Butlin B, Wilson C
School of Psychology,Trinity College Dublin,Dublin 2,Ireland.
Behav Cogn Psychother. 2018 Jul;46(4):405-420. doi: 10.1017/S1352465818000115. Epub 2018 Apr 4.
How we conceptualize mental health conditions is important as it impacts on a wide range of mediators of treatment outcome. We do not know how children intuitively conceptualize obsessive-compulsive disorder (OCD), nor do we know the relative impact of biomedical or cognitive behavioural conceptual explanations, yet both are being widely used in psychoeducation for children with OCD.
This study identified children's naive concepts of OCD, and the comparative impact of biomedical versus cognitive behavioural psychoeducation on perceived prognosis.
A within- and between-subjects experimental design was used. After watching a video of a young person describing their OCD, 202 children completed a questionnaire examining their concepts of the condition. They repeated the questionnaire following a second equivalent video, this time preceded by either biomedical or cognitive behavioural psychoeducation.
Participants' naive concepts of OCD reflected predominant models of OCD in healthcare. Even at the minimal dose of psychoeducation, participants' conceptualizations of OCD changed. Prior exposure to OCD resulted in a stronger alignment with the biomedical model. Exposure to biomedical psychoeducation resulted in participants predicting a slower recovery with less chance of complete remission.
Psychoeducation for childhood OCD is impactful. Despite its wide use by clinicians and mental health services, biomedical psychoeducation appears to have deleterious effects. Children's concepts of OCD merit attention but caution should be applied in how they are targeted.
我们如何界定心理健康状况至关重要,因为它会影响治疗结果的多种调节因素。我们尚不清楚儿童如何直观地理解强迫症(OCD),也不清楚生物医学或认知行为概念解释的相对影响,然而这两者都在广泛用于对患有强迫症的儿童进行心理教育。
本研究确定了儿童对强迫症的朴素概念,以及生物医学与认知行为心理教育对感知预后的比较影响。
采用了受试者内和受试者间的实验设计。在观看一段年轻人描述其强迫症的视频后,202名儿童完成了一份问卷,以考察他们对该病症的概念。在观看第二个等效视频后,他们再次填写问卷,这次在视频之前进行了生物医学或认知行为心理教育。
参与者对强迫症的朴素概念反映了医疗保健领域中强迫症的主要模式。即使在最低剂量的心理教育下,参与者对强迫症的概念也发生了变化。之前接触过强迫症会导致与生物医学模式的更强一致性。接触生物医学心理教育导致参与者预测康复较慢,完全缓解的机会较小。
对儿童强迫症进行心理教育是有影响的。尽管临床医生和心理健康服务机构广泛使用生物医学心理教育,但它似乎有有害影响。儿童对强迫症的概念值得关注,但在针对这些概念时应谨慎行事。