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.
J Affect Disord. 2023 Oct 1;338:349-357. doi: 10.1016/j.jad.2023.06.032. Epub 2023 Jun 17.
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.
A total of 631 participants completed scales to evaluate worry, rumination, negative metacognitive beliefs, QoL, functioning, and anxiety and depressive symptoms.
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.
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.
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.
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。
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。
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。
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。
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。
