Gaudiano Brandon A, Herbert James D
Department of Psychology, Drexel University, Mail Stop 988, Philadelphia, PA 19102, USA.
Behav Res Ther. 2006 Mar;44(3):415-37. doi: 10.1016/j.brat.2005.02.007.
Cognitive behavior therapy (CBT) has been demonstrated in a number of randomized controlled trials to be efficacious as an adjunctive treatment for psychotic disorders. Emerging evidence suggests the usefulness of CBT interventions that incorporate acceptance/mindfulness-based approaches for this population. The current study extended previous research by Bach and Hayes (2002. The use of Acceptance and Commitment Therapy to prevent the rehospitalization of psychotic patients: A randomized controlled trial. Journal of Consulting and Clinical Psychology, 70, 1129-1139) using Acceptance and Commitment Therapy (ACT) in the treatment of psychosis. Psychiatric inpatients with psychotic symptoms were randomly assigned to enhanced treatment as usual (ETAU) or ETAU plus individual sessions of ACT. At discharge from the hospital, results suggested short-term advantages in the ACT group in affective symptoms, overall improvement, social impairment, and distress associated with hallucinations. In addition, more participants in the ACT condition reached clinically significant symptom improvement at discharge. Although 4-month rehospitalization rates were lower in the ACT group, these differences did not reach statistical significance. Decreases in the believability of hallucinations during treatment were observed only in the ACT condition, and change in believability was strongly associated with change in distress after controlling for change in the frequency of hallucinations. Results are interpreted as largely consistent with the findings of Bach and Hayes and warrant further investigations with larger samples.
认知行为疗法（CBT）在多项随机对照试验中已被证明作为精神障碍的辅助治疗是有效的。新出现的证据表明，将基于接纳/正念的方法纳入其中的CBT干预措施对该人群有用。当前的研究扩展了Bach和Hayes（2002年。使用接纳与承诺疗法预防精神病患者再次住院：一项随机对照试验。《咨询与临床心理学杂志》，70，1129 - 1139）之前的研究，该研究将接纳与承诺疗法（ACT）用于精神病治疗。有精神病症状的精神科住院患者被随机分配到强化常规治疗（ETAU）组或ETAU加ACT个体治疗组。在出院时，结果表明ACT组在情感症状、总体改善、社会功能损害以及与幻觉相关的痛苦方面有短期优势。此外，在ACT组中有更多参与者在出院时达到了临床上显著的症状改善。虽然ACT组4个月的再次住院率较低，但这些差异未达到统计学显著性。仅在ACT组观察到治疗期间幻觉可信度的降低，并且在控制幻觉频率变化后，可信度的变化与痛苦的变化密切相关。结果在很大程度上被解释为与Bach和Hayes的研究结果一致，并且需要用更大的样本进行进一步研究。
