Patricia Cooney, BA, School of Psychology, University College Dublin; Catherine Jackman, MPsychSc, Cheeverstown House, Dublin; David Coyle, PhD, School of Computer Science, University College Dublin; Gary O'Reilly, PhD, School of Psychology, University College Dublin, Ireland
Patricia Cooney, BA, School of Psychology, University College Dublin; Catherine Jackman, MPsychSc, Cheeverstown House, Dublin; David Coyle, PhD, School of Computer Science, University College Dublin; Gary O'Reilly, PhD, School of Psychology, University College Dublin, Ireland.
Br J Psychiatry. 2017 Aug;211(2):95-102. doi: 10.1192/bjp.bp.117.198630. Epub 2017 Jun 8.
Despite the evidence base for computer-assisted cognitive-behavioural therapy (CBT) in the general population, it has not yet been adapted for use with adults who have an intellectual disability.To evaluate the utility of a CBT computer game for adults who have an intellectual disability.A 2 × 3 (group × time) randomised controlled trial design was used. Fifty-two adults with mild to moderate intellectual disability and anxiety or depression were randomly allocated to two groups: computerised CBT (cCBT) or psychiatric treatment as usual (TAU), and assessed at pre-treatment, post-treatment and 3-month follow-up. Forty-nine participants were included in the final analysis.A significant group × time interaction was observed on the primary outcome measure of anxiety (Glasgow Anxiety Scale for people with an Intellectual Disability), favouring cCBT over TAU, but not on the primary outcome measure of depression (Glasgow Depression Scale for people with a Learning Disability). A medium effect size for anxiety symptoms was observed at post-treatment and a large effect size was observed after follow-up. Reliability of Change Indices indicated that the intervention produced clinically significant change in the cCBT group in comparison with TAU.As the first application of cCBT for adults with intellectual disability, this intervention appears to be a useful treatment option to reduce anxiety symptoms in this population.
尽管计算机辅助认知行为疗法（CBT）在普通人群中有充分的证据支持，但它尚未适用于有智力障碍的成年人。
评估 CBT 电脑游戏在有智力障碍的成年人中的效用。采用了 2×3（组×时间）随机对照试验设计。52 名轻度至中度智力障碍和焦虑或抑郁的成年人被随机分配到两组：计算机化 CBT（cCBT）或常规精神病治疗（TAU），并在治疗前、治疗后和 3 个月随访时进行评估。49 名参与者纳入最终分析。在主要结局测量焦虑（智障人士格拉斯哥焦虑量表）上观察到显著的组×时间交互作用，cCBT 优于 TAU，但在主要结局测量抑郁（智障人士格拉斯哥抑郁量表）上没有。在治疗后观察到焦虑症状的中等效应大小，在随访后观察到较大的效应大小。变化指标的可靠性表明，与 TAU 相比，干预措施在 cCBT 组中产生了临床显著的变化。
作为智力障碍成年人的 cCBT 的首次应用，该干预措施似乎是一种有用的治疗选择，可以减轻该人群的焦虑症状。
