Siev Jedidiah, Chambless Dianne L
Department of Psychology, University of Pennsylvania, Philadelphia, PA 19104-6241, USA.
J Consult Clin Psychol. 2007 Aug;75(4):513-22. doi: 10.1037/0022-006X.75.4.513.
The aim of this study was to address claims that among bona fide treatments no one is more efficacious than another by comparing the relative efficacy of cognitive therapy (CT) and relaxation therapy (RT) in the treatment of generalized anxiety disorder (GAD) and panic disorder without agoraphobia (PD). Two fixed-effects meta-analyses were conducted, for GAD and PD separately, to review the treatment outcome literature directly comparing CT with RT in the treatment of those disorders. For GAD, CT and RT were equivalent. For PD, CT, which included interoceptive exposure, outperformed RT on all panic-related measures, as well as on indices of clinically significant change. There is ample evidence that both CT and RT qualify as bona fide treatments for GAD and PD, for which they are efficacious and intended to be so. Therefore, the finding that CT and RT do not differ in the treatment of GAD, but do for PD, is evidence for the specificity of treatment to disorder, even for 2 treatments within a CBT class, and 2 disorders within an anxiety class.
本研究的目的是通过比较认知疗法(CT)和放松疗法(RT)在治疗广泛性焦虑症(GAD)和无广场恐怖症的惊恐障碍(PD)中的相对疗效,来回应关于在真正的治疗方法中不存在一种比另一种更有效的说法。针对GAD和PD分别进行了两项固定效应荟萃分析,以回顾直接比较CT与RT治疗这些疾病的治疗结果文献。对于GAD,CT和RT疗效相当。对于PD,包含内感受暴露的CT在所有与惊恐相关的测量指标以及临床显著变化指标上均优于RT。有充分证据表明,CT和RT均符合GAD和PD的真正治疗方法的标准,它们对这些疾病有效且旨在如此。因此,CT和RT在治疗GAD时无差异,但在治疗PD时存在差异,这一发现证明了治疗针对疾病的特异性,即使是在认知行为疗法类别中的两种治疗方法,以及焦虑症类别中的两种疾病。