Group CBT versus MBSR for social anxiety disorder: A randomized controlled trial.
Group CBT versus MBSR for social anxiety disorder: A randomized controlled trial.
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DOI：
10.1037/ccp0000092
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发表时间：
2016-05
影响因子：
5.9
通讯作者：
Gross JJ
中科院分区：
文献类型：
--
作者：
Goldin PR;Morrison A;Jazaieri H;Brozovich F;Heimberg R;Gross JJ
探讨认知行为团体疗法（CBGT）、正念减压疗法（MBSR）和等待治疗（WL）对广泛性社交焦虑障碍（SAD）患者的治疗效果和介质。108例未用药患者（55.6%女性;平均年龄= 32.7，SD = 8.0; 43.5%白人，39%亚裔，9.3%西班牙裔，8.3%其他）被随机分配至CBGT、MBSR和WL，并在基线、治疗后/WL和1年随访时完成评估，包括Liebowitz社交焦虑量表-自我报告（主要结果）以及治疗相关过程的测量。线性混合模型分析表明，CBGT和MBSR都产生了更大的改善大多数措施相比，WL。两种治疗在社交焦虑症状、认知重新评价频率和自我效能、认知扭曲、正念技能、注意力集中和沉思方面都有类似的改善。CBGT后微妙的回避行为比MBSR后减少得更多。中介分析显示，增加重新评价频率，正念技能，注意力集中和注意力转移，减少微妙的回避行为和认知扭曲介导的CBGT和MBSR对社交焦虑症状的影响。然而，增加重新评价自我效能和减少回避行为介导的CBGT（与MBSR）对社交焦虑症状的影响。CBGT和MBSR似乎都对SAD有效。然而，它们的影响可能是潜在心理过程中共同和独特变化的结果。
To investigate treatment outcome and mediators of Cognitive-Behavioral Group Therapy (CBGT) vs. Mindfulness-Based Stress Reduction (MBSR) vs. Waitlist (WL) in patients with generalized social anxiety disorder (SAD). 108 unmedicated patients (55.6% female; mean age = 32.7, SD = 8.0; 43.5% Caucasian, 39% Asian, 9.3% Hispanic, 8.3% other) were randomized to CBGT vs. MBSR vs. WL and completed assessments at baseline, post-treatment/WL, and at 1-year follow-up, including the Liebowitz Social Anxiety Scale – Self-Report (primary outcome) as well as measures of treatment-related processes. Linear mixed model analysis showed that CBGT and MBSR both produced greater improvements on most measures compared to WL. Both treatments yielded similar improvements in social anxiety symptoms, cognitive reappraisal frequency and self-efficacy, cognitive distortions, mindfulness skills, attention focusing and rumination. There were greater decreases in subtle avoidance behaviors following CBGT than MBSR. Mediation analyses revealed that increases in reappraisal frequency, mindfulness skills, attention focusing and attention shifting, and decreases in subtle avoidance behaviors and cognitive distortions mediated the impact of both CBGT and MBSR on social anxiety symptoms. However, increases in reappraisal self-efficacy and decreases in avoidance behaviors mediated the impact of CBGT (vs. MBSR) on social anxiety symptoms. CBGT and MBSR both appear to be efficacious for SAD. However, their effects may be a result of both shared and unique changes in underlying psychological processes.