McEvoy Peter M, Erceg-Hurn David M, Saulsman Lisa M, Thibodeau Michel A
Centre for Clinical Interventions, Perth, Australia; School of Psychology and Speech Pathology, Curtin University, Perth, Australia.
Centre for Clinical Interventions, Perth, Australia; School of Psychology, University of Western Australia, Perth, Australia.
Behav Res Ther. 2015 Feb;65:42-51. doi: 10.1016/j.brat.2014.12.011. Epub 2014 Dec 27.
Emerging evidence suggests that imagery-based techniques may enhance the effectiveness of traditional verbal-linguistic cognitive interventions for emotional disorders. This study extends an earlier pilot study by reporting outcomes from a naturalistic trial of an imagery-enhanced cognitive behavioural group therapy (IE-CBGT, n = 53) protocol for social anxiety disorder (SAD), and comparing outcomes to historical controls who completed a predominantly verbally-based group protocol (n = 129). Patients were consecutive referrals from health professionals to a community clinic specialising in anxiety and mood disorders. Both treatments involved 12, two-hour group sessions plus a one-month follow-up. Analyses evaluated treatment adherence, predictors of dropout, treatment effect sizes, reliable and clinically significant change, and whether self-reported tendencies to use imagery in everyday life and imagery ability predicted symptom change. IE-CBGT patients were substantially more likely to complete treatment than controls (91% vs. 65%). Effect sizes were very large for both treatments, but were significantly larger for IE-CBGT. A higher proportion of the IE-CBGT patients achieved reliable change, and better imagery ability was associated with larger symptom change. Outcomes compared very favourably to published group and individual treatments for SAD, suggesting that IE-CBGT may be a particularly effective and efficient mode of treatment delivery.
新出现的证据表明，基于意象的技术可能会提高传统言语-语言认知干预对情绪障碍的有效性。本研究扩展了一项早期的试点研究，报告了一项针对社交焦虑障碍（SAD）的意象增强认知行为团体治疗（IE-CBGT，n = 53）方案的自然主义试验结果，并将结果与完成主要基于言语的团体方案的历史对照组（n = 129）进行比较。患者是从卫生专业人员连续转诊至一家专门治疗焦虑和情绪障碍的社区诊所的。两种治疗都包括12次两小时的团体治疗课程以及为期一个月的随访。分析评估了治疗依从性、退出治疗的预测因素、治疗效应大小、可靠且具有临床意义的变化，以及日常生活中自我报告的使用意象的倾向和意象能力是否能预测症状变化。IE-CBGT患者完成治疗的可能性显著高于对照组（91%对65%）。两种治疗的效应大小都非常大，但IE-CBGT的效应大小显著更大。更高比例的IE-CBGT患者实现了可靠的变化，且更好的意象能力与更大的症状变化相关。与已发表的针对SAD的团体和个体治疗相比，结果非常有利，表明IE-CBGT可能是一种特别有效且高效的治疗方式。
