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针对初级保健中对认知行为疗法(CBT)有抗药性的疾病患者的短期、手册化的聚焦图式团体治疗:一项采用自然主义治疗前和治疗后设计的试点研究。

Short-term, manualized schema-focused group therapy for patients with CBT-resistant disorders within primary care: a pilot study with a naturalistic pre-treatment and post-treatment design.

作者信息

Kiers Ingeborg L, de Haan Hein A

机构信息

Department Centiv, Vincent van Gogh, Venray, Netherlands.

Tactus Addiction Treatment, Enschede, Netherlands.

出版信息

Front Psychol. 2024 Mar 26;15:1349329. doi: 10.3389/fpsyg.2024.1349329. eCollection 2024.

DOI:10.3389/fpsyg.2024.1349329
PMID:38596334
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11002181/
Abstract

The aim of this study was to explore the feasibility and preliminary effectiveness of a short-term, manualized schema therapy group for 77 patients with CBT-resistant mood and/or anxiety and/or personality disorders (PDs) in primary care. The primary focus was on the effects of this treatment on Early Maladaptive Schemas (EMS), schema modes, and psychological well-being. These aspects were assessed pre-and post-treatment treatment using the Young Schema Questionnaire (YSQ), the Schema Mode Inventory version 1.1 (SMI), and the Symptom Questionnaire-48 (SQ-48). The treatment consisted of 16 sessions, incorporating cognitive, behavioral, and experiential techniques. EMS significantly decreased from pre-treatment to post-treatment, as along with maladaptive schema modes. Adaptive modes increased, as did psychological wellbeing. There were no significant differences between the DSM-5 classifications regarding changes in the aforementioned measures, except for the maladaptive modes, where the value of the corrected within-subject effect indicated a significant interaction. comparisons were therefore conducted which showed that patients with a mood disorder experienced more positive changes in maladaptive modes compared to patients with anxiety disorders and PDs ( < 0.001). There was no significant difference between those with PDs and those with Anxiety Disorders. Our findings provide preliminary evidence that short-term, manualized schema therapy might be an effective treatment for patients with CBT-resistant mood and/or anxiety and/or PDs in primary care.

摘要

本研究的目的是探讨在初级保健中为77名对认知行为疗法(CBT)有抵抗性的情绪和/或焦虑和/或人格障碍(PD)患者开展短期、标准化图式疗法小组治疗的可行性和初步效果。主要重点是这种治疗对早期适应不良图式(EMS)、图式模式和心理健康的影响。使用杨氏图式问卷(YSQ)、图式模式量表1.1版(SMI)和症状问卷-48(SQ-48)在治疗前后对这些方面进行评估。治疗包括16次疗程,采用了认知、行为和体验技术。从治疗前到治疗后,EMS以及适应不良图式模式均显著减少。适应模式增加,心理健康状况也有所改善。除了适应不良模式外,在上述测量指标的变化方面,《精神疾病诊断与统计手册》第5版(DSM-5)分类之间没有显著差异,其中校正后的受试者内效应值显示存在显著交互作用。因此进行了比较,结果显示与焦虑障碍和人格障碍患者相比,情绪障碍患者在适应不良模式方面经历了更积极的变化(<0.001)。人格障碍患者和焦虑障碍患者之间没有显著差异。我们的研究结果提供了初步证据,表明短期、标准化图式疗法可能是治疗初级保健中对CBT有抵抗性的情绪和/或焦虑和/或人格障碍患者的有效方法。

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本文引用的文献

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Effectiveness of Predominantly Group Schema Therapy and Combined Individual and Group Schema Therapy for Borderline Personality Disorder: A Randomized Clinical Trial.主要团体图式治疗和个体与团体图式治疗相结合治疗边缘型人格障碍的疗效:一项随机临床试验。
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Short-term group schema therapy for mixed personality disorders: a pilot study.混合性人格障碍的短期团体图式疗法:一项初步研究。
Front Psychol. 2015 Jan 22;5:1592. doi: 10.3389/fpsyg.2014.01592. eCollection 2014.
7
Personality disorder prevalence in psychiatric outpatients: a systematic literature review.精神科门诊患者的人格障碍患病率:系统文献综述。
Personal Ment Health. 2014 May;8(2):91-101. doi: 10.1002/pmh.1252. Epub 2014 Jan 15.
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Psychotherapy for depression: a randomized clinical trial comparing schema therapy and cognitive behavior therapy.抑郁症的心理治疗:一项比较图式治疗和认知行为治疗的随机临床试验。
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