Hall Pauline L, Tarrier Nicholas
Trafford Healthcare NHS Trust, Manchester, UK
Behav Res Ther. 2003 Mar;41(3):317-32. doi: 10.1016/s0005-7967(02)00013-x.
Low self esteem in individuals with a psychotic disorder is common and may be related to poorer clinical outcomes. However, there has been little research on devising treatment methods to improve self-esteem either generally or in psychotic patients in particular. The aims of this study were to evaluate the efficacy of a simple cognitive behavioural intervention to improve self esteem in psychotic patients who scored poorly on a self-esteem measure. This pilot study was a randomised control trial with a convenience sample of chronic psychotic inpatients. The cognitive behavioural self-esteem intervention, as an adjunct to treatment as usual (TAU), was compared to TAU alone in patients with psychosis. The individual self-esteem intervention as described by Tarrier (The use of coping strategies and self-regulation in the treatment of psychosis. (2001)) consisted of working with participants to elicit positive self-attributes and then identify specific behavioural examples to provide evidence of this attribute. Emphasis was given to any consequential change in the patient's belief that they had the attribute. The results indicated that this cognitive behavioural treatment for self-esteem used as an adjunct treatment in psychosis, resulted in clinical benefits in terms of increased self-esteem, decreased psychotic symptomatology and improved social functioning. These benefits were largely maintained at 3-month follow-up.
精神病性障碍患者中自尊水平低很常见，且可能与较差的临床结局相关。然而，无论是总体上还是特别是针对精神病患者，在设计改善自尊的治疗方法方面几乎没有研究。本研究的目的是评估一种简单的认知行为干预对在自尊测量中得分较低的精神病患者提高自尊的疗效。这项初步研究是一项随机对照试验，采用慢性精神病住院患者的便利样本。将认知行为自尊干预作为常规治疗（TAU）的辅助手段，与仅接受常规治疗的精神病患者进行比较。塔里尔描述的个体自尊干预（《应对策略和自我调节在精神病治疗中的应用》。（2001年））包括与参与者合作，引出积极的自我特质，然后确定具体的行为示例以证明这种特质。重点在于患者对自己拥有该特质的信念的任何相应变化。结果表明，这种用于精神病辅助治疗的自尊认知行为疗法在提高自尊、减轻精神病症状和改善社会功能方面产生了临床益处。这些益处在3个月的随访中基本得以维持。
