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强迫症状:强迫观念性信念与经验性回避的作用

Obsessive-compulsive symptoms: the contribution of obsessional beliefs and experiential avoidance.

作者信息

Abramowitz Jonathan S, Lackey Gerald R, Wheaton Michael G

机构信息

University of North Carolina at Chapel Hill, United States.

出版信息

J Anxiety Disord. 2009 Mar;23(2):160-6. doi: 10.1016/j.janxdis.2008.06.003. Epub 2008 Jun 24.

Abstract

Experiential (emotional) avoidance (EA), a core concept in acceptance and commitment therapy, involves an unwillingness to endure upsetting emotions, thoughts, memories, and other private experiences; and is hypothesized to play a role in obsessive-compulsive disorder (OCD). The present study examined how well EA, relative to traditional cognitive-behavioral theoretical constructs such as dysfunctional core beliefs about intrusive thoughts, predicts obsessive-compulsive (OC) symptoms. A sample of 353 non-clinical participants completed measures of EA, core "obsessive" beliefs, and OC symptoms. Individuals reporting greater levels of OC symptoms endorsed more obsessive beliefs and EA relative those with lower levels of OC symptoms, even when accounting for general levels of psychological distress. Among those with more OC symptoms, EA did not show relationships with obsessive beliefs. Moreover, EA did not add significantly to the prediction of OC symptom dimensions over and above the contribution of general distress and obsessive beliefs. Obsessive beliefs, meanwhile, contributed significantly to the prediction of OC checking and obsessing symptoms after accounting for EA. It appears the construct of EA is too general to explain OC symptoms over and above cognitive-behavioral constructs such as core obsessive beliefs, which are more specific.

摘要

经验性(情绪性)回避(EA)是接纳与承诺疗法中的一个核心概念,指的是不愿意忍受令人苦恼的情绪、想法、记忆及其他个人体验;据推测,它在强迫症(OCD)中起一定作用。本研究考察了与诸如对侵入性想法的功能失调核心信念等传统认知行为理论结构相比,经验性回避在预测强迫观念及强迫行为(OC)症状方面的效果如何。353名非临床参与者完成了经验性回避、核心“强迫观念”信念及强迫观念及强迫行为症状的测量。报告强迫观念及强迫行为症状水平较高的个体,相较于症状水平较低者,认可更多的强迫观念信念和经验性回避,即便在考虑了一般心理困扰水平之后也是如此。在那些强迫观念及强迫行为症状较多的个体中,经验性回避与强迫观念信念之间未显示出关联。此外,除了一般困扰和强迫观念信念的影响外,经验性回避在预测强迫观念及强迫行为症状维度方面并未显著增加预测能力。与此同时,在考虑了经验性回避之后,强迫观念信念对强迫检查和强迫观念症状的预测有显著贡献。看来,经验性回避这一结构过于宽泛,无法在诸如更具特异性的核心强迫观念信念等认知行为结构之外解释强迫观念及强迫行为症状。

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