McLarnon L D, Kaloupek D G
Department of Psychology, Concordia University, Montreal, Quebec, Canada.
Health Psychol. 1988;7(3):231-49. doi: 10.1037//0278-6133.7.3.231.
Previous studies suggest that anxiety and/or depressed mood are associated with recurrence of genital herpes lesions. The present study sought to extend the assessment of factors associated with genital herpes and to investigate the impact of psychological therapy on features of the disorder. Sixteen genital herpes patients received 5 weeks of either structured discussion or cognitive restructuring (CR) therapy in a group format. Measures of attitude about herpes, global coping, distress, loneliness, health locus of control, and recurrence frequency were administered at pretreatment, posttreatment, and 3 months follow-up. Patients also made daily reports during the 5 weeks of treatment from which information was extracted regarding their herpes symptoms, dysphoria, anxiety, and ongoing coping process. Therapy did not produce the expected reductions in reported distress or loneliness. The CR procedure, however, was associated with reduced frequency of lesion recurrence at follow-up. Avoidant coping was associated with lower recurrence rates, and loneliness scores were associated with higher recurrence rates. Prospective data indicated that recurrences were preceded by elevated anxiety that was independent of prodromal symptoms. These results provide support for the general proposals that psychological factors influence health status and that psychological intervention may reduce disease recurrence.
先前的研究表明，焦虑和/或抑郁情绪与生殖器疱疹皮损的复发有关。本研究旨在扩大对与生殖器疱疹相关因素的评估，并调查心理治疗对该疾病特征的影响。16名生殖器疱疹患者以小组形式接受了为期5周的结构化讨论或认知重建（CR）治疗。在治疗前、治疗后和3个月随访时，对疱疹态度、总体应对方式、痛苦、孤独感、健康控制点和复发频率进行了测量。患者在5周的治疗期间还进行了每日报告，从中提取了有关其疱疹症状、烦躁不安、焦虑和持续应对过程的信息。治疗并未如预期那样减轻报告的痛苦或孤独感。然而，CR程序与随访时皮损复发频率降低有关。回避应对方式与较低的复发率相关，而孤独感得分与较高的复发率相关。前瞻性数据表明，复发之前焦虑情绪会升高，且这种焦虑与前驱症状无关。这些结果为心理因素影响健康状况以及心理干预可能降低疾病复发率的总体观点提供了支持。
