A Common Elements Approach to the Development of a Modular Cognitive Behavioral Theory for Chronic Loneliness
A Common Elements Approach to the Development of a Modular Cognitive Behavioral Theory for Chronic Loneliness
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DOI：
10.1037/ccp0000454
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发表时间：
2020-03-01
影响因子：
5.9
通讯作者：
Andersson, Gerhard
中科院分区：
文献类型：
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作者：
Kall, Anton;Shafran, Roz;Andersson, Gerhard
背景：孤独是一种跨诊断的临床现象，可以显著影响整个生命周期的心理健康和福祉。目的：结合现有理论和循证治疗方法，提出一种跨障碍、年龄组和人群的慢性孤独感维持的综合跨诊断认知行为分析。方法：采用蒸馏和匹配模型框架方法来确定旨在减少孤独感的干预措施。根据实践要素的存在对符合条件的研究进行编码。这些发现与对更广泛的孤独感和精神病理学文献的分析相结合，得出了一个全面的认知行为分析，分析了人群长期以来的孤独感维持情况。结果：搜索得到11项研究，包含14个练习元素，相对频率从7%到64%不等。已确定的实践要素针对诸如负面人际评价等假定机制。焦虑和社交技能缺陷。基于更广泛的文献，反生产行为和认知过程（如以销售为中心的注意力）被确定为维持因素。提出了一种具有多种途径的模块化诊断模型，以与现有的理论和治疗文献保持一致。结论：将提炼和匹配模型框架与现有的文献理论相结合，是一种新的方法，可以建立一个长期维持孤独感的因素模型。该模型对不同人群有不同的治疗意义，包括患有自闭症谱系障碍的儿童和失去亲人的老年人。以跨诊断过程为目标，有可能在一系列形式和环境中改变对孤独的干预措施。
Background: Loneliness is a transdiagnostic clinical phenomenon that can significantly impact mental health and well-being across the lifespan. Objective: The aim was to combine existing theory and evidence-based treatment approaches to propose a comprehensive transdiagnostic cognitive-behavioral analysis of the maintenance of chronic loneliness relevant across disorders, age groups, and populations. Method: A distillation and matching model-framework approach was taken to identify interventions designed to reduce loneliness. Eligible studies were coded for the presence of practice elements. The findings were combined with an analysis of the broader literature on loneliness and psychopathology to derive a comprehensive cognitive-behavioral analysis of the maintenance of loneliness over time across populations. Results: The search yielded 11 studies containing 14 practice elements with relative frequencies ranging from 7% to 64%. The identified practice elements target putative mechanisms such as negative interpersonal appraisals. anxiety, and social skills deficits. Counterproductive behavior and cognitive processes such as sell-focused attention were identified as maintenance factors based on the broader literature. A modular transdiagnostic model with multiple pathways is proposed to be consistent with the existing theoretical and treatment literature. Conclusions: Combining the distillation and matching model framework with existing theory from the literature is a novel approach for developing a model of factors that maintain loneliness over time. The model has varying treatment implications for different populations including children with autism spectrum disorders and bereaved older adults. Targeting transdiagnostic processes has the potential to transform interventions for loneliness across a range of formats and settings.