Niles Andrea N, Mesri Bita, Burklund Lisa J, Lieberman Matthew D, Craske Michelle G
University of California, 1285 Franz Hall, Box 951563, Los Angeles, CA 90095-1563, United States.
Behav Res Ther. 2013 Oct;51(10):669-79. doi: 10.1016/j.brat.2013.06.005. Epub 2013 Jul 13.
Cognitive behavioral therapy (CBT) is a well-established treatment for anxiety disorders, and evidence is accruing for the effectiveness of acceptance and commitment therapy (ACT). Little is known about factors that relate to treatment outcome overall (predictors), or who will thrive in each treatment (moderators). The goal of the current project was to test attentional bias and negative emotional reactivity as moderators and predictors of treatment outcome in a randomized controlled trial comparing CBT and ACT for social phobia. Forty-six patients received 12 sessions of CBT or ACT and were assessed for self-reported and clinician-rated symptoms at baseline, post treatment, 6, and 12 months. Attentional bias significantly moderated the relationship between treatment group and outcome with patients slow to disengage from threatening stimuli showing greater clinician-rated symptom reduction in CBT than in ACT. Negative emotional reactivity, but not positive emotional reactivity, was a significant overall predictor with patients high in negative emotional reactivity showing the greatest self-reported symptom reduction.
认知行为疗法（CBT）是一种针对焦虑症的成熟治疗方法，而接纳与承诺疗法（ACT）有效性的证据也在不断积累。对于与总体治疗结果相关的因素（预测因素），或者谁会在每种治疗中取得良好效果（调节因素），我们知之甚少。当前项目的目标是，在一项比较CBT和ACT治疗社交恐惧症的随机对照试验中，检验注意偏向和负性情绪反应性作为治疗结果的调节因素和预测因素。46名患者接受了12次CBT或ACT治疗，并在基线、治疗后、6个月和12个月时接受了自我报告和临床医生评定的症状评估。注意偏向显著调节了治疗组与结果之间的关系，难以从威胁性刺激中脱离的患者在CBT中比在ACT中表现出更大程度的临床医生评定症状减轻。负性情绪反应性而非正性情绪反应性是一个显著的总体预测因素，负性情绪反应性高的患者自我报告的症状减轻最为明显。
