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认知疗法中患者对治疗内容的学习

Patient learning of treatment contents in cognitive therapy.

作者信息

Gumport Nicole B, Dong Lu, Lee Jason Y, Harvey Allison G

机构信息

Department of Psychology, University of California, Berkeley, USA.

Department of Psychology, University of California, Berkeley, USA.

出版信息

J Behav Ther Exp Psychiatry. 2018 Mar;58:51-59. doi: 10.1016/j.jbtep.2017.08.005. Epub 2017 Aug 31.

Abstract

BACKGROUND AND OBJECTIVES

Research has demonstrated that both memory and learning for treatment contents are poor, and that both are associated with worse treatment outcome. The Memory Support Intervention has been shown to improve memory for treatment, but it has not yet been established if this intervention can also improve learning of treatment contents. This study was designed to document the number of times participants exhibited each of the indices of learning, to examine the indices of learning and their relationship to recall of treatment points, and to investigate the association between the indices of learning and depression outcome.

METHODS

Adults diagnosed with major depressive disorder (N = 48) were randomly assigned to 14 sessions of cognitive therapy-as-usual (CT-as-usual) or cognitive therapy plus the Memory Support Intervention (CT + Memory Support). Measures of learning, memory, and depressive symptomatology were taken at mid-treatment, post-treatment, and at 6-month follow-up.

RESULTS

Relative to the CT-as-usual group, participants in the CT + Memory Support group reported more accurate thoughts and applications of treatment points at mid-treatment, post-treatment, and 6-month follow-up. Patient recall was significantly correlated with application and cognitive generalization. Thoughts and application at mid-treatment were associated with increased odds of treatment response at post-treatment.

LIMITATIONS

The learning measure for this study has not yet been psychometrically validated. The results are based on a small sample.

CONCLUSIONS

Learning during treatment is poor, but modifiable via the Memory Support Intervention. These results provide encouraging data that improving learning of treatment contents can reduce symptoms during and following treatment.

摘要

背景与目的

研究表明,对治疗内容的记忆和学习效果均较差,且二者均与较差的治疗结果相关。记忆支持干预已被证明可改善对治疗的记忆,但该干预是否也能改善对治疗内容的学习尚未得到证实。本研究旨在记录参与者表现出的各项学习指标的次数,考察学习指标及其与治疗要点回忆的关系,并调查学习指标与抑郁结局之间的关联。

方法

将被诊断为重度抑郁症的成年人(N = 48)随机分配至接受14次常规认知疗法(常规CT)或认知疗法加记忆支持干预(CT + 记忆支持)。在治疗中期、治疗后及6个月随访时测量学习、记忆和抑郁症状。

结果

与常规CT组相比,CT + 记忆支持组的参与者在治疗中期、治疗后及6个月随访时报告了更准确的治疗要点想法和应用。患者的回忆与应用及认知泛化显著相关。治疗中期的想法和应用与治疗后治疗反应几率增加相关。

局限性

本研究的学习测量方法尚未经过心理测量学验证。结果基于小样本。

结论

治疗期间的学习效果较差,但可通过记忆支持干预加以改善。这些结果提供了令人鼓舞的数据,表明改善对治疗内容的学习可减轻治疗期间及治疗后的症状。

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