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计算机化行为激活治疗抑郁症的初步开放性试验。

Initial open trial of a computerized behavioral activation treatment for depression.

机构信息

Western Michigan University, Kalamazoo, MI 49000, USA.

出版信息

Behav Modif. 2013 May;37(3):259-97. doi: 10.1177/0145445512455051. Epub 2012 Sep 17.

Abstract

This article presents preliminary findings from use of a novel computer program that implements an evidence-based psychological intervention to treat depression based on behavioral activation (BA) therapy. The program is titled "Building a Meaningful Life Through Behavioral Activation". The findings derive from an open trial with moderate to severely depressed individuals (N = 15) in an Intention to Treat sample. Hierarchical linear modeling (HLM) analyses revealed significant change over time on Beck Depression Inventory-Second Edition (BDI-II) scores, Revised Hamilton Depression Rating Scale scores, and significant contribution to BDI-II score variance by participant age over time, change over time in negative automatic thoughts, and change over time in BA scores. Piecewise HLM analyses revealed that significant change over time was associated uniquely with active treatment and not during 3 weeks of baseline measurement. In addition to treatment-associated significant change on all dependent measures over time, effect sizes were in the moderate to large range. Limitations are small sample size, nonrandomized control, research-recruited patients instead of purely treatment-seeking patients, possible rating bias by independent assessors who had knowledge that participants had received active treatment in this open trial, and the influence of additional services received in the post acute-treatment phase by some participants could have contributed to maintenance of gains reported for that period.

摘要

本文介绍了一项初步研究结果,该研究使用了一种新的计算机程序,该程序基于行为激活(BA)疗法实施了一种基于循证的心理干预措施来治疗抑郁症。该程序名为“通过行为激活建立有意义的生活”。研究结果来自一项中度至重度抑郁患者(N=15)的开放性试验,采用意向治疗样本。分层线性模型(HLM)分析显示,贝克抑郁量表第二版(BDI-II)评分、汉密尔顿抑郁评定量表修订版(HAMD-R)评分随时间显著变化,参与者年龄随时间的变化、负性自动思维的变化以及 BA 评分随时间的变化对 BDI-II 评分方差有显著贡献。分段 HLM 分析显示,随时间的显著变化与积极治疗相关,而不是在 3 周的基线测量期间。除了所有随时间变化的依赖测量值的治疗相关显著变化外,效应大小也处于中到大的范围。研究存在一些局限性,包括样本量小、非随机对照、研究招募的患者而非纯粹寻求治疗的患者、独立评估者可能存在评分偏差,因为他们知道参与者在这项开放性试验中接受了积极治疗,以及一些参与者在急性治疗后阶段接受的额外服务可能对报告的那段时间的收益维持有影响。

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