Kennedy J C, Dunlop B W, Baldwin S E, Liu C J, Mayberg H S, Craighead W E
Department of Psychiatry and Behavioral Sciences, School of Medicine, Emory University School of Medicine, Atlanta, GA, United States.
Department of Psychology, American University, Washington, D.C., United States.
J Mood Anxiety Disord. 2024 Sep;7. doi: 10.1016/j.xjmad.2024.100060. Epub 2024 Mar 2.
This study sought to further evaluate an observational measure of rumination that occurs during psychotherapy (i.e., in-session rumination). Specifically, the study aimed to replicate the reliability of an observational rating procedure in new therapy sessions and a new sample, clarify the relationship between in-session rumination and depressive symptoms, and evaluate for the first time the relationship between in-session rumination and self-reported rumination. A team of trained research assistants produced observational ratings of in-session rumination occurring during video-taped sessions of CBT from two separate treatment studies. Thirty-five patients with major depressive disorder (MDD) from one study had their final session rated, and 17 patients with MDD from another study had their first session rated. Results showed that the observational ratings were reliable, and that in-session rumination generally correlated with depressive symptom severity as expected, with higher in-session rumination predicting higher depressive symptom levels both cross-sectionally and longitudinally. Preliminary evidence also found that in-session rumination correlated with self-reported rumination, and exploratory analyses provided preliminary evidence supporting the incremental validity of in-session rumination for predicting depression severity after treatment. The results indicate that in-session rumination can be reliably identified during CBT sessions and consistently predicts higher depressive severity, both of which support efforts to develop treatments that specifically target rumination.
本研究旨在进一步评估心理治疗过程中出现的反刍思维的一种观察性测量方法（即治疗期间的反刍思维）。具体而言，该研究旨在在新的治疗疗程和新的样本中复制一种观察性评分程序的可靠性，阐明治疗期间的反刍思维与抑郁症状之间的关系，并首次评估治疗期间的反刍思维与自我报告的反刍思维之间的关系。一组经过培训的研究助理对来自两项独立治疗研究的认知行为疗法（CBT）录像疗程中出现的治疗期间反刍思维进行了观察性评分。对一项研究中的35名重度抑郁症（MDD）患者的最后一次疗程进行了评分，对另一项研究中的17名MDD患者的第一次疗程进行了评分。结果表明，观察性评分是可靠的，并且治疗期间的反刍思维通常与预期的抑郁症状严重程度相关，治疗期间反刍思维越高，在横断面和纵向都预示着抑郁症状水平越高。初步证据还发现，治疗期间的反刍思维与自我报告的反刍思维相关，探索性分析提供了初步证据，支持治疗期间的反刍思维在预测治疗后抑郁严重程度方面的增量效度。结果表明，在CBT疗程中可以可靠地识别出治疗期间的反刍思维，并且它始终预示着更高的抑郁严重程度，这两者都支持开发专门针对反刍思维的治疗方法的努力。
