A component analysis of cognitive-behavioral treatment for depression
A component analysis of cognitive-behavioral treatment for depression
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DOI：
10.1037/0022-006x.64.2.295
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发表时间：
1996-04-01
影响因子：
5.9
通讯作者：
Prince, SE
中科院分区：
文献类型：
--
作者：
Jacobson, NS;Dobson, KS;Prince, SE
本研究的目的是对A.T.Beck、A.J.Rush、B.F.Shaw和G.Emery(1979)提出的改变理论进行实验检验，以解释认知行为疗法(CT)对抑郁症的疗效。这项比较涉及将150名门诊抑郁症患者随机分配到只关注CT的行为激活(BA)部分的治疗，该治疗既包括BA，也包括教授修改自动思维(AT)的技能，但排除了专注于核心模式的CT部分，或完全CT治疗。四位经验丰富的认知治疗师进行了所有治疗。尽管治疗师极好地遵守了治疗方案，明显倾向于CT，而且CT表现良好，但没有证据表明，无论是在急性治疗终止时还是在6个月的随访中，完全治疗产生的结果都好于任何一个组成部分的治疗。此外，BA和AT治疗在改变消极思维和功能障碍归因风格方面与CT治疗同样有效。最后，归因方式对BA条件下的短期和长期结果都有很高的预测性，但在CT条件下则不能。
The purpose of this study was to provide an experimental test of the theory of change put forth by A. T. Beck, A. J. Rush, B. F. Shaw, and G. Emery (1979) to explain the efficacy of cognitive-behavioral therapy (CT) for depression. The comparison involved randomly assigning 150 outpatients with major depression to a treatment focused exclusively on the behavioral activation (BA) component of CT, a treatment that included both BA and the teaching of skills to modify automatic thoughts (AT), but excluding the components of CT focused on core schema, or the full CT treatment. Four experienced cognitive therapists conducted all treatments. Despite excellent adherence to treatment protocols by the therapists, a clear bias favoring CT, and the competent performance of CT, there was no evidence that the complete treatment produced better outcomes, at either the termination of acute treatment or the 6-month follow-up, than either component treatment. Furthermore, both BA and AT treatments were just as effective as CT at altering negative thinking as well as dysfunctional attributional styles. Finally, attributional style was highly predictive of both short- and long-term outcomes in the BA condition, but not in the CT condition.