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认知行为团体治疗对惊恐障碍患者应对策略改变的效果。

Effect of cognitive-behavioral group therapy for panic disorder in changing coping strategies.

机构信息

Anxiety Disorders Program, Hospital de Clínicas de Porto Alegre, Brazil; Graduate Program in Medical Sciences: Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.

出版信息

Compr Psychiatry. 2014 Jan;55(1):87-92. doi: 10.1016/j.comppsych.2013.06.008. Epub 2013 Aug 17.

Abstract

BACKGROUND

Cognitive-behavioral group therapy (CBGT) is an efficient treatment for panic disorder (PD). However, the role of CBGT in enhancing strategies to cope with stressful events has not been established.

AIM

To evaluate the effect of CBGT on the choice of coping strategy by PD patients compared to a group of individuals without mental disorders.

METHODS

Forty-eight PD patients who completed a 12-session CBGT protocol were compared to 75 individuals without mental disorders regarding coping strategies as evaluated by the Coping Strategies Inventory (CSI). The severity of PD was assessed at baseline and after CBGT through the Clinical Global Impression (CGI) scale, the Hamilton Anxiety Scale (HAM-A), and the Panic Inventory (PI).

RESULTS

Treatment was effective in reducing PD severity in all outcome measures. Patients used significantly fewer confrontation, escape and avoidance strategies after CBGT. The use of more adaptive coping strategies was related to a decrease in panic attacks and anticipatory anxiety. Application of the CSI showed that the use of strategies was also significantly different in patients as compared to the control group, except for escape and avoidance, which became similar after the CBGT protocol.

CONCLUSIONS

Despite the changes observed after the CBGT protocol, the choice of coping strategy was still different in patients vs. controls. The current CBGT protocol was used specifically to assess PD symptoms. Other cognitive tools should be included to address maladaptive coping strategies.

摘要

背景

认知行为团体治疗(CBGT)是治疗惊恐障碍(PD)的有效方法。然而,CBGT 在增强应对压力事件的策略方面的作用尚未确定。

目的

评估 CBGT 对 PD 患者与无精神障碍个体选择应对策略的影响。

方法

将完成 12 节 CBGT 方案的 48 名 PD 患者与 75 名无精神障碍个体进行比较,通过应对策略量表(CSI)评估应对策略。使用临床总体印象量表(CGI)、汉密尔顿焦虑量表(HAM-A)和惊恐量表(PI)在基线和 CBGT 后评估 PD 的严重程度。

结果

治疗在所有结局测量中均有效降低 PD 的严重程度。患者在 CBGT 后使用更少的对抗、逃避和回避策略。更多适应性应对策略的使用与惊恐发作和预期焦虑的减少有关。CSI 的应用表明,患者与对照组的策略使用也存在显著差异,除了逃避和回避,这两种策略在 CBGT 方案后变得相似。

结论

尽管 CBGT 方案后观察到了变化,但患者与对照组的应对策略选择仍存在差异。目前的 CBGT 方案专门用于评估 PD 症状。应该纳入其他认知工具来解决适应不良的应对策略。

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