Narayanan Gitanjali, Naaz Shaima
Department of Clinical Psychology and Centre for Addiction Medicine, National Institute of Mental Health and Neuro Sciences, Bengaluru, Karnataka, India.
Indian J Psychiatry. 2018 Feb;60(Suppl 4):S522-S528. doi: 10.4103/psychiatry.IndianJPsychiatry_20_18.
Recent research points to a shift from categorical diagnoses to a dimensional understanding of psychopathology and mental health disorders. In parallel, there has been a rise in newer psychosocial treatment modalities, which are inherently transdiagnostic. Transdiagnostic approaches are those that identify core vulnerabilities and apply universal principles to therapeutic treatment. As treatment of substance use disorders (SUD) must invariably accommodate such vulnerabilities, clinicians are finding such interventions useful. Therapies like Acceptance and Commitment Therapy (ACT), Dialectical Behavioural Therapy (DBT), Metacognitive Therapy, Mindfulness-Based Relapse Prevention (MBRP) use a transdiagnostic framework and are backed by evidence in the last 3-5 years. In this paper we first highlight the conceptual understanding of SUD through these frameworks and then discuss their clinical applications along with specific techniques that have been particularly useful with this population.
最近的研究表明,心理病理学和精神健康障碍的理解正从分类诊断转向维度理解。与此同时,更新的心理社会治疗模式有所增加,这些模式本质上是跨诊断的。跨诊断方法是指识别核心脆弱性并将通用原则应用于治疗的方法。由于物质使用障碍(SUD)的治疗必须始终适应这些脆弱性,临床医生发现此类干预措施很有用。像接纳与承诺疗法(ACT)、辩证行为疗法(DBT)、元认知疗法、基于正念的复发预防(MBRP)等疗法都使用跨诊断框架,并且在过去3至5年中有证据支持。在本文中,我们首先通过这些框架突出对SUD的概念理解,然后讨论它们的临床应用以及对这一人群特别有用的具体技术。