一项结合情绪聚焦和人际治疗技术的认知行为疗法治疗广泛性焦虑障碍的随机对照试验。
A randomized controlled trial of cognitive-behavioral therapy for generalized anxiety disorder with integrated techniques from emotion-focused and interpersonal therapies.
机构信息
Department of Psychology The Pennsylvania State University, 310 Moore Building, University Park, PA 16802-3103, USA.
出版信息
J Consult Clin Psychol. 2011 Apr;79(2):171-81. doi: 10.1037/a0022489.
OBJECTIVE
Recent models suggest that generalized anxiety disorder (GAD) symptoms may be maintained by emotional processing avoidance and interpersonal problems.
METHOD
This is the first randomized controlled trial to test directly whether cognitive-behavioral therapy (CBT) could be augmented with the addition of a module targeting interpersonal problems and emotional processing. Eighty-three primarily White participants (mean age = 37) with a principle diagnosis of GAD were recruited from the community. Participants were assigned randomly to CBT plus supportive listening (n = 40) or to CBT plus interpersonal and emotional processing therapy (n = 43) within a study using an additive design. Doctoral-level psychologists with full-time private practices treated participants in an outpatient clinic. Using blind assessors, participants were assessed at pretreatment, posttreatment, 6-month, 1-year, and 2-year follow-up with a composite of self-report and assessor-rated GAD symptom measures (the Penn State Worry Questionnaire; T. J. Meyer, M. L. Miller, R. L. Metzger, & T. D. Borkovec, 1990; Hamilton Anxiety Rating Scale; M. Hamilton, 1959; assessor severity rating; State-Trait Anxiety Inventory-Trait Version; C. D. Spielberger, R. L. Gorsuch, R. Lushene, P. R. Vagg, & G. A. Jacobs, 1983) as well as with indices of clinically significant change.
RESULTS
Mixed models analysis of all randomized participants showed very large within-treatment effect sizes for both treatments (CI = [-.40, -.28], d = 1.86) with no significant differences at post (CI = [-.09, .07], d = .07) or 2-year follow-up (CI = [-.01, .01]), d = .12). There was also no statistical difference between compared treatments on clinically significant change based on chi-square analysis.
CONCLUSIONS
Interpersonal and emotional processing techniques may not augment CBT for all GAD participants. Trial Registry name: Clinical Trials.gov, Identifier: NCT00951652.
目的
最近的模型表明，广泛性焦虑症（GAD）症状可能是通过情绪处理回避和人际关系问题维持的。
方法
这是第一个直接测试认知行为疗法（CBT）是否可以通过增加针对人际关系问题和情绪处理的模块来增强的随机对照试验。从社区招募了 83 名主要为白人的参与者（平均年龄=37 岁），他们的主要诊断为 GAD。参与者随机分配到 CBT 加支持性倾听（n=40）或 CBT 加人际和情绪处理治疗（n=43），在一项采用附加设计的研究中。具有全职私人执业的博士级心理学家在门诊诊所治疗参与者。使用盲法评估员，在治疗前、治疗后、6 个月、1 年和 2 年随访时，使用自我报告和评估者评定的 GAD 症状综合指标（宾夕法尼亚州担忧问卷；T.J.Meyer、M.L.Miller、R.L.Metzger 和 T.D.Borkovec，1990；汉密尔顿焦虑量表；M.Hamilton，1959；评估者严重程度评定；状态-特质焦虑量表特质版；C.D.Spielberger、R.L.Gorsuch、R.Lushene、P.R.Vagg 和 G.A.Jacobs，1983）以及临床显著变化的指标对参与者进行评估。
结果
对所有随机参与者的混合模型分析显示，两种治疗方法的治疗内效果都非常大（CI=[-.40，-.28]，d=1.86），在治疗后（CI=[-.09，.07]，d=。.07）或 2 年随访时（CI=[-.01，.01]，d=。.12）无显著差异。基于卡方分析，比较治疗方法在临床显著变化上也没有统计学差异。
结论
人际和情绪处理技术可能不会增强所有 GAD 参与者的 CBT。试验注册名称：ClinicalTrials.gov，标识符：NCT00951652。
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