Treating hoarding disorder with compassion-focused therapy: A pilot study examining treatment feasibility, acceptability, and exploring treatment effects
Treating hoarding disorder with compassion-focused therapy: A pilot study examining treatment feasibility, acceptability, and exploring treatment effects
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DOI：
10.1111/bjc.12228
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发表时间：
2019-07-04
影响因子：
3.1
通讯作者：
Mathews, Carol A.
中科院分区：
文献类型：
--
作者：
Chou, Chia-Ying;Tsoh, Janice Y.;Mathews, Carol A.
目标 囤积症 (HD) 于 2013 年被认定为一种精神疾病。现有文献表明其治疗仍有改进的空间。目前的试点研究旨在对同情聚焦疗法（CFT）作为 HD 干预措施的潜力进行初步评估，主要目的是评估其可行性和可接受性，其次是评估其效果。设计 本研究对 CFT 和第二轮现行治疗标准以及认知行为疗法 (CBT) 进行了调查，作为已完成 CBT 但仍有明显症状的个体的后续治疗选择。方法 纳入 40 名符合条件的个体（每次治疗 20 名）。通过定量和定性措施评估治疗的可行性和可接受性。为了探讨治疗效果，在治疗前和治疗后评估了 HD 症状的严重程度、HD 相关功能障碍及其潜在机制。结果 CFT 的保留率为 72%，CBT 的保留率为 37%。所有参与者和 79% 的参与者分别将 CFT 和 CBT 评为良好或优秀。在接受 CFT 作为后续治疗后，77% 的治疗完成者的 HD 症状严重程度降至临床显着 HD 的临界点以下，62% 的症状严重程度达到临床显着降低。相比之下，在完成第二个疗程的 CBT 后，23% 的 HD 症状严重程度降至截止阈值以下，29% 的患者实现了临床上显着的症状减轻。结论 目前的研究表明 CFT 具有令人满意的可行性和可接受性。此外，它还发现 CFT 在解决囤积相关机制方面具有良好的效果，而 CBT 可能无法充分解决这些问题。结果表明 CFT 作为 HD 治疗方法的潜力巨大。需要对这种干预措施进行进一步调查。从业者观点 CFT 可能是一种有前途的治疗选择，特别是对于那些对 CBT 反应不佳的人来说。通过应用 CFT 干预措施来改善情绪调节和消极自我认知可能有助于缓解囤积症状。鉴于当前研究的便利样本较小，应谨慎应用研究结果的概括。由于样本量较小，无法对 CFT 和 CBT 作为后续治疗的治疗效果指标进行统计比较。因此，基于本次试点研究的比较结论应谨慎做出。
Objectives Hoarding disorder (HD) was recognized as a psychiatric disorder in 2013. Existing literature suggests room for improvement in its treatment. The current pilot study aimed to provide an initial evaluation on the potential of compassion-focused therapy (CFT) as an intervention for HD, with the primary aim being assessing its feasibility and acceptability, and the secondary being evaluating its effects. Design Both CFT and a second round of the current standard of treatment and cognitive behavioural therapy (CBT) were investigated in the current study as follow-up treatment options for individuals who had completed CBT but were still significantly symptomatic. Methods Forty eligible individuals were enrolled (20 in each treatment). Treatment feasibility and acceptability were assessed by quantitative and qualitative measures. To explore treatment effects, HD symptom severity, HD-related dysfunctions, and their underlying mechanisms were assessed pre-treatment and post-treatment. Results Retention rates were 72% for CFT and 37% for CBT. All participants and 79% of the participants rated CFT and CBT, respectively, as good or excellent. After receiving CFT as a follow-up treatment, HD symptom severity dropped below the cut-off point for clinically significant HD for 77% of the treatment completers, and 62% achieved clinically significant reduction in symptom severity. In contrast, after completing a second course of CBT, 23% had HD symptom severity dropped below the cut-off threshold, and 29% achieved clinically significant symptom reduction. Conclusions The current study showed satisfactory feasibility and acceptability of CFT. Moreover, it also found promising effects of CFT in addressing hoarding-related mechanisms that may not have been sufficiently addressed by CBT. The results suggest promising potential of CFT as a treatment for HD. Further investigation on this intervention is needed. Practitioner pointsCFT may be a promising treatment option, particularly for those who do not respond well to CBT. Improving emotion regulation and negative self-perception by applying CFT interventions may help relieve hoarding symptoms. Generalization of the findings should be applied with caution given the small convenience sample of the current study. Statistical comparison on treatment effect measures between CFT and CBT as follow-up treatments was not available due to small sample size. Therefore, the comparative conclusions based on this pilot study should be made with caution.