Extreme nonresponse in cognitive therapy: Cean Behavioral activation succeed where cognitive therapy fails?
Extreme nonresponse in cognitive therapy: Cean Behavioral activation succeed where cognitive therapy fails?
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DOI：
10.1037/0022-006x.75.4.531
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发表时间：
2007-08-01
影响因子：
5.9
通讯作者：
Hollon, Steven D.
中科院分区：
文献类型：
--
作者：
Coffman, Sandra J.;Martell, Christopher R.;Hollon, Steven D.
在最近的一项安慰剂对照比较中，行为激活在治疗中度到重度抑郁症的成年人方面优于认知疗法。此外，一部分患者在自我报告抑郁症时表现出对认知治疗极端无反应的模式，这在临床医生评分中并不明显。这些患者严重抑郁，功能受损，并有主要的支持团体问题；大多数人还描述自己患有终生抑郁症。具有这种特征的患者被分配到相同数量的行为激活，这表明随机化并没有失败，而且大多数情况发生在适当的认知治疗的背景下。如果这种自我报告的对认知治疗极端无反应的模式重复出现，这可能表明，可能有一部分患者认为，在限时治疗中，持续关注行为变化会让自己表现得更好。
In a recent placebo-controlled comparison, behavioral activation was superior to cognitive therapy in the treatment of moderate to severely depressed adults. Moreover, a subset of patients exhibited a pattern of extreme nonresponse to cognitive therapy on self-reports of depression not evident on the clinician ratings. These patients were severely depressed, functionally impaired, and had primary support group problems; most also described themselves as having life-long depressions. Comparable numbers of patients with such characteristics were assigned to behavioral activation, indicating that randomization did not fail, and most instances occurred in the context of adequate cognitive therapy. If this pattern of self-reported extreme nonresponse to cognitive therapy replicates, it would suggest that there might be a subset of patients who see themselves as doing better with sustained attention to behavior change in time-limited treatment.