治疗大便失禁和慢性便秘的矛盾性指导：一项实验分析

Paradoxical instruction in the treatment of encopresis and chronic constipation: an experimental analysis.

作者信息

Bornstein P H, Sturm C A, Retzlaff P D, Kirby K L, Chong H

出版信息

J Behav Ther Exp Psychiatry. 1981 Jun;12(2):167-70. doi: 10.1016/0005-7916(81)90012-4.

Abstract

The purpose of the present single-case experimental investigation was to examine the efficacy of paradoxical instruction in the treatment of exacerbation-based discontinuous encopresis and chronic constipation. The subject, a 9-yr old male, complained of infrequent bowel movements and daily soiling. In addition, toileting and related activities appeared to cause considerable anxiety. An ABAB reversal design with 1-yr follow-up was used as a means of evaluating treatment effectiveness. Dependent measures included weekly parental records of soiling and appropriate bowel movements. Results indicated a clear demonstration of functional control and consistent improvement in the encopretic disturbance. These findings were maintained at 1-yr follow-up.

摘要

本单病例实验研究的目的是检验矛盾指令在治疗基于病情加重的间歇性大便失禁和慢性便秘中的疗效。受试者是一名9岁男性，主诉排便次数少且每天都有弄脏内裤的情况。此外，如厕及相关活动似乎会引发相当大的焦虑。采用带有1年随访的ABAB反转设计作为评估治疗效果的方法。相关测量指标包括家长每周记录的弄脏内裤情况和正常排便情况。结果表明在大便失禁问题上功能控制得到了明确显示且持续改善。这些结果在1年随访时依然保持。