Departmento de Psicologia de la Personalidad, Universidad de Valencia, Valencia, Spain.
Psychiatry Res. 2011 May 15;187(1-2):174-9. doi: 10.1016/j.psychres.2010.10.015. Epub 2010 Nov 13.
Current cognitive approaches postulate that obsessions and compulsions are caused and/or maintained by misinterpretations about their meaning. This assumption has led to the development of cognitive therapeutic (CT) procedures designed to challenge the dysfunctional appraisals and beliefs patients have about their obsessions. Nonetheless, few studies have compared the efficacy of individual and group CT in changing the dysfunctional cognitions that hypothetically underlie Obsessive-Compulsive Disorder (OCD). In this study, 44 OCD patients were assigned to individual (n=18) or group (n=24) CT. Sixteen completed the individual CT, and 22 completed the group CT. The effects of the two CT conditions on depression and worry tendencies were comparable. Individual treatment was more effective than group treatment in decreasing scores on dysfunctional beliefs (responsibility, overestimation of threat, and intolerance to uncertainty) and the use of suppression as a thought control strategy. The post-treatment changes were maintained one year later. The correlations between symptom improvement (OCD severity change) and belief changes were moderate: in the individual treatment the greatest associations were with beliefs about thoughts (importance and control), whereas in the group treatment the greatest associations were with beliefs related to anxiety in general (threat overestimation and intolerance to uncertainty).
当前的认知方法假设，强迫观念和强迫行为是由对其意义的误解引起和/或维持的。这一假设导致了认知治疗（CT）程序的发展，旨在挑战患者对强迫观念的功能失调的评估和信念。然而，很少有研究比较个体和团体 CT 在改变假设性地构成强迫症（OCD）的功能失调认知方面的疗效。在这项研究中，44 名强迫症患者被分配到个体（n=18）或团体（n=24）CT。16 人完成了个体 CT，22 人完成了团体 CT。两种 CT 条件对抑郁和担忧倾向的影响相当。个体治疗比团体治疗更有效地降低了功能失调信念（责任、对威胁的高估和对不确定性的不容忍）的得分和作为思维控制策略的抑制的使用。治疗后一年，治疗后的变化得以维持。症状改善（OCD 严重程度变化）与信念变化之间的相关性为中度：在个体治疗中，与思维相关的信念（重要性和控制）的相关性最大，而在团体治疗中，与一般焦虑相关的信念（对威胁的高估和对不确定性的不容忍）的相关性最大。
