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(何时以及如何)临床心理学的基础研究如何导致更有效的心理治疗精神障碍?

(When and how) does basic research in clinical psychology lead to more effective psychological treatment for mental disorders?

机构信息

Department of Psychology, LMU Munich, Munich, Germany.

Department of Psychology, LMU Munich, Munich, Germany.

出版信息

Clin Psychol Rev. 2022 Jul;95:102163. doi: 10.1016/j.cpr.2022.102163. Epub 2022 May 17.

Abstract

An important aim of basic research in Clinical Psychology is to improve clinical practice (e.g., by developing novel interventions or improving the efficacy of existing ones) based on an improved understanding of key mechanisms involved in psychopathology. In the first part of this article, we examine how frequently this translation has happened in the past by reviewing all 40 evidence-based psychological interventions recommended in current clinical guidelines for five important (groups of) mental disorders. Results show that only 23% of treatments showed a very strong link between basic research and the development of the intervention, and further 20% showed a strong link. These findings thus suggest that the route from basic research to clinical innovation may not be as strong historically as is commonly assumed. Important challenges for translational research in clinical psychology are reviewed, leading to the introduction of a new framework, and a discussion of possible solutions to overcome these challenges. Suggestions include increased attention to robust and replicable research findings, a stronger focus on experimental psychopathology research to establish causality of psychopathological mechanisms, a more systematic structural integration of basic and applied research in clinical psychology, a stronger emphasis on mechanisms of change and moderators of clinical interventions, increased attention to clinical subgroups, and emphasizing improvements to existing interventions over the development of novel interventions.

摘要

临床心理学基础研究的一个重要目标是基于对精神病理学中涉及的关键机制的深入理解,改善临床实践(例如,通过开发新的干预措施或提高现有干预措施的效果)。在本文的第一部分,我们通过回顾目前针对五种重要(类)精神障碍的临床指南中推荐的所有 40 种基于证据的心理干预措施,来检查过去这种转化发生的频率。结果表明,只有 23%的治疗方法显示出基础研究与干预措施发展之间的非常强的联系,另有 20%的治疗方法显示出较强的联系。因此,这些发现表明,从基础研究到临床创新的途径可能并不像人们普遍认为的那样强大。本文回顾了临床心理学转化研究中面临的重要挑战,提出了一个新的框架,并讨论了克服这些挑战的可能解决方案。建议包括更多地关注稳健且可复制的研究结果,更加强调实验精神病理学研究以确定精神病理机制的因果关系,更系统地将临床心理学的基础研究和应用研究结合起来,更加关注临床干预措施的变化机制和调节因素,增加对临床亚组的关注,并强调改进现有干预措施而不是开发新的干预措施。

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