Behavioral Activation in individual setting as adjunct to a meditation group programme for patients with chronic depression

个体环境中的行为激活作为慢性抑郁症患者冥想团体计划的辅助手段

• 批准号: 346384694
• 负责人: Professor Dr. Ulrich Stangier
• 金额: --
• 依托单位: Lehrstuhl für Klinische Psychologie und Psychotherapie
• 依托单位国家: 德国
• 项目类别: Research Grants
• 财政年份: 2017
• 资助国家: 德国
• 起止时间: 2016-12-31 至 2021-12-31
• 项目状态: 已结题
• 来源: https://gepris.dfg.de/gepris/projekt/346384694?language=en
• 关键词: Behavioral; Activation; individual; setting; adjunct

Chronic depression is a highly prevalent disorder, but despite high distress neglected in mental health care. The effectiveness and acceptance of pharmacological treatment is often limited. Thus, there is urgent need for psychological treatment options as an alternative. Besides positive results of interpersonal treatment approaches such as Cognitive Behavioral Analysis System of Psychotherapy, there is also preliminary evidence for the efficacy of mindfulness-based cognitive therapy. Based on this approach, we developed a group meditation program that combined mindfulness with metta meditation. The specific aim of metta is to enhance a positive attitude towards oneself and others. In two pilot studies, we observed preliminary positive effects on symptoms (Graser et al., 2016; Hofmann et al., 2015). The implementation of these interventions into daily life is complicated by intense withdrawal and avoidance. However, the positive outcome of a former RCT of Cognitive Therapy for recurrent depression (Stangier et al., 2013) as well as from unpublished cases indicate that behavioral activation in individual setting compensate for the shortcomings of the group mediation program and significantly contribute to the reduction of depression-prone behavior. In the present RCT, the efficacy of this combination will be examined more systematically than in preceding pilot studies, and controlled effect sizes will be established. 46 patients with chronic depression will be randomized to a) either a combination of 8 sessions group meditation and 8 individual sessions behavioral activation, or b) a wait-list control group. Symptoms of depression will be assessed at pre-, intermediate-, post-treatment and follow-up. Primary outcome measure is the independent and blind rating of depression, using the Quick Inventory of depressive symptoms. Self-report measures will be used to assess behavioral and cognitive avoidance, emotion regulation strategies, rumination and social adaptation, as well as a standardized Interview of emotion regulation. The study will be the first to provide evidence for the efficacy of the treatment and a basis for the calculation of controlled effect sizes. In case of positive outcome, further studies will have to test the efficacy in comparison with active treatments. The combination of group mediation and subsequent individual treatment may be a good treatment option for patients with chronic depression in mental health care.

慢性抑郁症是一种非常普遍的疾病，尽管有高度的痛苦，但在精神卫生保健中被忽视了。药物治疗的有效性和接受度往往是有限的。因此，迫切需要将心理治疗作为一种选择。除了心理治疗的认知行为分析系统等人际治疗方法的积极效果外，也有基于正念的认知治疗有效性的初步证据。基于这种方法，我们开发了一个将正念和冥想结合在一起的集体冥想计划。Metta的具体目标是增强对自己和他人的积极态度。在两项试点研究中，我们观察到对症状的初步积极影响(Graser等人，2016；Hofmann等人，2015)。这些干预措施在日常生活中的实施因强烈的回避和回避而变得复杂。然而，以前的认知治疗复发性抑郁症随机对照试验(Stangier et al.，2013)以及未发表的案例的积极结果表明，个人环境中的行为激活弥补了集体调解计划的不足，并显著有助于减少抑郁倾向行为。在目前的随机对照试验中，将比以前的试点研究更系统地检查这种组合的有效性，并将确定受控的效果大小。46名慢性抑郁症患者将被随机分为a)8次集体冥想和8次单独行为激活的组合，或b)等待名单对照组。抑郁症状将在治疗前、治疗中期、治疗后和随访时进行评估。主要结果衡量标准是使用抑郁症状快速清单对抑郁进行独立和盲目的评级。自我报告量表将用于评估行为和认知回避、情绪调节策略、沉思和社会适应，以及情绪调节的标准化访谈。这项研究将首次为治疗的有效性提供证据，并为计算受控效应大小奠定基础。如果结果是积极的，进一步的研究将不得不测试与积极治疗相比较的疗效。团体调解和随后的个别治疗相结合，可能是心理健康护理中慢性抑郁症患者的一个很好的治疗选择。