Institute of Living.
Silver School of Social Work, New York University.
J Consult Clin Psychol. 2019 Jul;87(7):590-602. doi: 10.1037/ccp0000405. Epub 2019 Apr 22.
Hoarding disorder (HD) is a common and potentially debilitating psychiatric disorder. Thus far, psychological treatments have yielded modest effects and/or were time-consuming and costly to deliver. The aim of the present study was to test the efficacy of a brief group cognitive-behavioral therapy (CBT) for adults with HD and to test hypothesized mediators of treatment outcome.
Eighty-seven adults with a primary diagnosis of HD were randomized to either immediate CBT or wait list. CBT consisted of 16 weekly, 90-min group sessions that emphasized in-session practice of discarding and refraining from acquiring, decision-making and problem-solving training, emotional distress tolerance, motivational interviewing strategies, and contingency management. Participants were assessed at pretreatment, midtreatment, and posttreatment by an independent evaluator unaware of treatment condition.
CBT was efficacious for the symptoms of HD compared with wait list. Saving-related cognitions, but not subjective cognitive impairment, partially mediated treatment outcomes.
Brief Group CBT is an efficacious and feasible treatment for adults with HD, and is partially mediated by reductions in maladaptive beliefs about possessions. Superiority trials comparing CBT to active treatments, and additional research into mechanisms of treatment outcome, are warranted. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
囤积症（HD）是一种常见且可能使人衰弱的精神疾病。到目前为止，心理治疗的效果有限，或者需要花费大量时间和成本来实施。本研究旨在检验针对 HD 成人的简短团体认知行为疗法（CBT）的疗效，并检验治疗结果的假设中介因素。
87 名被诊断为 HD 的成年人被随机分配到立即 CBT 或候补名单组。CBT 包括 16 次每周 90 分钟的团体会议，强调在会议期间练习丢弃和避免获取、决策和解决问题的训练、情绪困扰容忍度、动机访谈策略和应急管理。参与者在治疗前、治疗中期和治疗后由一位独立评估者进行评估，评估者不知道治疗条件。
与候补名单组相比，CBT 对 HD 的症状有效。与财产相关的认知，但不是主观认知障碍，部分介导了治疗结果。
简短的团体 CBT 是治疗成人 HD 的有效且可行的方法，其部分通过减少对财产的适应不良信念来介导。需要进行比较 CBT 与积极治疗的优越性试验，以及进一步研究治疗结果的机制。
