Transdiagnostic cognitive behavioral therapy for the treatment of emotional disorders: A preliminary open trial
Transdiagnostic cognitive behavioral therapy for the treatment of emotional disorders: A preliminary open trial
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DOI：
10.1016/j.jbtep.2019.101487
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发表时间：
2019-12-01
影响因子：
1.8
通讯作者：
Norton, Peter J.
中科院分区：
文献类型：
--
作者：
Harris, Kelly R.;Norton, Peter J.
背景和目标：评估跨诊断认知行为疗法 (tCBT) 方案治疗主要或合并抑郁症患者情绪障碍的疗效。方法：符合抑郁症诊断标准的寻求治疗的成年人参加为期 12 周的 tCBT 开放试验，旨在解决情绪障碍的潜在核心病理学。在治疗前和治疗后以及 4 个月的随访中评估了关于主要和合并症诊断的临床医生严重程度评级 (CSR)、总体严重程度以及临床总体印象严重程度 (CGI-S) 评级。临床医生在治疗后和 4 个月的随访中提供了临床总体印象改善 (CGI-I) 评级，使用自我报告测量（BDI-II 和 ADDQ）在治疗前和逐次治疗时测量抑郁和焦虑症状。结果：重复测量方差分析表明主要诊断严重性、总体严重性和 CGI-S 均有所降低，治疗后观察到的效果很大（Cohen ds = 1.29-1.92）和 4 个月随访时（Cohen's ds = 0.77-1.04）。混合效应回归模型表明，在治疗过程中抑郁和焦虑症状有所减轻。 CGI-I 评级确定 63.64% 的参与者在治疗后和 4 个月的随访中为治疗反应者。 局限性：试验的不受控制性质和小样本量是研究结果普遍性的主要限制。结论：研究结果虽然是初步的，但为使用 tCBT 有效治疗情绪障碍提供了额外的证据。有必要通过一项涉及患有一系列情绪障碍诊断的参与者群体的随机对照试验，进一步研究 tCBT 治疗情绪障碍方案的实施情况。
Background and objectives: To assess the efficacy of a transdiagnostic cognitive behavioral therapy (tCBT) protocol for the treatment of emotional disorders with individuals that have a principal or comorbid depressive diagnosis.Methods: Treatment-seeking adults meeting diagnostic criteria for a depressive disorder were enrolled in a 12-week tCBT open trial aimed at addressing the underlying core pathology of emotional disorders. Clinician severity ratings (CSRs) regarding principal and comorbid diagnoses, and overall severity as well as clinical global impression-severity (CGI-S) ratings were assessed at pre- and post-treatment and 4-month follow-up. Clinician's provided a clinical global impression-improvement (CGI-I) rating post-treatment and at 4-month follow-up, Depressive and anxiety symptoms were measured at pre-treatment and session-by-session using self-report measures (BDI-II and ADDQ).Results: Repeated measure ANOVAs indicated a reduction in principal diagnosis severity, overall severity, and CGI-S with large effects observed post-treatment (Cohen's ds = 1.29-1.92) and at 4-month follow-up (Cohen's ds = 0.77-1.04). Mixed-effect regression modelling demonstrated a decrease in depressive and anxiety symptoms over the course of treatment. CGI-I ratings identified 63.64% participants as treatment responders both post-treatment and at 4-month follow-up.Limitations: The uncontrolled nature of the trial and small sample size are the main limitations to generalizability of the findings.Conclusions: The findings, although preliminary, provide additional evidence for the utilization of tCBT in the effective treatment of emotional disorders. Further research into the implementation of the tCBT for emotional disorders protocol through a randomized controlled trial involving groups of participants with a range of emotional disorder diagnoses is warranted.