The role of executive functioning in CBT: a pilot study with anxious older adults
The role of executive functioning in CBT: a pilot study with anxious older adults
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DOI：
10.1016/j.brat.2004.03.007
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发表时间：
2005-04-01
影响因子：
4.1
通讯作者：
Gorman, JM
中科院分区：
文献类型：
--
作者：
Mohlman, J;Gorman, JM
认知行为疗法（CBT）是治疗晚年焦虑和抑郁的有效方法。 CBT 的成功使用被认为依赖于由前额皮质控制的称为执行功能（EF；例如假设生成、注意力分配、自我监控）的认知技能。由于老年人有时会因正常衰老而出现执行缺陷，因此 EF 可能是老年样本中 CBT 结果的中介因素。目前的试点研究测试了这样一个假设：与具有完整 EF 的群体相比，具有执行缺陷（通过神经心理学测试测量）的老年人从 CBT 中获得的治疗效果会降低。结果表明，功能障碍组内对 CBT 的反应存在差异，具体取决于治疗前和治疗后执行缺陷的稳定性（可能还有病因）。那些从治疗前到治疗后 EF 分数仍然较低的人对 CBT 没有反应，而那些分数提高的人反应很好，类似于完整 EF 组。结果表明，一些（但不是全部）患有执行功能障碍的老年人从 CBT 中获益减少，这与执行技能对于成功使用 CBT 很重要的假设是一致的。然而，一些参与者在治疗期间可能会表现出情绪和认知技能的改善，这将进一步讨论。 (c) 2004 Elsevier Ltd. 保留所有权利。
Cognitive behavior therapy (CBT) is an effective treatment for late life anxiety and depression. The successful use of CBT is assumed to rely on cognitive skills known as executive functions (EF; e.g., hypothesis generation, allocation of attention, self-monitoring) governed by the prefrontal cortex. Because older adults sometimes have executive deficits as a consequence of normal aging, EF may be a mediator of CBT outcome in older samples. The current pilot study tested the hypothesis that older adults with executive deficits (as measured by neuropsychological tests) would show decreased therapeutic benefit from CBT for generalized anxiety disorder, as compared to a group with intact EF. Results indicated differential response to CBT within the dysfunction group depending on the stability (and possibly, the etiology) of executive deficits from pre- to posttreatment. Those whose EF scores remained low from pre- to posttreatment did not respond to CBT, while those whose scores improved responded quite well, similar to an Intact EF group. Results indicate that some, but not all, older adults with executive dysfunction show decreased benefit from CBT, and are consistent with the assumption that executive skills are important for the successful use of CBT. However, some participants may show improvement on both mood and cognitive skills during treatment, which is discussed further. (c) 2004 Elsevier Ltd. All rights reserved.