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强迫症、广泛性焦虑症和疑病症患者临床侵入性思维的差异。

Differences in clinical intrusive thoughts between obsessive-compulsive disorder, generalized anxiety disorder, and hypochondria.

机构信息

Personality, Assessment,and Psychological Treatments Department, School of Psychology, University of Malaga, Malaga, Spain.

Mental Health Clinical Management Unit, Biomedical Research Institute of Malaga (IBIMA) Regional University Hospital Carlos Haya, Malaga, Spain.

出版信息

Clin Psychol Psychother. 2017 Nov;24(6):O1464-O1473. doi: 10.1002/cpp.2107. Epub 2017 Jul 26.

Abstract

Differences and similarities between intrusive thoughts typical of obsessive-compulsive disorder, generalized anxiety disorder, and hypochondriasis are relevant for their differential diagnosis, formulation, and psychological treatment. Previous research in non-clinical samples pointed out the relevance of some process variables, such as responsibility, guilt, or neutralization strategies. This research is aimed to investigate the differences and similarities between clinical obsessions, worries, and illness intrusions in some of these process variables. A second aim is to identify models based on these variables that could reliably differentiate between them. Three groups of patients with obsessive-compulsive disorder (n = 35; 60% women, mean age 38.57), generalized anxiety disorder (n = 36; 61.1% women, mean age 41.50), and hypochondriasis (n = 34; 70.6% women, mean age 31.59) were evaluated using the Cognitive Intrusions Questionnaire-Transdiagnostic Version (Romero-Sanchiz, Nogueira-Arjona, Godoy-Ávila, Gavino-Lázaro, & Freeston, ). The results showed that some appraisals (e.g., responsibility or egodystonicity), emotions (e.g., guilt or insecurity), neutralization strategies, and other variables (e.g., verbal content or trigger from body sensation) are relevant for the discrimination between obsessions, worries, and illness intrusions. The results also showed 3 stable models based on these variables for the discrimination between these thoughts. The implication of these results in the diagnosis, formulation, and psychological treatment of obsessive-compulsive disorder, generalized anxiety disorder, and hypochondriasis is discussed.

摘要

强迫症、广泛性焦虑症和疑病症中侵入性思维的差异和相似之处与它们的鉴别诊断、表述和心理治疗有关。先前在非临床样本中的研究指出了一些过程变量的相关性,例如责任感、内疚感或中和策略。本研究旨在调查这些过程变量中临床强迫观念、担忧和疾病侵入之间的差异和相似之处。第二个目的是确定基于这些变量的模型,这些模型可以可靠地区分它们。三组患者被纳入研究:强迫症患者(n=35;女性占 60%,平均年龄 38.57 岁)、广泛性焦虑症患者(n=36;女性占 61.1%,平均年龄 41.50 岁)和疑病症患者(n=34;女性占 70.6%,平均年龄 31.59 岁),使用认知侵入问卷-跨诊断版本(Romero-Sanchiz、Nogueira-Arjona、Godoy-Ávila、Gavino-Lázaro 和 Freeston,)进行评估。结果表明,一些评估(例如责任感或自我不和谐)、情绪(例如内疚感或不安全感)、中和策略和其他变量(例如言语内容或来自身体感觉的触发)对于区分强迫观念、担忧和疾病侵入是相关的。结果还显示,基于这些变量的 3 个稳定模型可用于区分这些思维。讨论了这些结果在强迫症、广泛性焦虑症和疑病症的诊断、表述和心理治疗中的意义。

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