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焦虑障碍认知行为治疗中幸福感的变化轨迹:量化改善焦虑对幸福感的影响和变化。

Trajectories of change in well-being during cognitive behavioral therapies for anxiety disorders: Quantifying the impact and covariation with improvements in anxiety.

机构信息

Department of Psychology, Texas Institute for Measurement, Evaluation, and Statistics, University of Houston.

Department of Psychology, University at Albany, State University of New York.

出版信息

Psychotherapy (Chic). 2020 Sep;57(3):379-390. doi: 10.1037/pst0000283. Epub 2020 Feb 6.

Abstract

Cognitive behavioral therapy (CBT) has been found to be very effective in reducing many forms of mental illness, but much less is known about whether CBT also promotes mental health or well-being. The goals of the present study were to (a) quantify the magnitude and timing of changes in overall well-being and specific facets of well-being during different CBTs for anxiety disorders, (b) determine whether these effects vary across transdiagnostic and disorder-specific CBT, and (c) examine how changes in well-being during treatment relate to changes in anxiety. A total of 223 adults (55.6% female, Mage = 31.1 years) were randomized to 1 of 5 CBT protocols for anxiety disorders at an outpatient clinic. Analyses included standardized mean gain effect sizes (ESsg) and latent growth curve modeling. Moderate-to-large increases in overall well-being and the 3 components of subjective, psychological, and social well-being were observed, mainly during the second half of CBT, and these increases were maintained at a 6-month follow-up. The magnitude of effects was comparable for transdiagnostic and disorder-specific CBT protocols and greater than in the waitlist condition. Parallel process latent growth curve models indicated that trajectories of change in well-being across treatment were strongly correlated with trajectories of change in clinician-rated and self-reported anxiety. Together, these findings suggest that different CBT protocols for anxiety consistently produce robust and lasting changes in well-being, and these changes are strongly linked to changes in anxiety during treatment. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

摘要

认知行为疗法(CBT)已被证明在减少许多形式的精神疾病方面非常有效,但对于 CBT 是否也能促进心理健康或幸福感知之甚少。本研究的目的是:(a) 量化焦虑障碍的不同 CBT 期间整体幸福感和幸福感特定方面的变化幅度和时间;(b) 确定这些影响是否因跨诊断和特定于疾病的 CBT 而有所不同;(c) 检查治疗期间幸福感的变化与焦虑的变化有何关系。共有 223 名成年人(55.6%为女性,Mage = 31.1 岁)被随机分配到门诊的 5 种焦虑障碍 CBT 方案之一。分析包括标准化平均增益效应大小(ESsg)和潜在增长曲线建模。观察到整体幸福感和主观、心理和社会幸福感的 3 个组成部分适度到大幅度增加,主要发生在 CBT 的后半段,这些增加在 6 个月的随访中得到维持。跨诊断和特定于疾病的 CBT 方案的效果大小相当,并且大于候补名单条件。平行过程潜在增长曲线模型表明,治疗过程中幸福感变化的轨迹与临床医生评定和自我报告的焦虑变化的轨迹密切相关。总之,这些发现表明,不同的焦虑 CBT 方案一致地产生了幸福感的强大且持久的变化,并且这些变化与治疗期间焦虑的变化密切相关。(PsycInfo 数据库记录(c)2020 APA,保留所有权利)。

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