在基于暴露和反应预防的强迫症强化治疗过程中,改善作为症状减轻机制的压力耐受性

IF 3.4 2区 心理学 Q2 PSYCHIATRY Behavior Therapy Pub Date : 2024-01-03 DOI:10.1016/j.beth.2023.12.006
Donald A. Godfrey, Allison Heinrich, Elizabeth McIngvale, Jennifer Sy, Michael G. Wheaton, Thröstur Björgvinsson
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引用次数: 0

摘要

暴露与反应预防疗法(ERP)是治疗强迫症(OCD)的有效方法,但ERP改善症状的具体机制仍不清楚。最初的理论认为,对诱发事件和刺激的习惯化是ERP的关键治疗因素,而其他理论则强调发展对困扰的耐受能力的作用,而不是减少困扰。当前的研究考察了在基于 ERP 的强化项目中,作为强迫症、焦虑症和抑郁症状减轻机制的困扰耐受能力的改善情况。参与者(N = 180)每周完成一次强迫症、焦虑症和抑郁症的困扰不耐受性和症状严重程度的测量。通过多层次结构方程模型,我们发现参与者在接受基于 ERP 的治疗过程中,强迫症、焦虑症和抑郁症状的严重程度每周都有显著下降。强迫症症状严重程度的每周下降部分归因于参与者忍受痛苦能力的每周提高,尤其是强迫症状。这种效果对于焦虑和抑郁症状的严重程度也很明显,超过了强迫症症状严重程度每周减轻的效果。目前的研究表明,通过基于 ERP 的强化心理治疗方案,提高对痛苦的耐受能力是降低强迫症、焦虑症和抑郁症状严重程度的一种跨诊断机制。本研究还讨论了改进强迫症、焦虑症和抑郁症状治疗的局限性和未来方向。
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Improvement in Distress Tolerance as a Mechanism of Symptom Reduction during Intensive Exposure and Response Prevention Based Treatment for OCD

Exposure and Response Prevention (ERP) is an effective treatment for obsessive compulsive disorder (OCD), yet the specific underlying mechanisms by which ERP improves symptoms remain unclear. Initial theories suggested that habituation to triggering events and stimuli was the key therapeutic factor in ERP, while other theories highlight the role of developing the ability to tolerate distress, rather than reduction of distress. The current study examined improvements in distress tolerance as a mechanism of OCD, anxiety, and depressive symptom reductions during an ERP based intensive program. Participants (N = 180) completed weekly measures of distress intolerance, and symptom severity of OCD, anxiety, and depression. Using Multi-Level Structural Equation Modeling, we found that participants experienced significant weekly decreases in OCD, anxiety, and depressive symptom severity across the course of their ERP based treatment. Weekly reductions in OCD symptom severity were partially accounted for by weekly improvements in participants’ ability to tolerate distress, particularly for obsession symptoms. This effect was also significant for anxiety and depressive symptom severity, above-and-beyond the effects of weekly reductions in OCD symptom severity. The current study suggests improving the ability to tolerate distress represents a transdiagnostic mechanism of symptom severity reduction in OCD, anxiety, and depressive psychopathology via intensive ERP based psychotherapy programming. Limitations and future directions for improving treatments for OCD, anxiety, and depressive symptoms are discussed.

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来源期刊
Behavior Therapy
Behavior Therapy Multiple-
CiteScore
7.40
自引率
2.70%
发文量
113
审稿时长
121 days
期刊介绍: Behavior Therapy is a quarterly international journal devoted to the application of the behavioral and cognitive sciences to the conceptualization, assessment, and treatment of psychopathology and related clinical problems. It is intended for mental health professionals and students from all related disciplines who wish to remain current in these areas and provides a vehicle for scientist-practitioners and clinical scientists to report the results of their original empirical research. Although the major emphasis is placed upon empirical research, methodological and theoretical papers as well as evaluative reviews of the literature will also be published. Controlled single-case designs and clinical replication series are welcome.
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