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成人门诊样本中认知行为疗法治疗焦虑症的长期疗效:一项随访研究。

Long-term effectiveness of CBT for anxiety disorders in an adult outpatient clinic sample: a follow-up study.

机构信息

Anxiety Disorders Center, Institute of Living/Hartford Hospital, Hartford, CT 06106, USA.

出版信息

Behav Res Ther. 2013 Feb;51(2):82-6. doi: 10.1016/j.brat.2012.10.003. Epub 2012 Oct 30.

Abstract

The short-term efficacy and effectiveness of Cognitive-Behavioral Therapy (CBT) for treating anxiety disorders in adults has been well established by a multitude of clinical studies and well-controlled randomized trials. However, though the long-term efficacy of CBT as a treatment modality is fairly well established, the degree of its long-term effectiveness has yet to be fully evaluated. Thus, the present study sought to assess both the immediate and long-term effectiveness of individually-administered CBT for the treatment of anxiety disorders in an outpatient psychological clinic. Individuals with a primary diagnosis of Panic Disorder, Social Phobia, Posttraumatic Stress Disorder, Generalized Anxiety Disorder, or Obsessive-Compulsive Disorder who had received 3 or more sessions of CBT were assessed for symptom severity and improvement prior to initiating treatment, at posttreatment, and at one-year follow-up. Symptom severity and improvement ratings were used to categorize patients as "responders" or "remitters" at posttreatment, and "maintained responders" or "maintained remitters" at follow-up. Findings demonstrated that posttreatment success as responder and remitter was significantly maintained at one-year follow-up. Additionally, pre- and posttreatment severity and posttreatment improvement scores were also predictive of maintenance. Furthermore, effect sizes were used to compare the effectiveness of CBT in the present clinical sample to research treatment outcomes demonstrated by previous efficacy studies.

摘要

认知行为疗法(CBT)治疗成人焦虑症的短期疗效和有效性已被大量临床研究和对照随机试验所证实。然而,尽管 CBT 作为一种治疗方式的长期疗效已得到相当充分的确立,但它的长期有效性程度尚未得到充分评估。因此,本研究旨在评估门诊心理诊所中个体实施的 CBT 治疗焦虑症的即时和长期效果。在开始治疗之前、治疗后和一年随访时,对患有惊恐障碍、社交恐惧症、创伤后应激障碍、广泛性焦虑症或强迫症的患者进行症状严重程度和改善情况的评估,这些患者已经接受了 3 次或更多次的 CBT。症状严重程度和改善评分用于在治疗后将患者归类为“应答者”或“缓解者”,并在随访时将患者归类为“持续应答者”或“持续缓解者”。研究结果表明,治疗后作为应答者和缓解者的成功率在一年随访时显著维持。此外,治疗前和治疗后的严重程度以及治疗后的改善评分也可预测维持情况。此外,还使用效应量将本临床样本中的 CBT 有效性与以前的疗效研究显示的研究治疗结果进行比较。

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