Department of Behavioural Sciences and Learning, Linkoping University.
Population, Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health.
J Consult Clin Psychol. 2020 Mar;88(3):269-282. doi: 10.1037/ccp0000454.
Loneliness is a transdiagnostic clinical phenomenon that can significantly impact mental health and well-being across the lifespan.
The aim was to combine existing theory and evidence-based treatment approaches to propose a comprehensive transdiagnostic cognitive-behavioral analysis of the maintenance of chronic loneliness relevant across disorders, age groups, and populations.
A distillation and matching model-framework approach was taken to identify interventions designed to reduce loneliness. Eligible studies were coded for the presence of practice elements. The findings were combined with an analysis of the broader literature on loneliness and psychopathology to derive a comprehensive cognitive-behavioral analysis of the maintenance of loneliness over time across populations.
The search yielded 11 studies containing 14 practice elements with relative frequencies ranging from 7% to 64%. The identified practice elements target putative mechanisms such as negative interpersonal appraisals, anxiety, and social skills deficits. Counterproductive behavior and cognitive processes such as self-focused attention were identified as maintenance factors based on the broader literature. A modular transdiagnostic model with multiple pathways is proposed to be consistent with the existing theoretical and treatment literature.
Combining the distillation and matching model framework with existing theory from the literature is a novel approach for developing a model of factors that maintain loneliness over time. The model has varying treatment implications for different populations including children with autism spectrum disorders and bereaved older adults. Targeting transdiagnostic processes has the potential to transform interventions for loneliness across a range of formats and settings. (PsycINFO Database Record (c) 2020 APA, all rights reserved).
孤独是一种跨诊断的临床现象，它会显著影响整个生命周期的心理健康和幸福感。
旨在结合现有理论和循证治疗方法，提出一种全面的跨诊断认知行为分析，以解释和预测不同障碍、年龄组和人群中慢性孤独的维持。
采用蒸馏和匹配模型框架方法来识别旨在减少孤独感的干预措施。对符合条件的研究进行了实践元素存在情况的编码。将这些发现与更广泛的孤独和精神病理学文献分析相结合，得出了一个关于不同人群中孤独感随时间维持的全面认知行为分析。
搜索结果显示，有 11 项研究包含 14 个实践元素，相对频率范围为 7%至 64%。确定的实践元素针对假设机制，如负面人际评价、焦虑和社交技能缺陷。根据更广泛的文献，自我关注等不良行为和认知过程被确定为维持因素。提出了一个具有多种途径的模块化跨诊断模型，与现有理论和治疗文献一致。
将蒸馏和匹配模型框架与文献中的现有理论相结合，是一种开发随时间维持孤独因素模型的新方法。该模型对包括自闭症谱系障碍儿童和丧亲老年人在内的不同人群具有不同的治疗意义。针对跨诊断过程有可能改变各种形式和环境下孤独感的干预措施。（APA，2020 年，所有权利保留）。
