Landmann Sarah, Cludius Barbara, Tuschen-Caffier Brunna, Moritz Steffen, Külz Anne Katrin
Department of Psychiatry and Psychotherapy Medical Center - University of Freiburg, Faculty of Medicine University of Freiburg, Germany.
Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Germany.
Psychiatry Res. 2020 Feb 3;286:112842. doi: 10.1016/j.psychres.2020.112842.
The current study examines changes in daily life experiences following mindfulness-based cognitive therapy (MBCT) in a sample of 38 patients with obsessive-compulsive disorder (OCD) and residual symptoms following cognitive behavioral therapy (CBT). Participants were randomized to either an MBCT group (n = 17), or to a psychoeducational group (OCD-EP; n = 21) as an active control condition. Both groups underwent ecological momentary assessment (EMA) six times a day for a period of six consecutive days pre- and posttreatment. Contrary to hypotheses, MBCT participation did not, when compared to OCD-EP, result in significant changes of positive affect, negative affect, acceptance of momentary emotions, or distress associated with obsessive-compulsive (OC) symptoms. In fact, insight into the unreasonableness of OC symptoms improved significantly more in the OCD-EP group compared to MBCT. However, in the MBCT group, the presence of momentary OC symptoms at post assessment predicted increased insight, which indicates an improved ability to detach from OC symptoms in the moments in which they occur. All in all, however, results do not indicate favorable changes in everyday life experiences of OCD patients following MBCT. Owing to the modest sample size, results must be considered preliminary. Implications and directions for future research are discussed.
本研究调查了38名患有强迫症（OCD）且在接受认知行为疗法（CBT）后仍有残留症状的患者，在接受基于正念的认知疗法（MBCT）后日常生活体验的变化。参与者被随机分为MBCT组（n = 17）或心理教育组（OCD-EP；n = 21）作为积极对照条件。两组在治疗前和治疗后的连续六天里，每天进行六次生态瞬时评估（EMA）。与假设相反，与OCD-EP组相比，参与MBCT并没有导致积极情绪、消极情绪、对瞬时情绪的接纳或与强迫观念及强迫行为（OC）症状相关的痛苦感发生显著变化。事实上，与MBCT组相比，OCD-EP组对OC症状不合理性的洞察力改善更为显著。然而，在MBCT组中，评估后瞬时OC症状的出现预示着洞察力的提高，这表明在OC症状出现时，从这些症状中脱离出来的能力有所改善。然而，总体而言，结果并未表明OCD患者在接受MBCT后日常生活体验有积极变化。由于样本量较小，结果必须视为初步结果。文中讨论了对未来研究的启示和方向。
