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认知偏差修正解释作为强迫症及相关障碍辅助治疗的可行性与可接受性:一项初步随机对照试验

Feasibility and Acceptability of Cognitive Bias Modification for Interpretation as an Adjunctive Treatment for OCD and Related Disorders: A Pilot Randomized Controlled Trial.

作者信息

Falkenstein Martha J, Kelley Kara N, Dattolico Devin, Kuckertz Jennie M, Bezahler Andreas, Krompinger Jason, Webb Christian A, Beard Courtney

机构信息

McLean Hospital/Harvard Medical School.

McLean Hospital/Harvard Medical School.

出版信息

Behav Ther. 2022 Mar;53(2):294-309. doi: 10.1016/j.beth.2021.09.002. Epub 2021 Sep 29.

DOI:10.1016/j.beth.2021.09.002
PMID:35227405
Abstract

Cognitive models implicate interpretation bias in the development and maintenance of obsessive compulsive and related disorders (OCRDs), and research supports Cognitive Bias Modification for Interpretation (CBM-I) in targeting this mechanism. However, prior studies in OCRDs have been limited to nonclinical populations, adolescents, and adults in a laboratory setting. This study evaluated the feasibility and acceptability of CBM-I as an adjunctive intervention during intensive/residential treatment (IRT) for adults with OCRDs. We modified a lab-based CBM-I training for adults seeking IRT for OCRDs, and conducted a feasibility trial (N = 4) and subsequent pilot RCT; participants (N = 31) were randomized to receive CBM-I or psychoeducation. Benchmarks were met for feasibility, acceptability, and target engagement. From pre- to post-intervention, the CBM-I group showed a large effect for change in interpretation bias (d = .90), whereas this effect was trivial (d = .06) for psychoeducation. This was the first study to evaluate CBM-I in naturalistic treatment for adults seeking IRT for OCRDs. Findings support the feasibility and acceptability of CBM-I in this novel sample and setting. A larger scale RCT is needed to determine whether CBM-I can enhance OCRD treatment response.

摘要

认知模型表明,解释偏差在强迫症及相关障碍(OCRD)的发展和维持中起作用,并且研究支持针对这一机制的认知偏差修正解释(CBM-I)。然而,先前针对OCRD的研究仅限于非临床人群、青少年以及实验室环境中的成年人。本研究评估了CBM-I作为OCRD成年患者强化/住院治疗(IRT)期间辅助干预措施的可行性和可接受性。我们对寻求IRT治疗的OCRD成年患者的基于实验室的CBM-I训练进行了修改,并开展了一项可行性试验(N = 4)及后续的试点随机对照试验;参与者(N = 31)被随机分配接受CBM-I或心理教育。在可行性、可接受性和目标参与度方面均达到了基准。从干预前到干预后,CBM-I组在解释偏差变化方面显示出较大效应(d = 0.90),而心理教育的效应微不足道(d = 0.06)。这是第一项评估CBM-I在寻求IRT治疗的OCRD成年患者自然主义治疗中的研究。研究结果支持了CBM-I在这个新样本和环境中的可行性和可接受性。需要进行更大规模的随机对照试验来确定CBM-I是否能增强OCRD的治疗反应。

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