Modini Matthew, Abbott Maree J
Clinical Psychology Unit, School of Psychology, The University of Sydney, 88 Mallet St, Building F, MO2F, NSW, 2050, Australia.
Clinical Psychology Unit, School of Psychology, The University of Sydney, 88 Mallet St, Building F, MO2F, NSW, 2050, Australia.
J Behav Ther Exp Psychiatry. 2018 Dec;61:72-79. doi: 10.1016/j.jbtep.2018.06.009. Epub 2018 Jun 25.
Pre-event rumination has a clear role in maintaining social anxiety according to cognitive models. However, it is unclear what specific strategies can address pre-event rumination for individuals diagnosed with SAD. The current study aimed to determine the effectiveness of a brief intervention on multiple aspects of pre-event rumination, state anxiety and performance and threat appraisals. Additionally, the trajectory of pre-event rumination was investigated over four days.
Participants with SAD were informed they would be required to complete a speech task in four days' time and were randomised to an intervention (n = 27) or a non-active control group (n = 25). The intervention group were instructed to "ban" pre-event rumination using a metacognitive therapy technique known as detached mindfulness. All participants completed daily measures of pre-evet rumination that assessed frequency, uncontrollability, engagement and distress associated with pre-event rumination. On the day of the speech task, participants also completed state and cognitive measures before delivering the speech task.
The intervention group reported reduced frequency, uncontrollability and distress associated with pre-event rumination, compared to the control group. There was no difference between groups for performance and threat appraisals as well as state anxiety. Rumination is a stable and robust process, with an increase in frequency and associated distress 24 hours before a feared social situation.
The lack of an active control group precludes comparisons to more traditional cognitive-behavioural therapy strategies for pre-event rumination.
Pre-event rumination is a durable process but banning pre-event rumination using metacognitive therapy techniques shows promise for specifically addressing this maladaptive process.
根据认知模型，事件前反复思考在维持社交焦虑方面具有明确作用。然而，目前尚不清楚针对被诊断为社交焦虑障碍（SAD）的个体，哪些具体策略可以解决事件前反复思考的问题。本研究旨在确定一种简短干预措施在事件前反复思考、状态焦虑、表现及威胁评估等多个方面的有效性。此外，还对四天内事件前反复思考的轨迹进行了研究。
告知患有社交焦虑障碍的参与者，他们需要在四天后完成一项演讲任务，并将其随机分为干预组（n = 27）或非主动对照组（n = 25）。干预组被指示使用一种称为超脱正念的元认知治疗技术“禁止”事件前反复思考。所有参与者每天完成事件前反复思考的测量，评估与事件前反复思考相关的频率、不可控性、参与度和痛苦程度。在演讲任务当天，参与者在完成演讲任务前还完成了状态和认知测量。
与对照组相比，干预组报告的与事件前反复思考相关的频率、不可控性和痛苦程度有所降低。在表现、威胁评估以及状态焦虑方面，两组之间没有差异。反复思考是一个稳定且强烈的过程，在恐惧的社交情境前24小时，其频率和相关痛苦会增加。
缺乏主动对照组，无法与更传统的针对事件前反复思考的认知行为治疗策略进行比较。
事件前反复思考是一个持久的过程，但使用元认知治疗技术禁止事件前反复思考对于专门解决这一适应不良过程显示出了前景。
