulation scale showed that the scores of self-blame, focus on thought/rumination and catastrophizing were significantly de-creased (P < 0.05). The scores of positive reappraisal were significantly increased (P < 0.05), but there were no significant differences in the scores of acceptance, positive refocusing, refocus on planning, rational analysis and blaming others (P > 0.05). Before and after treatment, the score of five factors of mindfulness scale showed that the score of unresponsiveness increased significantly (P < 0.05) , there was no significant difference in the scores of observation, description, conscious action and non-judgment (P < 0.05). Conclusion: Trans-diagnostic cognitive behavior group therapy has a positive effect on emotion regulation in patients with emotional disorders.
[1] | 戴维?H?巴洛, 王珊珊, 等(2013). 情绪障碍跨诊断治疗的统一方案: 治疗师指南(万千心理) (王辰怡 译). 中国轻工业出版社. |
[2] | 刘文娟, 季建林, 叶尘宇, 等(2012). 跨诊断取向团体认知行为治疗对焦虑障碍患者的疗效. 中国心理卫生杂志, 26(11), 814-818. |
[3] | 潘狄, 周勤, 刘岩, 等(2023). 正念疗法对青少年抑郁症患者负面情绪、认知功能及生活质量的影响. 中外医学研究, 21(17), 175-179. https://doi.org/10.14033/j.cnki.cfmr.2023.17.044 |
[4] | 吴爱红, 李春梅, 李翠萍, 等(2018). 团体正念减压训练对结核科护士认知情绪调节的效果. 中国临床护理, 10(4), 277-281. |
[5] | 朱熊兆, 罗伏生, 等(2007). 认知情绪调节问卷中文版(CERQ-C)的信效度研究. 中国临床心理学杂志, 15(2), 121-124+131. |
[6] | Baer, R. A., Smith, G. T., Lykins, E. et al. (2008). Construct Validity of the Five Facet Mindfulness Questionnaire in Meditating and Nonmeditating Samples. Assessment, 15, 329-342. https://doi.org/10.1177/1073191107313003 |
[7] | Barlow, D. H., Allen, L. B., & Choate, M. L. (2004). Toward a Uni-fied Treatment for Emotional Disorders. Behavior Therapy, 35, 205-230. https://doi.org/10.1016/S0005-7894(04)80036-4 |
[8] | Barlow, D. H., Farchione, T. J., Bullis, J. R., Gallagher, M. W., Murray-Latin, H., Sauer-Zavala, S., Bentley, K. H., Thompson-Hollands, J., Conklin, L. R., Boswell, J. F., Ametaj, A., Carl, J. R., Boettcher, H. T., & Cassiello-Robbins, C. (2017). The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders Compared with Diagnosis-Specific Protocols for Anxiety Disorders. JAMA Psychiatry, 74, 875-884. https://doi.org/10.1001/jamapsychiatry.2017.2164 |
[9] | Barrera, T. L., Smith, A. H., & Norton, P. J. (2014). Transdi-agnostic CBT for Anxiety Disorders. In P. Emmelkamp, & T. Ehring (Eds.), The Wiley Handbook of Anxiety Disorders (1st ed., pp. 787-803). John Wiley & Sons, Inc.
https://doi.org/10.1002/9781118775349.ch38 |
[10] | Harris, K. R., & Norton, P. J. (2019). Transdiagnostic Cognitive Behavioral Therapy for the Treatment of Emotional Disorders: A Preliminary Open Trial. Journal of Behavior Therapy and Experimental Psychiatry, 65, Article 101487.
https://doi.org/10.1016/j.jbtep.2019.101487 |
[11] | Norton, P. (2017). Transdiagnostic Approaches to the Understanding and Treatment of Anxiety and Related Disorders. Journal of Anxiety Disorders, 46, 1-3. https://doi.org/10.1016/j.janxdis.2017.02.004 |
[12] | Pearl, S. B., & Norton, P. J. (2017). Transdiagnostic versus Diag-nosis Specific Cognitive Behavioural Therapies for Anxiety: A Meta-Analysis. Journal of Anxiety Disorders, 46, 11-24. https://doi.org/10.1016/j.janxdis.2016.07.004 |
[13] | Sloan, E., Hall, K., Moulding, R., Bryce S., Mildred, H., & Staiger, P. K. (2017). Emotion Regulation as a Transdiagnostic Treatment Construct across Anxiety, Depression, Substance, Eating and Borderline Personality Disorders: A Systematic Review. Clinical Psychology Review, 57, 141-163. https://doi.org/10.1016/j.cpr.2017.09.002 |
[14] | Young, A. S., Klap, R., Sherbourne, C. D., & Wells, K. B. (2001). The Quality of Care for Depressive and Anxiety Disorders in the United States. Archives of General Psychiatry, 58, 55-61. https://doi.org/10.1001/archpsyc.58.1.55 |