体感放大调节了互联网提供的认知行为疗法对新兴成年人躯体症状困扰的疗效：一项随机对照试验的探索性分析。
Somatosensory amplification moderates the efficacy of internet-delivered CBT for somatic symptom distress in emerging adults: Exploratory analysis of a randomized controlled trial.
作者信息
Hennemann Severin, Witthöft Michael, Kleinstäuber Maria, Böhme Katja, Baumeister Harald, Ebert David Daniel, Probst Thomas
机构信息
Johannes Gutenberg University Mainz, Department of Clinical Psychology, Psychotherapy and Experimental Psychopathology, Mainz, Germany.
Johannes Gutenberg University Mainz, Department of Clinical Psychology, Psychotherapy and Experimental Psychopathology, Mainz, Germany.
出版信息
J Psychosom Res. 2022 Apr;155:110761. doi: 10.1016/j.jpsychores.2022.110761. Epub 2022 Feb 11.
OBJECTIVE
While studies mainly provide positive evidence for the efficacy of internet-delivered cognitive-behavioral therapy (ICBT) for various persistent somatic symptoms, it remains largely unclear for whom these interventions work or not. This exploratory analysis aimed to identify moderators for the outcome between ICBT for somatic symptom distres and a waitlist control group (WL) in a vulnerable target group of emerging adults.
METHODS
Based on data from a randomized controlled trial on 156 university students with varying degrees of somatic symptom distress who were allocated to either an eight-week, therapist guided ICBT (iSOMA) or to the WL, we examined pretreatment demographic characteristics, health-related variables (e.g., somatic symptom duration), mental distress (e.g., depression, anxiety) and cognitive-emotional factors (emotional reactivity, somatosensory amplification) as candidate moderators of the outcome, somatic symptom distress (assessed by the Patient Health Questionnaire, PHQ-15) from pre- to posttreatment.
RESULTS
Somatosensory amplification (assessed by the Somatosensory Amplification Scale, SSAS) moderated the outcome in favor of iSOMA (B = -0.17, SE = 0.08, p = 0.031), i.e., higher pretreatment somatosensory amplification was associated with better outcome in the active compared to the control intervention. No significant moderation effects were found among demographic characteristics, health-related variables, or mental distress.
CONCLUSION
Our findings suggest that an internet-delivered CBT for somatic symptom distress should be preferred over no active treatment particularly in individuals with moderate to high levels of somatosensory amplification, which as a next step should be tested against further treatments and in clinical populations.
TRIAL REGISTRATION
German Clinical Trials Register (DRKS00014375).
目的
虽然研究主要为互联网认知行为疗法（ICBT）对各种持续性躯体症状的疗效提供了积极证据，但这些干预措施对哪些人有效或无效在很大程度上仍不清楚。本探索性分析旨在确定在新兴成年人这一脆弱目标群体中，ICBT治疗躯体症状困扰与等待名单对照组（WL）之间结果的调节因素。
方法
基于一项随机对照试验的数据，该试验对156名有不同程度躯体症状困扰的大学生进行了研究，他们被分配到为期八周、由治疗师指导的ICBT组（iSOMA）或WL组，我们检查了治疗前的人口统计学特征、健康相关变量（如躯体症状持续时间）、心理困扰（如抑郁、焦虑）和认知情感因素（情绪反应性、体感放大）作为结果的候选调节因素，即从治疗前到治疗后通过患者健康问卷（PHQ - 15）评估的躯体症状困扰。
结果
体感放大（通过体感放大量表，SSAS评估）调节了结果，有利于iSOMA（B = -0.17，SE = 0.08，p = 0.031），即与对照干预相比，治疗前较高的体感放大与积极干预组更好的结果相关。在人口统计学特征、健康相关变量或心理困扰方面未发现显著的调节作用。
结论
我们的研究结果表明，对于躯体症状困扰，互联网认知行为疗法应优于无积极治疗，特别是在体感放大水平中等至高的个体中，下一步应针对进一步的治疗方法并在临床人群中进行测试。
试验注册
德国临床试验注册中心（DRKS00014375）。
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