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严重创伤性脑损伤后团体愤怒管理项目的有效性

Effectiveness of a group anger management programme after severe traumatic brain injury.

作者信息

Walker Alexandra J, Nott Melissa T, Doyle Margaret, Onus Margaret, McCarthy Kathleen, Baguley Ian J

机构信息

Brain Injury Rehabilitation Service, Westmead Hospital, Sydney, Australia.

出版信息

Brain Inj. 2010;24(3):517-24. doi: 10.3109/02699051003601721.

Abstract

PRIMARY OBJECTIVE

This study examined the effectiveness of a group approach to the treatment of anger management difficulties for people with severe traumatic brain injury (TBI).

RESEARCH DESIGN

Repeated-measures design with convenience sampling.

METHOD AND PROCEDURE

Participants were community living clients of a tertiary brain injury service. The group programme consisted of 12 weekly sessions based on a cognitive behavioural therapy (CBT) model, with modifications to incorporate compensations for TBI-related cognitive impairment. Treatment effectiveness was measured using the State-Trait Anger Expression Inventory (STAXI), at pre-treatment, post-treatment and follow-up.

MAIN OUTCOMES AND RESULTS

The programme was completed by 52 people across nine groups over the years 1998-2006 and 31 of these attended a follow-up session. Completion of the programme was associated with significant decreases in self-reported frequency with which anger was experienced (STAXI Trait Anger) and frequency of expression of anger (Anger Expression-Out), as well as a significant increase in reported attempts to control feelings of anger (Anger Control); changes were maintained at follow-up assessment.

CONCLUSIONS

A group CBT approach shows promise as an effective community-based treatment for anger control issues after severe TBI. Future research directions should include a wait-list control group and objective rating of anger expression.

摘要

主要目标

本研究考察了一种团体治疗方法对重度创伤性脑损伤(TBI)患者愤怒管理困难的治疗效果。

研究设计

采用便利抽样的重复测量设计。

方法与程序

参与者为一家三级脑损伤服务机构的社区居住客户。该团体项目包括基于认知行为疗法(CBT)模型的12次每周一次的课程,并进行了修改以纳入对TBI相关认知障碍的补偿。在治疗前、治疗后和随访时,使用状态-特质愤怒表达量表(STAXI)测量治疗效果。

主要结果

在1998年至2006年期间,九个小组中的52人完成了该项目,其中31人参加了随访。完成该项目与自我报告的愤怒体验频率(STAXI特质愤怒)和愤怒表达频率(愤怒表达-外向)显著降低以及报告的控制愤怒情绪尝试显著增加相关;这些变化在随访评估中得以维持。

结论

团体CBT方法有望成为重度TBI后基于社区的有效愤怒控制问题治疗方法。未来的研究方向应包括设立等待名单对照组以及对愤怒表达进行客观评分。

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