Department of Basic, Clinical Psychology and Psychobiology, Universitat Jaume I, Castellón, Spain.
Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health research institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
Clin Psychol Psychother. 2021 Mar;28(2):313-324. doi: 10.1002/cpp.2518. Epub 2020 Oct 2.
Evidence of self-help interventions for adjustment disorder (AjD) is limited. This study aims at testing in a randomized controlled trial (RCT) the effectiveness of a disorder-specific, Internet-delivered cognitive-behavioural therapy (ICBT) intervention for AjD. Participants were randomly allocated to either an ICBT with brief weekly telephone support (n = 34) or a waiting list group (n = 34). Beck's inventories for depression and anxiety were used as primary outcomes. The secondary outcomes were AjD symptoms, post-traumatic growth, positive and negative affect, and quality of life. In all, 76.5% of the participants completed the intervention. Compared with the control group, participants in the intervention condition showed significantly greater improvement in all outcomes (Cohen's d ranged from 0.54 to 1.21) except in anxiety symptoms measured by Beck Anxiety Inventory (d = 0.27). Only ICBT group showed a significant improvement in post-traumatic growth, positive and negative affect, and quality of life. The number of cases that achieved clinically meaningful change in all outcome measures was also higher in the ICBT group. All therapeutic gains were maintained at 3-, 6- and 12-month follow-ups. The current study provides evidence on the effectiveness of ICBT interventions to reduce the impact of AjD. Results suggest that brief self-help intervention with minimal therapist support is more effective than the mere passage of time in reducing the distress symptoms associated to the disorder and also can confer additional benefits.
调整障碍（AjD）的自助干预证据有限。本研究旨在通过随机对照试验（RCT）测试针对 AjD 的特定障碍、基于互联网的认知行为疗法（ICBT）干预的有效性。参与者被随机分配到接受 ICBT 加每周简短电话支持（n = 34）或等待名单组（n = 34）。贝克抑郁和焦虑量表被用作主要结局。次要结局为 AjD 症状、创伤后成长、积极和消极情绪以及生活质量。共有 76.5%的参与者完成了干预。与对照组相比，干预组在所有结局（贝克抑郁量表：Cohen's d 范围为 0.54-1.21；贝克焦虑量表：d = 0.27）上均表现出显著改善，除焦虑症状外。只有 ICBT 组在创伤后成长、积极和消极情绪以及生活质量方面表现出显著改善。在所有结局测量中，达到临床有意义变化的病例数在 ICBT 组中也更高。所有治疗效果在 3、6 和 12 个月随访时均得以维持。本研究提供了关于 ICBT 干预措施减少 AjD 影响的有效性的证据。结果表明，与单纯等待相比，接受简短的自助干预，仅需最少的治疗师支持，更能有效减轻与该障碍相关的痛苦症状，还能带来额外的益处。
