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焦虑敏感性作为惊恐障碍认知行为治疗后精神病理学广泛维度的预测指标。

Anxiety sensitivity as a predictor of broad dimensions of psychopathology after cognitive behavioral therapy for panic disorder.

作者信息

Ino Keiko, Ogawa Sei, Kondo Masaki, Imai Risa, Ii Toshitaka, Furukawa Toshi A, Akechi Tatsuo

机构信息

Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya.

Department of Health Promotion and Human Behavior, Kyoto University Graduate School of Medicine/School of Public Health, Kyoto, Japan.

出版信息

Neuropsychiatr Dis Treat. 2017 Jul 13;13:1835-1840. doi: 10.2147/NDT.S121360. eCollection 2017.

Abstract

BACKGROUND

Panic disorder (PD) is a common disease and presents with broad dimensions of psychopathology. Cognitive behavioral therapy (CBT) is known to improve these broad dimensions of psychopathology in addition to PD symptoms. However, little is known about the predictors of treatment response in comorbid psychiatric symptoms after CBT for PD. Recent studies suggest that anxiety sensitivity (AS) may be a key vulnerability for PD. This study aimed to examine AS as a predictor of broad dimensions of psychopathology after CBT for PD.

MATERIALS AND METHODS

In total, 118 patients with PD were treated with manualized group CBT. We used multiple regression analysis to examine the associations between 3 Anxiety Sensitivity Index (ASI) factors (physical concerns, mental incapacitation concerns, and social concerns) at baseline and the subscales of the Symptom Checklist-90 Revised (SCL-90-R) at endpoint.

RESULTS

Low levels of social concerns at baseline predicted low levels on 5 SCL-90-R subscales after CBT: interpersonal sensitivity, depression, hostility, paranoid ideation, and psychosis. High levels of mental incapacitation concerns significantly predicted low levels on 3 SCL-90-R subscales after treatment: interpersonal sensitivity, hostility, and paranoid ideation. Physical concerns at baseline did not predict broad dimensions of psychopathology.

CONCLUSION

This study suggested that the social concerns and mental incapacitation concerns subscales of the ASI at baseline predicted several dimensions of psychopathology after CBT for PD. To improve comorbid psychopathology, it may be useful to direct more attention to these ASI subscales.

摘要

背景

惊恐障碍(PD)是一种常见疾病,具有广泛的精神病理学表现。认知行为疗法(CBT)已知除了能改善PD症状外,还能改善这些广泛的精神病理学表现。然而,对于PD患者接受CBT治疗后共病精神症状的治疗反应预测因素知之甚少。最近的研究表明,焦虑敏感性(AS)可能是PD的一个关键易感性因素。本研究旨在检验AS作为PD患者接受CBT治疗后精神病理学广泛维度的预测因素。

材料与方法

总共118例PD患者接受了标准化的团体CBT治疗。我们使用多元回归分析来检验基线时3个焦虑敏感性指数(ASI)因素(身体担忧、心理无能担忧和社交担忧)与治疗结束时症状自评量表90修订版(SCL-90-R)各分量表之间的关联。

结果

基线时社交担忧水平较低预测了CBT治疗后SCL-90-R的5个分量表得分较低:人际敏感、抑郁、敌对、偏执观念和精神病性。心理无能担忧水平较高显著预测了治疗后SCL-90-R的3个分量表得分较低:人际敏感、敌对和偏执观念。基线时的身体担忧并未预测精神病理学的广泛维度。

结论

本研究表明,基线时ASI的社交担忧和心理无能担忧分量表预测了PD患者接受CBT治疗后的几个精神病理学维度。为了改善共病的精神病理学,更多地关注这些ASI分量表可能会有所帮助。

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Influence of vulnerability factors in panic disorder severity.
Psicothema. 2016 May;28(2):167-73. doi: 10.7334/psicothema2015.223.
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Combined psychotherapy plus benzodiazepines for panic disorder.联合心理治疗与苯二氮䓬类药物治疗惊恐障碍。
Cochrane Database Syst Rev. 2009 Jan 21(1):CD005335. doi: 10.1002/14651858.CD005335.pub2.
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Reliability and validity of the Japanese version of the Anxiety Sensitivity Index.日语版焦虑敏感性指数的信度与效度
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