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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.

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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