考察功能失调性态度和极端反应模式对基于指导的互联网认知行为疗法治疗抑郁症复发的预测作用。
An examination of dysfunctional attitudes and extreme response styles as predictors of relapse in guided internet-based cognitive behavioral therapy for depression.
机构信息
Department of Psychology, The Ohio State University, Columbus, Ohio.
Department of Psychiatry, The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York.
出版信息
J Clin Psychol. 2020 Jun;76(6):1047-1059. doi: 10.1002/jclp.22955. Epub 2020 Apr 21.
OBJECTIVES
Internet-based cognitive behavioral therapy (iCBT) is an effective treatment option for depression, but its long-term effects are not well understood. We investigate for whom iCBT may have more enduring effects by evaluating dysfunctional attitudes as predictors of relapse.
METHODS
The sample consists of 31 iCBT responders (20 women, average age 31.6) who were followed for 1 year.
RESULTS
Higher Dysfunctional Attitudes Scale scores predicted higher risk of relapse (hazard ratio = 1.98). This relation remained significant when controlling for high style (dysfunctional) or content (functional) responses. Having relatively more positive extreme responses on style rather than content items did not predict risk of relapse.
CONCLUSIONS
Our results were consistent with the value of differentiating an extreme style of responding from otherwise endorsing belief in dysfunctional attitudes. Research that refines our understanding of patients' individual risk for relapse has the potential to inform how treatment might be individually tailored.
目的
基于互联网的认知行为疗法（iCBT）是治疗抑郁症的有效选择，但人们对其长期效果了解甚少。我们通过评估功能失调性态度作为复发的预测指标，来研究 iCBT 对哪些人可能具有更持久的效果。
方法
该样本包括 31 名 iCBT 应答者（20 名女性，平均年龄 31.6 岁），随访时间为 1 年。
结果
较高的功能失调性态度量表评分预示着更高的复发风险（危险比=1.98）。当控制高风格（功能失调）或内容（功能）反应时，这种关系仍然显著。在风格上的极端反应相对较多，而不是在内容项目上的极端反应，并没有预测复发的风险。
结论
我们的结果与区分极端的反应风格与其他功能失调态度信念的价值相一致。研究进一步了解患者个体复发风险的潜力可以为如何对治疗进行个体化调整提供信息。
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