Motivational Interviewing to Increase Cognitive Rehabilitation Adherence in Schizophrenia
Motivational Interviewing to Increase Cognitive Rehabilitation Adherence in Schizophrenia
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DOI：
10.1093/schbul/sbv143
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发表时间：
2016-03-01
影响因子：
6.6
通讯作者：
Martino, Steve
中科院分区：
文献类型：
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作者：
Fiszdon, Joanna M.;Kurtz, Matthew M.;Martino, Steve
众所周知，精神病患者的治疗依从性很低。在这项随机、对照、概念验证的研究中，我们试图研究动机性访谈（MI）是否可以用于增强认知康复的动机、依从性和受益。双重诊断心肌梗死，专门为个人开发的精神病症状和混乱，进一步调整，以专注于认知障碍及其影响。64名诊断为精神分裂症谱系障碍的门诊患者完成了基线评估，并随机接受2次MI，重点是认知功能或2次假对照访谈，重点是评估和反馈首选的学习风格。接下来，所有参与者都有4周的时间，在此期间，他们可以参加多达10次基于计算机的数学训练计划，这是一个完整的认知康复课程的简短模拟。正如假设的那样，MI条件与任务特定动机的增加相关，沿着的是更高的培训课程出勤率。此外，面试后的动机水平预测会议出席。认知训练内容的改善没有显著差异，这可能是由于训练的简短性质。虽然文献中关于MI对精神病患者疗效的报道褒贬不一，但我们推测，我们的积极发现可能受到MI适应性以及非药物干预的影响。
Adherence to treatment in psychiatric populations is notoriously low. In this randomized, controlled, proof-of-concept study, we sought to examine whether motivational interviewing (MI) could be used to enhance motivation for, adherence to, and benefit obtained from cognitive rehabilitation. Dual diagnosis MI, developed specifically for individuals with psychotic symptoms and disorganization, was further adapted to focus on cognitive impairments and their impact. Sixty-four outpatients diagnosed with schizophrenia spectrum disorders completed baseline assessments and were randomized to receive either the 2-session MI focused on cognitive functioning or a 2-session sham control interview focused on assessment and feedback about preferred learning styles. Next, all participants were given 4 weeks during which they could attend up to 10 sessions of a computer-based math training program, which served as a brief analog for a full course of cognitive rehabilitation. As hypothesized, MI condition was associated with greater increases in task-specific motivation along with greater training program session attendance. Moreover, postinterview motivation level predicted session attendance. There were no significant differences in improvement on a measure of cognitive training content, which may have been due to the abbreviated nature of the training. While the literature on the efficacy of MI for individuals with psychosis has been mixed, we speculate that our positive findings may have been influenced by the adaptations made to MI as well as the focus on a nonpharmacological intervention.