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心境正常在心理治疗研究与实践中的新作用。

The emerging role of euthymia in psychotherapy research and practice.

作者信息

Guidi Jenny, Fava Giovanni A

机构信息

Department of Psychology, University of Bologna, Italy.

Department of Psychiatry, University at Buffalo, State University of New York, Buffalo, New York, USA.

出版信息

Clin Psychol Rev. 2020 Dec;82:101941. doi: 10.1016/j.cpr.2020.101941. Epub 2020 Oct 22.

Abstract

Euthymia is generally conceived in negative terms (absence of psychiatric disorders), yet it may also indicate a trans-diagnostic construct where lack of mood disturbances is associated with positive affects and psychological well-being (flexibility, consistency and resilience). Specific strategies for the assessment of euthymia are available, including both observer- and self-rated instruments that may be applied within a clinimetric framework encompassing macro-analysis and staging. Self-observation of psychological distress in a diary is the basic, neglected method of cognitive and behavioral strategies. Self-observation of instances of well-being may become the source of psychotherapeutic work geared to euthymia, combined with cognitive restructuring, homework assignments and clinical interaction. Well-Being Therapy (WBT) specifically pursues this approach. It may be incorporated in a therapeutic plan based on clinical reasoning and case formulation. The target of euthymia may also be accomplished by other psychotherapeutic strategies, such as mindfulness-based cognitive therapy and acceptance and commitment therapy. Clinical applications encompass decreasing vulnerability to relapse, increasing the level of recovery and modulating mood. The practice of self-observation of psychological well-being in a diary, as manualized in WBT, may trigger important developments in clinical assessment and in other psychotherapeutic techniques geared to a state of euthymia.

摘要

心境正常通常从负面角度来理解(即没有精神障碍),然而它也可能表示一种跨诊断概念,其中情绪紊乱的缺失与积极情绪和心理健康(灵活性、一致性和恢复力)相关。评估心境正常有特定的策略,包括可在涵盖宏观分析和分期的临床测量框架内应用的观察评定和自评工具。在日记中自我观察心理困扰是认知和行为策略中基本却被忽视的方法。对幸福时刻的自我观察可能成为针对心境正常的心理治疗工作的源头,可与认知重构、家庭作业及临床互动相结合。幸福疗法(WBT)专门采用这种方法。它可以纳入基于临床推理和病例制定的治疗计划中。心境正常的目标也可以通过其他心理治疗策略来实现,如基于正念的认知疗法和接纳与承诺疗法。临床应用包括降低复发易感性、提高康复水平和调节情绪。如幸福疗法中所规范的,在日记中自我观察心理幸福感的做法可能会在临床评估以及其他针对心境正常状态的心理治疗技术方面引发重要进展。

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