Miklowitz David J, Johnson Sheri L
University of Colorado, Boulder.
Clin Psychol (New York). 2009 Dec 1;16(4):470-475. doi: 10.1111/j.1468-2850.2009.01185.x.
Nusslock, Abramson, Harmon-Jones, Alloy, and Coan (this issue) propose that current psychosocial treatments for bipolar disorder be supplemented with interventions focused on altering goal dysregulation pathways. While innovations to existing treatment manuals are always welcome, there are several reasons why this suggestion may require further consideration. We highlight issues pertaining to the status of cognitive-behavioral therapy for bipolar disorder, the distinction between education and psychoeducation, the nature of familial expressed emotion, differences between clinical and analog samples, and the larger question of how to assess mechanisms in psychosocial treatment studies. We also raise the question of whether an optimistic goal orientation can be a protective factor in patients' long-term coping with bipolar disorder.
努斯洛克、艾布拉姆森、哈蒙-琼斯、阿洛伊和科恩（本期）提议，双相情感障碍的当前心理社会治疗应辅以专注于改变目标失调途径的干预措施。虽然现有治疗手册的创新总是值得欢迎的，但有几个原因表明这一建议可能需要进一步考虑。我们强调了与双相情感障碍认知行为疗法的地位、教育与心理教育的区别、家族性情感表达的性质、临床样本与模拟样本之间的差异，以及心理社会治疗研究中如何评估机制这一更大问题相关的问题。我们还提出了一个问题，即乐观的目标导向是否可以成为患者长期应对双相情感障碍的保护因素。
