Behavioral Medicine Service, MGH Department of Psychiatry, One Bowdoin Square, 7th Floor, Boston, MA 02114, USA.
Psychiatr Clin North Am. 2010 Sep;33(3):497-509. doi: 10.1016/j.psc.2010.04.001.
Attention-deficit/hyperactivity disorder (ADHD) is a valid and impairing psychological disorder that persists into adulthood in a majority of cases and is associated with chronic functional impairment and increased rates of comorbidity. Cognitive behavioral therapy (CBT) approaches for this disorder have emerged recently, and available evidence from open and randomized controlled trials suggests that these approaches are promising in producing significant symptom reduction. A conceptual model of how CBT may work for ADHD is reviewed along with existing efficacy studies. A preliminary comparison of effect sizes across intervention packages suggests that targeted learning and practice of specific behavioral compensatory strategies may be a critical active ingredient in CBT for adult ADHD. The article concludes with a discussion of future directions and critical questions that must be addressed in this area of clinical research.
注意缺陷多动障碍(ADHD)是一种有效的、会造成损害的心理障碍,在大多数情况下会持续到成年期,并且与慢性功能障碍和更高的合并症发生率相关。针对这种障碍的认知行为疗法(CBT)方法最近已经出现,来自开放和随机对照试验的现有证据表明,这些方法在产生显著症状减轻方面很有前景。本文回顾了 CBT 对 ADHD 可能起作用的概念模型以及现有的疗效研究。对干预方案的效应大小进行初步比较表明,有针对性地学习和实践特定的行为补偿策略可能是成人 ADHD 的 CBT 的一个关键有效成分。文章最后讨论了该临床研究领域未来的方向和必须解决的关键问题。