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271.
《Cognitive behaviour therapy》2013,42(4):235-246
The clinical and cost-effectiveness of a computer-aided cognitive behavioural therapy (CCBT) programme, Beating the Blues, is indicated by a number of studies, but relatively little is known about its acceptability for patients with depression, anxiety, or both. This study investigated the acceptability of Beating the Blues offered on eight scheduled clinic visits with brief face-to-face support. Pre and posttreatment measures explored the relationship among programme acceptability, treatment continuation, and outcomes for people accessing the programme in routine care. Two hundred and nineteen patients with depression, anxiety, or both were offered Beating the Blues in 11 primary and secondary care practices. One hundred and ninety-one (87%) completed the pretreatment measures and 84 (38%) completed a treatment feedback questionnaire. Analysis of treatment acceptability for CCBT indicated a positive patient experience with the programme. Pretreatment expectancies predicted CCBT treatment completion but not outcomes. No differences were found between men and women on pretreatment measures. Posttreatment, women reported more favourable responses to the therapy, finding the programme more helpful and more satisfactory, than did men. No relationship between treatment acceptability and age was found. Study limitations, including research methods and attrition rates, and implications for future research are discussed. It is concluded that the Beating the Blues CCBT programme is an acceptable treatment for common mental health problems in routine care. 相似文献
272.
《Cognitive behaviour therapy》2013,42(3):113-134
Abstract De olika kontrollerade gruppstudier och okontrollerade fallstudier som finns publicerade rörande beteendeterapeutiska metoder vid ångestneuros presenters och evalueras. Studierna har uppenbara brister vad gäller presentation av patientmaterialet, mätmetoderna och tillämpningen av vissa behandlingsmetoder. Resultaten visar i allmänhet på relativt små och sällan kliniskt signifikanta förbättringar. Artikeln avslutas med rekommendationer för fortsatt forskning framför allt rörande andra behandlingsmetoder än de hittills prövade. 相似文献
273.
Abstract The preliminary results of an evaluation of a systematic assertiveness training programme (based on a cognitive-behavioural approach) in psychiatric care in Hungary are presented. The method adopted was specific to the Hungarian/Middle-European circumstances since people had difficulty in exercising their personal rights in the past. In groups of “neurotic” patients and comparison subjects three questionnaires (the Rathus-scale (R), the Assertiveness Inventory (AI) and the Uncertainty Questionnaire (UQ)) were administered at the beginning and at the end of the treatment. The training programme consisted of eight sessions with an emphasis on education about assertiveness and on the practice of skills such as saying “no” or standing up for oneself. A statistical analysis indicated significant improvement in the social skills of the participants, while an item analysis showed high internal consistency in all three questionnaires, and a concurrent validity analysis revealed a strong correlation between the Rathus-scale and the Assertiveness Inventory. The results indicate that assertiveness training can be used effectively in mental health care in Hungary. 相似文献
274.
《Cognitive behaviour therapy》2013,42(3):185-192
This paper reviews the evidence‐based literature concerning the efficacy and effectiveness of cognitive behavior therapy (CBT), drug treatment and their combination for obsessive‐compulsive disorder (OCD). After a brief outline of the seminal studies, the state of the art is presented with reference to the consensual recommendations proposed in the last 10 years. Management of OCD rests on potent selective serotonin re‐uptake inhibitors and CBT, used separately, sequentially, or concurrently. A hierarchical model for clinical decision‐making is reported. With greater severity of OCD, it is recommended to add medications. However, the response rate is still too low in many patients, and some patients remain refractory to any kind of treatment. This stresses the importance of joint efforts of psychological and biological teams to develop new treatments. 相似文献
275.
《Cognitive behaviour therapy》2013,42(3):180-192
Internet-delivered transdiagnostic anxiety interventions aim to reduce symptoms across several anxiety disorders using one treatment protocol. However, it is unclear whether comorbidity affects outcomes of such treatment. This study re-examined data from a recent randomised controlled trial (N = 129) that evaluated the efficacy of an Internet-delivered transdiagnostic cognitive behavioural therapy (iCBT) intervention for participants with principal diagnoses of generalised anxiety disorder (GAD), social phobia (SP) panic disorder and agoraphobia (PDA), of whom 72% met criteria for a comorbid anxiety disorder or depression. Participants were divided into two groups based on whether or not they had a comorbid disorder before treatment. Participants with comorbid conditions reported higher symptom levels at pre-treatment, post-treatment, and follow-up across a range of measures. Both groups showed significant reductions in symptoms over treatment; however, participants with comorbid disorders showed greater reductions in measures of GAD, PDA, SP, depression, and neuroticism. In addition, treatment significantly reduced the number of comorbid diagnoses at follow-up. These results indicate transdiagnostic iCBT protocols have the potential to reduce comorbidity. 相似文献
276.
