Petrocchi Nicola, Cosentino Teresa, Pellegrini Valerio, Femia Giuseppe, D'Innocenzo Antonella, Mancini Francesco
Department of Economics and Social Sciences, John Cabot University, Rome, Italy.
Compassionate Mind Italia, Rome, Italy.
Front Psychol. 2021 Jan 12;11:594277. doi: 10.3389/fpsyg.2020.594277. eCollection 2020.
Obsessive-compulsive disorder (OCD) is a debilitating mental health disorder that can easily become a treatment-resistant condition. Although effective therapies exist, only about half of the patients seem to benefit from them when we consider treatment refusal, dropout rates, and residual symptoms. Thus, providing effective augmentation to standard therapies could improve existing treatments. Group compassion-focused interventions have shown promise for reducing depression, anxiety, and avoidance related to various clinical problems, but this approach has never been evaluated for OCD individuals. However, cultivating compassion for self and others seems crucial for OCD patients, given the accumulating research suggesting that fear of guilt, along with isolation and self-criticism, can strongly contribute to the development and maintenance of OCD. The primary aim of this pilot study was to evaluate the acceptability, tolerability, and effectiveness of an 8-week group compassion-focused intervention for reducing OCD symptoms, depression, fear of guilt and self-criticism, and increasing common humanity and compassionate self-reassuring skills in treatment-resistant OCD patients. Using a multiple baseline experimental design, the intervention was evaluated in a sample of OCD patients ( = 8) who had completed at least 6 months of CBT treatment for OCD, but who continued to suffer from significant symptoms. Participants were randomized to different baseline assessment lengths; they then received 8 weekly, 120-min group sessions of compassion-focused therapy for OCD (CFT-OCD), and then were tested again at post-treatment and at 1 month follow up. Despite the adverse external circumstances (post-treatment and follow-up data collection were carried out, respectively, at the beginning and in the middle of the Italian lockdown due to the COVID-19 pandemic), by the end of treatment, all participants demonstrated reliable decreases in OCD symptoms, and these improvements were maintained at 4-week follow-up for seven of eight participants. The intervention was also associated with improvements in fear of guilt, self-criticism, and self-reassurance, but less consistent improvements in depression and common humanity. Participants reported high levels of acceptability of and satisfaction with the intervention. Results suggest that the intervention may be beneficial as either a stand-alone treatment or as an augmentation to other treatments.
强迫症（OCD）是一种使人衰弱的心理健康障碍，很容易发展成为难治性疾病。尽管存在有效的治疗方法，但考虑到治疗拒绝率、脱落率和残留症状，似乎只有约一半的患者能从中受益。因此，为标准疗法提供有效的增强手段可以改善现有治疗效果。以群体为基础的聚焦同情干预已显示出有望减轻与各种临床问题相关的抑郁、焦虑和回避行为，但这种方法从未在强迫症患者中进行过评估。然而，鉴于越来越多的研究表明，对内疚的恐惧，以及孤立和自我批评，会对强迫症的发展和维持产生强烈影响，因此培养对自己和他人的同情心对强迫症患者似乎至关重要。这项初步研究的主要目的是评估一项为期8周的以群体为基础的聚焦同情干预的可接受性、耐受性和有效性，该干预旨在减轻难治性强迫症患者的强迫症状、抑郁、对内疚的恐惧和自我批评，并提高共同人性和富有同情心的自我安慰技能。采用多基线实验设计，对一组强迫症患者（n = 8）进行了干预评估，这些患者已完成至少6个月的强迫症认知行为疗法（CBT）治疗，但仍有明显症状。参与者被随机分配到不同的基线评估时长；然后他们接受了为期8周、每周120分钟的针对强迫症的聚焦同情疗法（CFT-OCD）小组治疗，之后在治疗后和1个月随访时再次进行测试。尽管外部环境不利（治疗后和随访数据收集分别在意大利因新冠疫情封锁开始时和中期进行），但到治疗结束时，所有参与者的强迫症状都有可靠的减轻，并且在8名参与者中的7名在4周随访时这些改善得以维持。该干预还与对内疚的恐惧、自我批评和自我安慰的改善相关，但在抑郁和共同人性方面的改善不太一致。参与者报告对该干预的接受度和满意度很高。结果表明该干预作为单独治疗或作为其他治疗的增强手段可能是有益的。
