Mennin Douglas S, Fresco David M, Ritter Michael, Heimberg Richard G
Department of Psychology, Hunter College, City University of New York, New York.
Department of Psychological Sciences, Kent State University, Kent, Ohio.
Depress Anxiety. 2015 Aug;32(8):614-23. doi: 10.1002/da.22377. Epub 2015 May 6.
Although CBT is efficacious for a wide variety of psychiatric conditions, relatively fewer GAD patients achieve high endstate functioning as compared to patients receiving CBTs for other disorders. Moreover, GAD trials that utilized patient samples without prominent depression have tended to report that effect sizes for depressive outcomes were small or diminished to pretreatment levels in the follow-up period. Emotion regulation therapy (ERT) integrates principles from traditional and contemporary cognitive behavioral treatments with basic and translational findings from affect science to offer a blueprint for improving intervention by focusing on motivational, regulatory, and contextual learning mechanisms.
The purpose of this investigation was to provide initial support for the efficacy of ERT in an open trial of patients with GAD and cooccurring depressive symptoms. Twenty-one patients received a 20-session version of ERT delivered in weekly individual sessions. Standardized clinician ratings and self-report measures were assessed at pre-, mid-, and posttreatment as well as at three- and nine-month follow-ups. Intent-to-treat analyzes were utilized.
GAD patients, half with comorbid major depression, evidenced statistically, and clinically meaningful improvements in symptom severity, impairment, quality of life, and in model-related outcomes including emotional/motivational intensity, mindful attending/acceptance, decentering, and cognitive reappraisal. Patients maintained gains across the three and nine month follow-up periods.
These findings, although preliminary, provide additional evidence for the role of emotion dysregulation in the onset, maintenance, and now treatment of conditions such as GAD and cooccurring depressive symptoms.
尽管认知行为疗法（CBT）对多种精神疾病有效，但与接受CBT治疗其他疾病的患者相比，广泛性焦虑症（GAD）患者达到高最终状态功能的相对较少。此外，使用无明显抑郁的患者样本的GAD试验往往报告，抑郁结果的效应大小较小或在随访期降至治疗前水平。情绪调节疗法（ERT）将传统和当代认知行为治疗的原则与情感科学的基础和转化研究结果相结合，通过关注动机、调节和情境学习机制，为改善干预提供了一个蓝图。
本研究的目的是在一项针对患有GAD和并发抑郁症状患者的开放试验中，为ERT的疗效提供初步支持。21名患者接受了为期20节的ERT治疗，每周进行一次个体治疗。在治疗前、治疗中期、治疗后以及三个月和九个月的随访中，评估标准化的临床医生评分和自我报告测量。采用意向性分析。
GAD患者中，一半患有共病的重度抑郁症，在症状严重程度、损害、生活质量以及包括情绪/动机强度、正念关注/接受、去中心化和认知重新评估等与模型相关的结果方面，有统计学意义和临床意义的改善。患者在三个月和九个月的随访期内保持了改善。
这些发现虽然是初步的，但为情绪调节障碍在GAD和并发抑郁症状等疾病的发病、维持以及现在的治疗中的作用提供了额外证据。
