Sanders Kathryn Amelia, Blanchard Edward B, Sykes Mark A
Department of Veterans Affairs, VA Connecticut Healthcare System, West Haven, CT 06516-2700, USA.
Appl Psychophysiol Biofeedback. 2007 Jun;32(2):111-9. doi: 10.1007/s10484-007-9037-7. Epub 2007 Jun 13.
Despite the accumulation of efficacy data for cognitive-behavioral treatment of Irritable Bowel Syndrome (IBS), efforts to investigate methods for increasing access to psychological treatments are in their infancy. The current study examined the efficacy of self-administered treatment in comparison to a wait list control. Twenty-eight participants monitored gastrointestinal (GI) symptoms and completed measures of quality of life (QOL) and psychological distress prior to randomized assignment to self-help treatment or wait list. Wait listed participants later received treatment. A 3 month post-treatment follow-up was included. Seven participants completed immediate treatment; nine the wait list. The self-help treatment significantly decreased composite GI symptom scores in comparison to the wait list, but did not lead to significant improvements in QOL or distress. In the entire treated sample, including wait list crossovers, analyses showed significant improvement in abdominal pain, average GI symptoms, and perceived health and well-being. Interpretation of these results should be considered in the context of several limitations, including small sample size, brief baseline symptom monitoring, and high drop out rate. Despite these limitations, this study is an important first step in empirically validating low-cost, self-administered treatments as a first line psychological intervention for IBS.
尽管肠易激综合征(IBS)认知行为治疗的疗效数据不断积累,但增加心理治疗可及性方法的研究仍处于起步阶段。本研究将自我管理治疗与等待名单对照组进行对比,检验了前者的疗效。28名参与者在被随机分配至自助治疗组或等待名单组之前,监测了胃肠道(GI)症状,并完成了生活质量(QOL)和心理困扰的测量。被列入等待名单的参与者随后接受了治疗。研究还包括治疗后3个月的随访。7名参与者完成了即时治疗;9名完成了等待名单治疗。与等待名单组相比,自助治疗显著降低了综合GI症状评分,但并未使QOL或困扰得到显著改善。在整个接受治疗的样本中,包括等待名单组中的交叉治疗者,分析显示腹痛、平均GI症状以及感知到的健康和幸福感均有显著改善。这些结果的解读应考虑到若干局限性,包括样本量小、基线症状监测时间短以及高失访率。尽管存在这些局限性,但本研究是将低成本的自我管理治疗作为IBS一线心理干预措施进行实证验证的重要第一步。