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担忧、反刍思维和消极元认知信念作为跨诊断群组认知行为疗法在情绪障碍中疗效的调节因素。

Worry, rumination and negative metacognitive beliefs as moderators of outcomes of Transdiagnostic group cognitive-behavioural therapy in emotional disorders.

机构信息

Faculty of Psychology, Complutense University of Madrid, Madrid, Spain; Valdecilla Biomedical Research Institute (IDIVAL), Santander, Spain.

Faculty of Psychology, Complutense University of Madrid, Madrid, Spain.

出版信息

J Affect Disord. 2023 Oct 1;338:349-357. doi: 10.1016/j.jad.2023.06.032. Epub 2023 Jun 17.


DOI:10.1016/j.jad.2023.06.032
PMID:37336250
Abstract

BACKGROUND: Despite the relevance of cognitive processes such as rumination, worry, negative metacognitive beliefs in emotional disorders, the existing literature about how these cognitive processes moderate the effect of treatment in treatment outcomes is limited. The aim of the present study was to explore the potential moderator effect of baseline cognitive processes-worry, rumination and negative metacognitive beliefs-on the relationship between treatment allocation (transdiagnostic cognitive-behavioural therapy -TD-CBT plus treatment as usual-TAU vs. TAU alone) and treatment outcomes (anxiety and depressive symptoms, quality of life [QoL], and functioning) in primary care patients with emotional disorders. METHODS: A total of 631 participants completed scales to evaluate worry, rumination, negative metacognitive beliefs, QoL, functioning, and anxiety and depressive symptoms. RESULTS: Worry and rumination acted as moderators on the effect of treatment for anxiety (b = -1.25, p = .003; b = -0.98, p = .048 respectively) and depressive symptoms (b = -1.21, p = .017; b = -1.34, p = .024 respectively). Individuals with higher baseline levels of worry and rumination obtained a greater reduction in emotional symptoms from the addition TD-CBT to TAU. Negative metacognitive beliefs were not a significant moderator of any treatment outcome. LIMITATIONS: The study assesses cognitive processes over a relatively short period of time and uses self-reported instruments. In addition, it only includes individuals with mild or moderate anxiety or depressive disorders, which limits generalization to other populations. CONCLUSIONS: These results underscore the generalization of the TD-CBT to individuals with emotional disorders in primary care with different cognitive profiles, especially those with high levels of worry and rumination.

摘要

背景:尽管反思、担忧、消极元认知信念等认知过程与情绪障碍有关,但关于这些认知过程如何调节治疗对治疗结果的影响的现有文献有限。本研究旨在探讨基线认知过程(担忧、反思和消极元认知信念)对治疗分配(跨诊断认知行为治疗-TD-CBT 加常规治疗-TAU 与单独 TAU)与治疗结果(焦虑和抑郁症状、生活质量[QoL]和功能)的潜在调节作用在初级保健中患有情绪障碍的患者。

方法:共有 631 名参与者完成了评估担忧、反思、消极元认知信念、QoL、功能以及焦虑和抑郁症状的量表。

结果:担忧和反思分别作为治疗对焦虑(b=-1.25,p=.003;b=-0.98,p=.048)和抑郁症状(b=-1.21,p=.017;b=-1.34,p=.024)效果的调节因素。基线担忧和反思水平较高的个体从 TAU 中加入 TD-CBT 后,情绪症状得到了更大的缓解。消极元认知信念不是任何治疗结果的显著调节因素。

局限性:该研究在相对较短的时间内评估认知过程,并使用自我报告的工具。此外,它仅包括轻度或中度焦虑或抑郁障碍的个体,这限制了对其他人群的推广。

结论:这些结果强调了 TD-CBT 在初级保健中具有不同认知特征的情绪障碍患者中的推广,尤其是那些担忧和反思水平较高的患者。

相似文献

[1]
Worry, rumination and negative metacognitive beliefs as moderators of outcomes of Transdiagnostic group cognitive-behavioural therapy in emotional disorders.

J Affect Disord. 2023-10-1

[2]
The mediating role of emotion regulation in transdiagnostic cognitive behavioural therapy for emotional disorders in primary care: Secondary analyses of the PsicAP randomized controlled trial.

J Affect Disord. 2022-4-15

[3]
Patterns of cognitive-emotional change after cognitive-behavioural treatment in emotional disorders: A 12-month longitudinal cluster analysis.

PLoS One. 2024

[4]
Cost-effectiveness of transdiagnostic group cognitive behavioural therapy versus group relaxation therapy for emotional disorders in primary care (PsicAP-Costs2): Protocol for a multicentre randomised controlled trial.

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[5]
Emotion Regulation as a Moderator of Outcomes of Transdiagnostic Group Cognitive-Behavioral Therapy for Emotional Disorders.

Behav Ther. 2022-7

[6]
Effectiveness of Metacognitive Therapy in Patients With Depression and Comorbid Anxiety Symptoms: A Case Series From India.

Cureus. 2022-4-18

[7]
Internet-Delivered Cognitive Behavioural Therapy for Major Depression and Anxiety Disorders: A Health Technology Assessment.

Ont Health Technol Assess Ser. 2019-2-19

[8]
Comparing cognitive styles in social anxiety and major depressive disorders: An examination of rumination, worry, and reappraisal.

Br J Clin Psychol. 2018-11-28

[9]
Effect of CBT on Metacognitive Beliefs in Depressive Disorders.

Turk Psikiyatri Derg. 2023

[10]
Reductions in negative repetitive thinking and metacognitive beliefs during transdiagnostic internet cognitive behavioural therapy (iCBT) for mixed anxiety and depression.

Behav Res Ther. 2014-6-2

引用本文的文献

[1]
Mechanics of Mindfulness: Investigating Metacognitive Beliefs as a Pathway of Effect on Anxiety and Depression.

Eur J Investig Health Psychol Educ. 2025-6-12

[2]
Rumination and drug craving scores in Chinese male patients with methamphetamine and heroin use disorders: a cross-sectional study.

Subst Abuse Treat Prev Policy. 2025-3-26

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