Institute of Psychiatry,Psychology and Neuroscience,King's College London,UK.
University of Oxford,UK.
Behav Cogn Psychother. 2017 Jan;45(1):58-72. doi: 10.1017/S1352465816000394. Epub 2016 Oct 3.
It has been suggested that the behavioural activation (BA) treatments for depression unfold their effects, at least partly, through changes in approach and avoidance tendencies. However, as yet, little research has examined the cognitive effects of these interventions.
This study investigated the impact of a single session of BA on depressive symptomatology, self-reported avoidance, and behavioural approach and avoidance tendencies.
Forty-six patients with a diagnosis of Major Depression were recruited from primary care psychological therapies services and block randomized to either a single session of behavioural activation (n = 22) or waiting list control (n = 24) delivered by an unblinded therapist. Self-reports of symptoms and cognitive factors were assessed before and after the one-week intervention phase. Approach and avoidance behavioural tendencies were assessed using the Approach-Avoidance Task (AAT).
Data from 40 participants (n = 20 in each group) was available for analyses. Depressive symptoms significantly decreased, and activation significantly increased from before to after treatment in the treatment group, but not in the control group. Performance on the AAT showed a trend indicating increased approach to positive valence stimuli in the treatment group, but not in the control group. Mediational analyses indicated small indirect effects of self-reported change in activation as mediators of the effect of condition on symptoms.
The findings suggest that a single session of BA can have significant effects on symptoms in clinically depressed patients. Results hint at the possibility that increased behavioural approach might mediate the effect of BA.
有人认为,行为激活(BA)治疗抑郁症的效果至少部分是通过改变接近和回避倾向来实现的。然而,迄今为止,很少有研究检查这些干预措施的认知效果。
本研究调查了单次 BA 对抑郁症状、自我报告的回避以及行为接近和回避倾向的影响。
从初级保健心理治疗服务中招募了 46 名被诊断为重度抑郁症的患者,并按块随机分为行为激活(n = 22)或等待名单对照(n = 24)组,由非盲治疗师进行治疗。在一周的干预阶段前后评估自我报告的症状和认知因素。使用接近回避任务(AAT)评估接近和回避行为倾向。
可分析的 40 名参与者的数据(n = 20 人/组)。在治疗组中,治疗后抑郁症状显著减轻,激活显著增加,但在对照组中则没有。AAT 的结果显示出一种趋势,表明治疗组对正性效价刺激的接近程度增加,但对照组则没有。中介分析表明,自我报告的激活变化作为条件对症状影响的中介因素,具有较小的间接效应。
这些发现表明,单次 BA 可以对临床抑郁患者的症状产生显著影响。结果暗示,行为接近的增加可能介导 BA 的效果。