Toward a Unified Treatment for Emotional Disorders
Toward a Unified Treatment for Emotional Disorders
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DOI：
10.1016/j.beth.2016.11.005
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发表时间：
2016-11-01
期刊：
影响因子：
3.7
通讯作者：
Choate, Molly L.
中科院分区：
文献类型：
--
作者：
Barlow, David H.;Allen, Laura B.;Choate, Molly L.
40多年来，治疗焦虑和相关情绪障碍的认知行为方法的发展为我们留下了高度有效的治疗方法，这些方法越来越被广泛接受。尽管如此，这些手册已变得数量众多，有些复杂，限制了有效的培训和传播。对情绪障碍本质的深入了解表明，这些障碍在病因和潜在结构上的共性取代了差异。这表明，有可能提炼出一套心理程序，包括对情绪障碍的统一干预。基于学习、情绪发展和调节以及认知科学领域出现的理论和数据，我们确定了三个与情绪障碍治疗相关的基本治疗成分。这三个部分包括：(A)改变先前的认知重新评估；(B)防止情绪回避；(C)促进与情绪失控无关的行动倾向。这种治疗是在通过情景、内部和躯体(内感线索)以及标准的情绪诱导练习来激发情绪表达(情绪暴露)的背景下进行的，不同的患者只在所使用的情景线索和练习上有所不同。描述了支持这一新方法的理论和基本原理，以及使用该协议的一些初步经验。这种统一的治疗可能代表了一种更有效的治疗情绪障碍的策略，有待进一步评估。
Over 40 years of development of cognitive behavioral approaches to treating anxiety and related emotional disorders have left us with highly efficacious treatments that are increasingly widely accepted. Nevertheless, these manualized protocols have become numerous and somewhat complex, restricting effective training and dissemination. Deepening understanding of the nature of emotional disorders reveals that commonalities in etiology and latent structure among these disorders supercedes differences. This suggests the possibility of distilling a set of psychological procedures that would comprise a unified intervention for emotional disorders. Based on theory and data emerging from the fields of learning, emotional development and regulation, and cognitive science, we identify three fundamental therapeutic components relevant to the treatment of emotional disorders generally. These three components include (a) altering antecedent cognitive reappraisals; (b) preventing emotional avoidance; and (c) facilitating action tendencies not associated with the emotion that is dysregulated. This treatment takes place in the context of provoking emotional expression (emotional exposure) through situational, internal, and somatic (interoceptive cues), as well as through standard mood-induction exercises, and differs from patient to patient only in the situational cues and exercises utilized. Theory and rationale supporting this new approach are described along with some preliminary experience with the protocol. This unified treatment may represent a more efficient and possibly a more effective strategy in treating emotional disorders, pending further evaluation.