简短、每日使用移动应用程序训练能否改变适应不良的信念？交叉随机对照试验。
Can Brief, Daily Training Using a Mobile App Help Change Maladaptive Beliefs? Crossover Randomized Controlled Trial.
机构信息
Research and Treatment Unit for Obsessive-Compulsive and Related Disorders, Department of Personality, Faculty of Psychology, University of Valencia, Valencia, Spain.
Baruch Ivcher School of Psychology, Interdisciplinary Center Herzliya, Herzliya, Israel.
出版信息
JMIR Mhealth Uhealth. 2019 Feb 13;7(2):e11443. doi: 10.2196/11443.
BACKGROUND
Obsessive-compulsive disorder (OCD) is a disabling condition with a wide variety of clinical presentations including contamination fears, fear of harm, and relationship-related obsessions. Cognitive behavioral models of OCD suggest that OC symptoms result from catastrophic misinterpretations of commonly occurring intrusive experiences and associated dysfunctional strategies used to manage them. OCD-related maladaptive beliefs including inflated responsibility, importance and control of thoughts, perfectionism, and intolerance for uncertainty increase the likelihood of such misinterpretations.
OBJECTIVE
Considering accumulating evidence suggesting that mobile health (mHealth) apps based on cognitive-behavioral principles may lead to significant reductions in psychopathological symptoms, we assessed the effectiveness of a novel cognitive training app (GGRO) designed to challenge OCD-related beliefs.
METHODS
A total of 97 students were randomized to groups undertaking immediate-use (iApp) or delayed use (dApp) of GGRO. All participants were requested to complete Web-based assessments, with questionnaires relating to maladaptive beliefs, mood, and OC symptoms at baseline (T1), 15 days from baseline (T2), and 30 days from baseline (T3). Participants in iApp group started using the app at baseline and continued using the app for 15 consecutive days. They were then requested to stop using the app until T3. Participants in the dApp group were requested to wait for 15 days and only then start using the app (crossover) for 15 consecutive days.
RESULTS
All participants used the app for a mean of 14.07 (SD 1.41) days with 2.94 levels per day. Consistent with previous findings, app use was associated with medium-large effect size reductions in both iApp (n=51) and dApp (n=46) groups. In the iApp group, all effects remained significant during the 15 days of follow-up. Analyses focusing on the first two assessment occasions revealed significant treatment × repeated measures interactions on maladaptive beliefs, several OC symptom measures, and self-esteem.
CONCLUSIONS
This study provides further evidence for the efficacy of GGRO as a mobile-delivered training exercise that is useful for reducing OCD-related beliefs and symptoms.
TRIAL REGISTRATION
ClinicalTrials.gov NCT03571464; https://clinicaltrials.gov/ct2/show/NCT03571464 (Archived by WebCite at http://www.webcitation.org/7675sYPsH).
背景
强迫症（OCD）是一种致残性疾病，临床表现多种多样，包括污染恐惧、伤害恐惧和与人际关系相关的强迫观念。OCD 的认知行为模型表明，OC 症状是由对常见侵入性体验的灾难性误解以及用于管理这些体验的相关功能失调策略引起的。与 OCD 相关的适应不良信念，包括对想法的过分责任、重要性和控制、完美主义和对不确定性的不容忍，增加了这种误解的可能性。
目的
鉴于越来越多的证据表明，基于认知行为原则的移动健康（mHealth）应用程序可能会导致心理病理症状的显著减轻，我们评估了一种新的认知训练应用程序（GGRO）的有效性，该应用程序旨在挑战与 OCD 相关的信念。
方法
共有 97 名学生被随机分为立即使用（iApp）或延迟使用（dApp） GGRO 组。所有参与者都被要求在基线（T1）、从基线开始 15 天（T2）和 30 天（T3）完成基于网络的评估，评估内容与适应不良信念、情绪和 OC 症状有关。iApp 组的参与者在基线时开始使用该应用程序，并连续使用该应用程序 15 天。然后，他们被要求在 T3 之前停止使用该应用程序。dApp 组的参与者被要求等待 15 天，然后才开始使用该应用程序（交叉）连续 15 天。
结果
所有参与者平均使用该应用程序 14.07（SD 1.41）天，每天使用 2.94 个级别。与之前的研究结果一致，iApp（n=51）和 dApp（n=46）组的应用程序使用均与中到大效应量的降低相关。在 iApp 组中，所有效果在 15 天的随访期间仍然显著。对前两个评估时刻的分析显示，在适应不良信念、几种 OC 症状测量和自尊方面，治疗与重复测量的交互作用具有显著意义。
结论
这项研究为 GGRO 作为一种有用的移动交付训练工具的有效性提供了进一步的证据，可用于减少与 OCD 相关的信念和症状。
试验注册
ClinicalTrials.gov NCT03571464; https://clinicaltrials.gov/ct2/show/NCT03571464（由 WebCite 存档；http://www.webcitation.org/7675sYPsH）。
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