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修正解释偏差对跨诊断重复性消极思维的影响。

Effects of modifying interpretation bias on transdiagnostic repetitive negative thinking.

机构信息

Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London.

Department of Psychology, University of California, Davis.

出版信息

J Consult Clin Psychol. 2020 Mar;88(3):226-239. doi: 10.1037/ccp0000455.

Abstract

OBJECTIVE

Repetitive negative thinking (RNT; e.g., worry and rumination) is common across emotional disorders, as is the tendency to generate negative interpretations (interpretation bias). Ameliorating negative interpretations via cognitive bias modification of interpretations (CBM-I) reduces worry/rumination, and improves mood in people diagnosed with generalized anxiety disorder (GAD) or depression. We investigated whether these findings generalize to high worry or rumination populations, irrespective of diagnosis, and whether effects are increased by enhancing emotional engagement with training with active generation of positive resolutions of ambiguity and imagery.

METHOD

Community volunteers with excessive worry and/or rumination, who were above clinical cut-off on anxiety and/or depression measures, were allocated to an active control condition ( = 54), interpretation training condition with prior activation of RNT (CBM_RNT; = 54), or training condition augmented with positive outcome generation and imagery (CBM_ENH; = 53). Interpretation bias, RNT, and mood were assessed before and following 10 Internet-based sessions completed within a 1-month period. RNT and mood questionnaires were also completed at 1-month follow-up.

RESULTS

After training, both forms of CBM-I (vs. control) facilitated more positive interpretations and reduced negative intrusions during a worry task. At 1-month follow-up, anxiety, depression, RNT, and worry in the past week were lower in the CBM-I than control conditions, but not rumination or trait worry. Compared with standard CBM-I, the augmented form facilitated more positive interpretations, reduced negative intrusions after training, and reduced trait rumination at 1-month follow-up, but it did not augment effects on trait worry, anxiety or depression.

CONCLUSIONS

Interpretation bias maintains transdiagnostic RNT and Internet-based CBM-I can reduce longer-term RNT. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

摘要

目的

重复性消极思维(RNT;例如,担忧和沉思)在各种情绪障碍中都很常见,产生消极解释的倾向(解释偏差)也是如此。通过解释的认知偏差修正(CBM-I)来减轻消极解释可以减少担忧/沉思,并改善被诊断为广泛性焦虑症(GAD)或抑郁症的人的情绪。我们调查了这些发现是否适用于无论诊断如何,都有过度担忧或沉思的高风险人群,以及通过增强对训练的情感投入并积极生成歧义与意象的积极解决方案,是否可以增加效果。

方法

被分配到积极对照组(n=54)、RNT 先行激活的解释训练组(CBM_RNT;n=54)或增强积极结果生成和意象组(CBM_ENH;n=53)的社区志愿者具有过度的担忧和/或沉思,他们在焦虑和/或抑郁测量上高于临床临界值。在 1 个月内完成 10 次基于互联网的课程后,评估了解释偏差、RNT 和情绪。RNT 和情绪问卷也在 1 个月的随访中完成。

结果

在训练后,两种形式的 CBM-I(与对照组相比)都促进了在担忧任务中进行更积极的解释并减少了消极的闯入。在 1 个月的随访中,CBM-I 组的焦虑、抑郁、RNT 和过去一周的担忧均低于对照组,但沉思和特质性担忧除外。与标准 CBM-I 相比,增强型促进了更积极的解释,在训练后减少了负面闯入,在 1 个月的随访中减少了特质性沉思,但并未增加特质性担忧、焦虑或抑郁的效果。

结论

解释偏差维持了跨诊断的 RNT,基于互联网的 CBM-I 可以减少长期的 RNT。

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