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《掌控焦虑与惊恐及在惊恐障碍治疗中的简短治疗师接触》

Mastery of Your Anxiety and Panic and brief therapist contact in the treatment of panic disorder.

作者信息

Hecker Jeffrey E, Losee Melinda C, Roberson-Nay Roxann, Maki Kristin

机构信息

Psychological Services Center, University of Maine, 5717 Corbett Hall, Orono, ME 04469-5717, USA.

出版信息

J Anxiety Disord. 2004;18(2):111-26. doi: 10.1016/S0887-6185(02)00241-4.

Abstract

Twenty-eight individuals with panic disorder were provided with a copy of Mastery of Your Anxiety and Panic II and received either four sessions of group cognitive-behavior therapy (Group) or one meeting with a therapist plus three telephone contacts (Telephone). Between group repeated measures analyses revealed significant improvement over the course of treatment and maintenance of gains over the follow-up period with few treatment by trials interactions. A higher percentage of participants in the Telephone condition achieved high end-state functioning status at posttreatment compared to those who participated in group CBT (72% vs. 24%), but this difference disappeared at 6 months posttreatment (45% vs. 55%). Participants with characteristics of either borderline, dependent, or depressive personality disorders, as assessed by the MCMI-III, were unlikely to achieve high end-state functioning status at posttreatment. Trends in the data suggest that participants who met criteria for panic disorder with agoraphobia, and those with comorbid generalized anxiety disorder, were also less likely to achieve clinically significant outcome. These findings add to the growing literature indicating that self-directed treatment with brief therapist contact is a viable option for many people with panic disorder. Furthermore, the study provides preliminary data suggesting that certain comorbid conditions negatively impact self-directed treatment outcome.

摘要

28名惊恐障碍患者获得了《掌控你的焦虑与惊恐II》手册,并接受了四节团体认知行为疗法(团体组)或与治疗师进行一次面谈加三次电话联系(电话组)。组间重复测量分析显示,在治疗过程中症状有显著改善,且在随访期内改善得以维持,治疗与试验的交互作用较少。与参加团体认知行为疗法的参与者相比,电话组中有更高比例的参与者在治疗后达到了高终末状态功能水平(72%对24%),但这种差异在治疗后6个月消失(45%对55%)。根据MCMI-III评估,具有边缘型、依赖型或抑郁型人格障碍特征的参与者在治疗后不太可能达到高终末状态功能水平。数据趋势表明,符合惊恐障碍伴广场恐惧症标准的参与者以及患有共病广泛性焦虑症的参与者,也不太可能取得具有临床意义的治疗结果。这些发现进一步丰富了现有文献,表明对于许多惊恐障碍患者来说,在治疗师简短接触下的自我指导治疗是一种可行的选择。此外,该研究提供的初步数据表明,某些共病状况会对自我指导治疗的结果产生负面影响。

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