Breitholtz E, Johansson B, Ost L G
Department of Psychiatry, University of Uppsala, Sweden.
Behav Res Ther. 1999 Jun;37(6):533-44. doi: 10.1016/s0005-7967(98)00147-8.
Self-observations of cognitions during episodes of anxiety were examined in 38 patients with generalized anxiety disorder and 36 patients with panic disorder. Two independent observers who where blind to the diagnoses categorised the cognitions. The inter-rater reliability was high (mean kappa 0.82). The GAD-patients had significantly more cognitions in the following categories: interpersonal confrontation, competence, acceptance, concern about others and worry over minor matters, while the PD-patients had significantly more cognitions in the physical catastrophe category. Furthermore, GAD-patients with a comorbidity of social phobia reported more cognitions regarding social embarrassment than did GAD-patients with other or no (axis-I) comorbidity. The results of this study support the cognitive theory regarding the cognitive specificity of anxiety disorders. The implications of these results are discussed, along with the issues of reliability and validity of the instrument used.
对38名广泛性焦虑症患者和36名惊恐障碍患者在焦虑发作期间的认知自我观察进行了研究。两名对诊断不知情的独立观察者对认知进行了分类。评分者间信度很高(平均卡帕值为0.82)。广泛性焦虑症患者在以下类别中的认知明显更多:人际对抗、能力、接受、对他人的关注以及对小事的担忧,而惊恐障碍患者在身体灾难类别中的认知明显更多。此外,合并社交恐惧症的广泛性焦虑症患者比合并其他或无(轴I)共病的广泛性焦虑症患者报告了更多关于社交尴尬的认知。本研究结果支持了关于焦虑症认知特异性的认知理论。讨论了这些结果的意义以及所用工具的信度和效度问题。