Perivoliotis Dimitri, Cather Corinne
University of Pennsylvania, 3535 Market St., Room 2032, Philadelphia, PA 19104, USA.
J Clin Psychol. 2009 Aug;65(8):815-30. doi: 10.1002/jclp.20614.
Negative symptoms account for much of the functional disability associated with schizophrenia and often persist despite pharmacological treatment. Cognitive behavioral therapy (CBT) is a promising adjunctive psychotherapy for negative symptoms. The treatment is based on a cognitive formulation in which negative symptoms arise and are maintained by dysfunctional beliefs that are a reaction to the neurocognitive impairment and discouraging life events frequently experienced by individuals with schizophrenia. This article outlines recent innovations in tailoring CBT for negative symptoms and functioning, including the use of a strong goal-oriented recovery approach, in-session exercises designed to disconfirm dysfunctional beliefs, and adaptations to circumvent neurocognitive and engagement difficulties. A case illustration is provided.
阴性症状是精神分裂症相关功能残疾的主要原因,并且即便经过药物治疗往往仍会持续存在。认知行为疗法(CBT)是一种针对阴性症状很有前景的辅助心理治疗方法。该治疗基于一种认知模式,即阴性症状的出现和持续是由功能失调性信念导致的,这些信念是对精神分裂症患者经常经历的神经认知损害和令人沮丧的生活事件的一种反应。本文概述了为阴性症状和功能量身定制CBT的最新创新方法,包括采用强有力的以康复为导向的方法、旨在反驳功能失调性信念的 session 内练习,以及为规避神经认知和参与困难而进行的调整。文中提供了一个病例说明。