Changes in Self-Schema Structure in Cognitive Therapy for Major Depressive Disorder: A Randomized Clinical Trial
Changes in Self-Schema Structure in Cognitive Therapy for Major Depressive Disorder: A Randomized Clinical Trial
复制标题
DOI：
10.1037/a0016886
复制
发表时间：
2009-12-01
影响因子：
5.9
通讯作者：
Westra, Henny A.
中科院分区：
文献类型：
--
作者：
Dozois, David J. A.;Bieling, Peter J.;Westra, Henny A.
一些研究表明，消极认知结构（特别是人际内容）在当前抑郁症发作后仍会持续存在，并可能成为抑郁症脆弱性的稳定标志（D. J. A. Dozois，2007；D. J. A. Dozois & K. S. Dobson，2001 a）。鉴于认知疗法 (CT) 对于治疗抑郁发作的急性期非常有效，而且这种治疗还可以降低复发和复发的风险，因此 CT 可能会改变这些稳定的认知结构。在本研究中，患者被随机分配接受 CT+ 药物治疗 (n = 21) 或单独接受药物治疗 (n = 21)。两组患者的抑郁程度（根据贝克抑郁量表-II 和汉密尔顿抑郁量表测量）以及自动化思维和功能失调态度均显着且相似地降低。然而，在认知组织方面发现了群体差异，有利于接受 CT+ 药物治疗组合的个体。讨论了这些结果对于理解治疗变化机制和 CT 预防性质的影响。
Negative cognitive structure (particularly for interpersonal content) has been shown in some research to persist past a current episode of depression and potentially to be a stable marker of vulnerability for depression (D. J. A. Dozois, 2007; D. J. A. Dozois & K. S. Dobson, 2001 a). Given that cognitive therapy (CT) is highly effective for treating the acute phase of a depressive episode and that this treatment also reduces the risk of relapse and recurrence, it is possible that CT may alter these stable cognitive structures. In the current study, patients were randomly assigned to CT+ pharmacotherapy (n = 21) or to pharmacotherapy alone (n = 21). Both groups evidenced significant and similar reductions in level of depression (as measured with the Beck Depression Inventory-II and the Hamilton Rating Scale for Depression), as well as automatic thoughts and dysfunctional attitudes. However, group differences were found on cognitive organization in favor of individuals who received the combination of CT+ pharmacotherapy. The implications of these results for understanding mechanisms of change in therapy and the prophylactic nature of CT are discussed.