创伤性脑损伤后适应认知行为疗法治疗焦虑和抑郁的反应相关因素。
Factors Associated With Response to Adapted Cognitive Behavioral Therapy for Anxiety and Depression Following Traumatic Brain Injury.
机构信息
Monash-Epworth Rehabilitation Research Centre, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia (Drs Ponsford, Wong, McKay, Haines, Downing, Alway, and Furtado); National Drug Research Institute, Curtin University, Bentley, Western Australia (Dr Lee); School of Psychology & Public Health, La Trobe University, Bundoora, Victoria, Australia (Dr Wong); and Phoenix Australia, University of Melbourne, Carlton, Victoria, Australia (Dr O'Donnell).
出版信息
J Head Trauma Rehabil. 2020 Mar/Apr;35(2):117-126. doi: 10.1097/HTR.0000000000000510.
BACKGROUND
Given the high frequency and significance of anxiety and depression following traumatic brain injury (TBI), there is a need to evaluate the efficacy of psychological interventions and to understand factors influencing response to such interventions. The present study investigated factors associated with positive response to cognitive behavioral therapy adapted for cognitive impairments (CBT-ABI) for individuals with anxiety and depression following TBI, including demographic and injury-related factors, pretreatment levels of anxiety and depression, working alliance, and change expectancy as predictors.
METHODS
Participants were 45 individuals enrolled in an active treatment condition within a randomized controlled trial, examining the efficacy of a 9-session CBT-ABI program for anxiety and depression following TBI. These participants completed all CBT sessions.
RESULTS
Mixed-effects regressions controlling for baseline anxiety and depression indicated that for anxiety, older age at injury, as well as higher level of baseline anxiety, was associated with greater symptom reduction. For depression, longer time since injury and higher expectancy for change, as well as higher baseline level of depression, were significantly associated with a greater reduction in depression symptoms.
CONCLUSIONS
This study paves the way for more detailed studies of the therapeutic processes involved in alleviating anxiety and depression following TBI.
背景
鉴于创伤性脑损伤（TBI）后焦虑和抑郁的高频率和重要性，有必要评估心理干预的疗效，并了解影响此类干预反应的因素。本研究调查了与创伤性脑损伤后焦虑和抑郁患者认知行为疗法适应认知障碍（CBT-ABI）的积极反应相关的因素，包括人口统计学和损伤相关因素、治疗前焦虑和抑郁水平、工作联盟以及变化预期作为预测因素。
方法
本研究共纳入 45 名参与者，他们参加了一项随机对照试验中的积极治疗组，该试验旨在研究 9 节 CBT-ABI 方案对 TBI 后焦虑和抑郁的疗效。这些参与者完成了所有的 CBT 课程。
结果
控制基线焦虑和抑郁的混合效应回归表明，对于焦虑，损伤时年龄较大，以及基线焦虑水平较高，与症状减轻呈正相关。对于抑郁，受伤时间较长，对变化的期望较高，以及基线抑郁水平较高，与抑郁症状的更大减轻显著相关。
结论
这项研究为更详细地研究 TBI 后缓解焦虑和抑郁的治疗过程铺平了道路。
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