Efficacy of meta-cognitive therapy for adult ADHD.
Efficacy of meta-cognitive therapy for adult ADHD.
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DOI：
10.1176/appi.ajp.2009.09081123
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发表时间：
2010-08
期刊：
影响因子：
--
通讯作者：
Kofman MD
中科院分区：
文献类型：
--
作者：
Solanto MV;Marks DJ;Wasserstein J;Mitchell K;Abikoff H;Alvir JM;Kofman MD
研究为期12周的人工元认知疗法(MCT)组的有效性，旨在加强成人AD/HD患者的时间管理、组织和计划。根据临床和结构化诊断访谈和标准化问卷，88名符合DSM-IV ADHD标准的临床转诊成年人被分成不同的ADHD药物使用情况，并以团体模式随机分配接受MCT或支持性心理治疗。MCT使用认知行为原理和方法来传授时间管理、组织和计划方面的技能和策略，并针对破坏有效自我管理的抑郁和焦虑认知。支持组通过提供支持来控制治疗的非特定方面，同时避免讨论认知行为策略。MCT组和支持组在性别(男性分别为29%和39%)和年龄(分别为41±11.59岁和42±12.09岁)方面相似。治疗反应由一名独立的(盲人)评估者通过结构化访谈在治疗前后以及通过自我报告和附带告密者行为评级进行评估。一般线性模型，比较不同治疗之间的基线变化，显示了对DSM-IV注意力不集中症状的独立评估者、自我报告和附带评级的统计上的显著影响。采用治疗反应的二分法指数，MCT与支持组成员相比有显著更大比例的改善。Logistic回归检验了两组在手术定义的反应(控制基线ADHD严重程度)方面的差异，显示出治疗组的强劲效果(优势比=5.41；95%CI=1.77，16.55)。MCT(与支持相比)在ADHD严重程度的维度和分类估计方面产生了显著的改善，支持其作为一种可行的心理社会干预的有效性。
To examine the efficacy of a 12-week manualized Meta-Cognitive Therapy (MCT) group designed to enhance time-management, organization, and planning in adults with AD/HD. Eighty-eight clinically referred adults who met DSM-IV criteria for ADHD based on clinical and structured diagnostic interviews and standardized questionnaires were stratified vis-à-vis ADHD medication use and otherwise randomly assigned to receive MCT or supportive psychotherapy in a group modality. MCT employs cognitive-behavioral principles and methods to impart skills and strategies in time-management, organization, and planning, and target depressogenic and anxiogenic cognitions that undermine effective self-management. The Support group controlled for non-specific aspects of treatment by providing support while avoiding discussion of cognitive-behavioral strategies. MCT and Support groups were comparable in gender (29% and 39% male, respectively) and age (41±11.59 yr and 42 ± 12.09 years, respectively). Therapeutic response was assessed by an independent (blind) evaluator via structured interview pre- and post-treatment, as well as by self-report and collateral informant behavioral ratings. General linear models, comparing change from baseline between treatments, revealed statistically significant effects for independent evaluator, self-report, and collateral ratings of DSM-IV inattentive symptoms. Employing dichotomous indices of therapeutic response, a significantly greater proportion of MCT vs. Support group members demonstrated improvement. Logistic regression examining group differences in operationally defined response (controlling for baseline ADHD severity) revealed a robust effect of Treatment Group (odds ratio=5.41; 95%CI=1.77,16.55). MCT (vs. Support) yielded significantly greater improvements in dimensional and categorical estimates of ADHD severity, supporting its efficacy as a viable psychosocial intervention.
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DOI：
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发表时间：
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影响因子：
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