Gros Daniel F, Merrifield Colleen, Rowa Karen, Szafranski Derek D, Young Lisa, McCabe Randi E
Mental Health Service,Ralph H. Johnson Veterans Affairs Medical Center,Charleston,SC,USAandDepartment of Psychiatry and Behavioral Sciences,Medical University of South Carolina,Charleston,SC,USA.
Anxiety Treatment and Research Clinic,St Joseph's Healthcare, Hamilton,Ontario,Canada,Mood Disorders Outpatient Clinic,St Joseph's Healthcare,Hamilton,Ontario,CanadaandDepartment of Psychiatry and Behavioural Neurosciences,McMaster University,Hamilton,Ontario,Canada.
Behav Cogn Psychother. 2019 Jan;47(1):39-51. doi: 10.1017/S1352465818000309. Epub 2018 May 29.
Transdiagnostic psychotherapies are designed to apply the same underlying treatment principles across a set of psychiatric disorders, without significant tailoring to specific diagnoses. Several transdiagnostic psychotherapy protocols have been developed recently, each of which has its own strengths and weaknesses. One promising treatment is Transdiagnostic Behaviour Therapy (TBT), in that it is one of the few transdiagnostic treatments to date shown to be effective in patients with depressive and anxiety disorders. However, TBT has only been investigated via individual psychotherapy.
The present study investigated the effectiveness of a group protocol for TBT, compared with disorder-specific group psychotherapies, in a naturalistic setting.
109 participants with various diagnoses of affective disorders completed either group TBT (n = 37) or a disorder-specific group psychotherapy (n = 72). Measures included assessments of psychiatric symptomatology and transdiagnostic impairment at baseline and post-treatment.
Overall, participants in the TBT group demonstrated significant improvements across all measures. When compared with disorder-specific groups, no statistical differences were observed between groups across symptoms; however, participants in the TBT group demonstrated roughly twice the treatment effect sizes in transdiagnostic impairment compared with participants in the disorder-specific groups. In addition, when participants from the most well-represented diagnosis and disorder-specific treatment (social anxiety disorder) were investigated separately, participants in the TBT group demonstrated significantly larger improvements in comorbid depressive symptoms than participants in the disorder-specific treatment.
Pending replication and additional comparison studies, group TBT may provide an effective group treatment option for patients with affective disorders.
跨诊断心理疗法旨在将相同的潜在治疗原则应用于一系列精神障碍，而无需针对特定诊断进行显著调整。最近已经开发了几种跨诊断心理治疗方案，每种方案都有其自身的优缺点。一种有前景的治疗方法是跨诊断行为疗法（TBT），因为它是迄今为止少数几种被证明对抑郁和焦虑症患者有效的跨诊断治疗方法之一。然而，TBT仅通过个体心理治疗进行了研究。
本研究在自然环境中调查了TBT团体方案与特定障碍团体心理治疗相比的有效性。
109名患有各种情感障碍诊断的参与者完成了团体TBT（n = 37）或特定障碍团体心理治疗（n = 72）。测量包括基线和治疗后的精神症状学评估和跨诊断损害评估。
总体而言，TBT组的参与者在所有测量中都表现出显著改善。与特定障碍组相比，各症状组间未观察到统计学差异；然而，与特定障碍组的参与者相比，TBT组的参与者在跨诊断损害方面的治疗效果大小约为其两倍。此外，当分别调查代表性最强的诊断和特定障碍治疗（社交焦虑症）的参与者时，TBT组的参与者在共病抑郁症状方面的改善明显大于特定障碍治疗组的参与者。
在进行重复研究和其他比较研究之前，团体TBT可能为情感障碍患者提供一种有效的团体治疗选择。
