a Sunnybrook Health Sciences Centre , Toronto , Ontario , Canada.
b Department of Psychiatry , University of Toronto , Toronto , Ontario , Canada.
Cogn Behav Ther. 2017 Nov;46(6):459-477. doi: 10.1080/16506073.2017.1334087. Epub 2017 Jun 22.
Distress tolerance (DT) and intolerance of uncertainty (IU) have been identified as transdiagnostic processes that predict symptom severity across a range of distinct anxiety disorders. However, the joint effect of these two variables on therapeutic outcome has not yet been examined. It is possible that DT and IU may both impact on treatment response to cognitive-behavioural therapy (CBT) in clients with anxiety, as clients with weak DT and strong IU may be less likely to engage in exposure and cognitive restructuring tasks across treatment due to their associated distress. The purpose of this study was to examine the interaction of DT and IU as predictors of post-treatment symptom severity and treatment response to group CBT in participants with primary DSM-IV-TR diagnosed social anxiety disorder (SAD). Participants (N = 95) with SAD completed 12 weeks of manualized group CBT. Results of multilevel longitudinal analysis demonstrated an interaction effect, such that lower DT and higher IU predicted higher SAD symptom severity across the course of therapy. The findings are discussed in terms of clinical implications for the disorder-specific and transdiagnostic treatment of anxiety disorders.
痛苦容忍度（DT）和不确定性容忍度（IU）已被确定为跨诊断过程，可预测一系列不同焦虑症的症状严重程度。然而，这两个变量对治疗结果的联合影响尚未得到检验。DT 和 IU 都可能影响焦虑症患者对认知行为疗法（CBT）的治疗反应，因为 DT 较弱且 IU 较强的患者由于相关的痛苦，可能不太愿意在整个治疗过程中进行暴露和认知重构任务。本研究的目的是检验 DT 和 IU 的交互作用，作为预测原发性 DSM-IV-TR 诊断社交焦虑障碍（SAD）患者治疗后症状严重程度和对团体 CBT 治疗反应的指标。患有 SAD 的参与者（N=95）完成了 12 周的手册化团体 CBT。多层次纵向分析的结果表明存在交互作用，即较低的 DT 和较高的 IU 预示着治疗过程中 SAD 症状严重程度较高。这些发现从特定于疾病和跨诊断治疗焦虑症的临床意义方面进行了讨论。