《Cognitive behaviour therapy》2013,42(6):445-462
ABSTRACTMindfulness-based cognitive therapy (MBCT) appears to be a promising intervention for the prevention of relapse in major depressive disorder, but its efficacy in patients with current depressive symptoms is less clear. Randomized clinical trials of MBCT for adult patients with current depressive symptoms were included (k = 13, N = 1046). Comparison conditions were coded based on whether they were intended to be therapeutic (specific active controls) or not (non-specific controls). MBCT was superior to non-specific controls at post-treatment (k = 10, d = 0.71, 95% confidence interval [CI] [0.47, 0.96]), although not at longest follow-up (k = 2, d = 1.47, [?0.71, 3.65], mean follow-up = 5.70 months across all studies with follow-up). MBCT did not differ from other active therapies at post-treatment (k = 6, d = 0.002, [?0.43, 0.44]) and longest follow-up (k = 4, d = 0.26, [?0.24, 0.75]). There was some evidence that studies with higher methodological quality showed smaller effects at post-treatment, but no evidence that effects varied by inclusion criterion. The impact of publication bias appeared minimal. MBCT seems to be efficacious for samples with current depressive symptoms at post-treatment, although a limited number of studies tested the long-term effects of this therapy. 相似文献
277.
《Cognitive behaviour therapy》2013,42(2):93-104
Background: Acceptance and commitment therapy (ACT) is a promising treatment option for fibromyalgia (FM). Studies have shown that many cognitive behavioral protocols can be transferred to the Internet with sustained efficacy. However, no study has investigated the effect on an Internet-delivered ACT-based protocol for FM. This study evaluated the efficacy, acceptability, and the health economic effects of an Internet-delivered acceptance and values-based exposure treatment for FM. Methods: This open pilot trial included 41 self-referred women with a FM diagnosis. The 10-week Internet-delivered treatment included acceptance, mindfulness, work with life-values, and systematic exposure to FM symptoms and FM-related situations. Participants also had regular contact with an assigned online therapist. Assessments were made at pretreatment, post-treatment, and 6-month follow-up. Results: The treatment was completed by 70% of the participants. Attrition rates were low, with 98% completing the post-treatment assessment and 90% completing the 6-month follow-up assessment. Multiple imputations were used to replace missing values. Pre- to post-treatment within-group effect sizes were in the moderate to large range (Cohen's d = 0.62–1.56) on measures of FM symptoms and impact, disability, quality of life, depression, anxiety, fatigue, and psychological flexibility. All improvements were maintained at follow-up. Economical analyses revealed significant societal cost reductions that offset the treatment costs within 2 months of treatment completion. Conclusions: An Internet-delivered psychological treatment based on acceptance and exposure principles seems to be an efficacious, acceptable, and cost-effective treatment for FM. Randomized controlled trials are needed to confirm these results. 相似文献
278.
279.
相对稳定的负性认知特征会使个体容易发生抑郁,被称为抑郁认知易感性.文章总结并对比当前关于抑郁认知易感性的稳定性与可变性的观点,提出从儿童发展早期开始研究认知易感性因素的必要性.接着回顾消极归因方式、功能失调态度和冗思这三种认知易感性因素在儿童期的表现及其前期心理特征,试图找到抑郁认知易感性在个体发展中的连续性.建议今后探讨认知易感性因素在不同年龄的发展特点,关注发展早期认知易感性因素的测量. 相似文献
280.
幸福的体验效用与非理性决策行为的偏差机制 总被引:1,自引:0,他引:1
基于体验效用的幸福包括预期幸福、即时幸福和回忆幸福,这三者有极其重要的本质差异,导致决策偏差和非理性。本研究运用行为科学和认知神经科学相结合的研究方法,首次从行为层次—信息加工层次—脑神经层次三个层面,立体地开展幸福感的体验效用与非理性决策行为研究。研究计划分为三个部分:(1)预期幸福、即时幸福和回忆幸福的本质特点和行为规律;(2)三种体验效用产生偏差的认知心理机制;(3)体验效用与非理性决策偏差的脑神经机制。通过系列研究,拟解决三个关键问题:(1)在人类判断与决策过程中,预期、即时和回忆三种效用是如何影响人们的判断与决策?(2)三种体验效用出现偏差的信息加工特点和脑神经机制究竟是什么?(3)三种效用的偏差规律及对政府公共政策的启示。对这些问题的深入探讨,不仅对决策理论研究的发展是一个贡献;对政府管理制定有效的公共政策,避免"牺牲体验追求指标",解决"幸福悖论",同样有很强的实践指导意义。 相似文献