Ellard Kristen K, Fairholme Christopher P, Boisseau Christina L, Farchione Todd J, Barlow David H
Center for Anxiety and Related Disorders, Boston University.
Cogn Behav Pract. 2010 Feb;17(1):88-101. doi: 10.1016/j.cbpra.2009.06.002. Epub 2010 Jan 29.
Two studies present preliminary support for the Unified Protocol (UP), a transdiagnostic, emotion-focused cognitive-behavioral treatment developed to be applicable across the emotional disorders. Study 1 presents data from an open clinical trial of the initial version of the UP in a heterogeneous clinical sample, yielding large pre- to post-treatment effect sizes across disorders on measures of DSM-IV diagnostic category severity, and medium to large effect sizes on general measures of depression and anxiety, social adjustment, and levels of negative and positive affect. Following a period of further manual development resulting in specific modifications and enhancements to core treatment components, Study 2 presents data from an additional pilot study of this revised version of the UP. Results from Study 2 demonstrated more robust treatment effect sizes and greater changes across measures of depression, anxiety, positive and negative affect, social adjustment, and quality of life. Relatively similar treatment effects were again demonstrated across a full range of anxiety and mood disorders, suggesting roughly equivalent transdiagnostic efficacy. Implications for the treatment of emotional disorders, clinical practice, and dimensional conceptualizations of psychopathology are discussed.
两项研究为统一方案(UP)提供了初步支持,该方案是一种跨诊断、以情绪为重点的认知行为疗法,旨在适用于各种情绪障碍。研究1展示了UP初始版本在异质性临床样本中的开放临床试验数据,在DSM-IV诊断类别严重程度的测量上,治疗前后产生了较大的效应量,在抑郁、焦虑、社会适应以及消极和积极情绪水平的一般测量上,产生了中等至较大的效应量。经过一段时间对手册的进一步完善,对核心治疗成分进行了具体修改和强化,研究2展示了UP修订版的另一项初步研究数据。研究2的结果表明,在抑郁、焦虑、积极和消极情绪、社会适应以及生活质量的测量上,治疗效应量更强,变化更大。在一系列焦虑和情绪障碍中再次显示出相对相似的治疗效果,表明跨诊断疗效大致相当。文中还讨论了该研究对情绪障碍治疗、临床实践以及精神病理学维度概念化的意义。