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严重精神疾病患者辅助性社会认知与互动训练、辅助性治疗联盟聚焦疗法及常规治疗的随机对照试验

Randomized Controlled Trial of Adjunctive Social Cognition and Interaction Training, Adjunctive Therapeutic Alliance Focused Therapy, and Treatment As Usual Among Persons With Serious Mental Illness.

作者信息

Hasson-Ohayon Ilanit, Mashiach-Eizenberg Michal, Lavi-Rotenberg Adi, Roe David

机构信息

Department of Psychology, Bar-Ilan University, Ramat Gan, Israel.

Department of Health System Management, Max Stern Yezreel Valley College, Emek Yezreel, Israel.

出版信息

Front Psychiatry. 2019 Jun 11;10:364. doi: 10.3389/fpsyt.2019.00364. eCollection 2019.

Abstract

As one of the areas of greatest concern for people with serious mental illness (SMI) are unmet social needs, psychosocial interventions have been developed to address them. The current study utilized a randomized controlled trial to examine the effectiveness of social cognition and interaction training (SCIT) versus a therapeutic alliance focused theraphy (TAFT) versus a treatment-as-usual (TAU) control group on social functioning and quality of life as primary outcomes and social cognition variables as secondary outcomes. Sixty-three persons between the ages of 24 and 69 years with SMI (41 men and 22 women), completers of the trial (23 in SCIT, 20 in TAFT, and 20 in TAU), were assessed at baseline, completion, and at a 3-month follow-up with measurements assessing social cognition (The Facial Emotion Identification Task, The Faux pas test, The Ambiguous Intentions Hostility Questionnaire) social functioning, (The Social Skills Performance Assessment, The Wisconsin Social Quality of Life Scale), and therapeutic alliance (adapted version for group of system for observing family therapy alliance). Results reveal that the two interventions were more effective than the control condition (TAU) in reducing attribution bias anger scores, SCIT was also effective in improving theory of mind (as can be seen in Faux pas test scores), and the TAFT in improving emotion recognition and reducing intentionality attribution bias scores. Improvement was related to therapeutic alliance which did not differ between the two intervention groups. Considering the role of alliance, it is recommended to consider the integration of the two studied interventions with other approaches that emphasize alliance and reflection. www.ClinicalTrials.gov, identifier NCT02380885.

摘要

严重精神疾病(SMI)患者最关心的领域之一是未得到满足的社会需求,因此已经开发了心理社会干预措施来解决这些需求。本研究采用随机对照试验,以社会功能和生活质量作为主要结果,社会认知变量作为次要结果,检验社会认知与互动训练(SCIT)、以治疗联盟为重点的治疗(TAFT)与常规治疗(TAU)对照组的效果。63名年龄在24至69岁之间的SMI患者(41名男性和22名女性),试验完成者(SCIT组23人,TAFT组20人,TAU组20人),在基线、完成时和3个月随访时进行评估,测量内容包括社会认知(面部情绪识别任务、失礼测试、模糊意图敌意问卷)、社会功能(社交技能表现评估、威斯康星社会生活质量量表)和治疗联盟(家庭治疗联盟观察系统组的改编版)。结果显示,两种干预措施在降低归因偏差愤怒得分方面比对照条件(TAU)更有效,SCIT在改善心理理论方面也有效(如失礼测试得分所示),TAFT在改善情绪识别和降低意图归因偏差得分方面有效。改善与治疗联盟有关,两个干预组之间没有差异。考虑到联盟的作用,建议考虑将两种研究干预措施与其他强调联盟和反思的方法相结合。ClinicalTrials.gov,标识符NCT02380885。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/59ee/6580150/1e052d3b8bb9/fpsyt-10-00364-g001.jpg

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