Can the components of a cognitive model predict the severity of generalized anxiety disorder?
Can the components of a cognitive model predict the severity of generalized anxiety disorder?
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DOI：
10.1016/j.beth.2006.07.002
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发表时间：
2007-06-01
期刊：
影响因子：
3.7
通讯作者：
Koerner, Naomi
中科院分区：
文献类型：
--
作者：
Dugas, Michel J.;Savard, Pierre;Koerner, Naomi
在过去的十年里，一些控制良好的研究支持了广泛性焦虑症(GAD)认知模型的有效性，该模型包括四个主要组成部分：不容忍不确定性、对担忧的积极信念、消极的问题定向和认知回避。尽管这些研究表明，模型组件在非临床样本中与高水平的担忧相关，在临床样本中与GAD的诊断相关，但它们没有解决模型组件是否能预测GAD严重程度的问题。因此，本研究试图在84名被初步诊断为广泛性焦虑症的患者样本中，确定模型组件是否与诊断严重性、焦虑严重性和躯体症状严重性有关。所有模型组件都与广泛性痴呆的严重程度有关，尽管对担忧和认知回避的积极信念仅与疾病的严重程度略有关联。不容忍不确定性和消极的问题导向与GAD的严重程度(特别是与担忧的严重程度)有更强的关系。当参与者被分成轻度、中度和重度GAD组时，即使在年龄、性别和抑郁症状得到统计控制的情况下，不确定性的不容忍和消极的问题导向也将中度和重度GAD组与轻度GAD组区分开来。总体而言，研究结果进一步支持了该模型的有效性，并表明对不确定性的不容忍和消极的问题导向与广泛性AD的严重程度有关，与社会人口和相关的临床因素无关。本文还讨论了这一发现的理论和临床意义。
Over the past decade, a number of well-controlled studies have supported the validity of a cognitive model of generalized anxiety disorder (GAD) that has four main components: intolerance of uncertainty, positive beliefs about worry, negative problem orientation, and cognitive avoidance. Although these studies have shown that the model components are associated with high levels of worry in nonclinical samples and with a diagnosis of GAD in clinical samples, they have not addressed the question of whether the model components can predict the severity of GAD. Accordingly, the present study sought to determine if the model components are related to diagnostic severity, worry severity, and somatic symptom severity in a sample of 84 patients with a primary diagnosis of GAD. All model components were related to GAD severity, although positive beliefs about worry and cognitive avoidance were only modestly associated with the severity of the disorder. Intolerance of uncertainty and negative problem orientation had more robust relationships with the severity of GAD (and with worry severity, in particular). When participants were divided into Mild, Moderate, and Severe GAD groups, intolerance of uncertainty and negative problem orientation distinguished the Moderate and Severe GAD groups from the Mild GAD group, even when age, gender, and depressive symptoms were statistically controlled. Overall, the results lend further support to the validity of the model and suggest that intolerance of uncertainty and negative problem orientation are related to the severity of GAD, independently of sociodemographic and associated clinical factors. The theoretical and clinical implications of the findings are discussed.