Sudden Gains in Cognitive Behavioural Therapy and Metacognitive Therapy for Complex Anxiety Disorders

IF 3.2 3区心理学 Q1 PSYCHOLOGY, CLINICAL

Clinical psychology & psychotherapy Pub Date : 2025-07-09 DOI:10.1002/cpp.70111

Kenneth M. Pålerud, Marieke A. Helmich, Asle Hoffart, Omid V. Ebrahimi, Therese R. Snuggerud, Sverre U. Johnson

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Abstract

The present study investigated the prevalence of sudden gains in a large sample of patients with complex anxiety disorders, that is, long-lasting and treatment-resistant anxiety disorders. The properties of these gains were explored in a longitudinal design from two treatment modalities: cognitive behavioural therapy (CBT) and metacognitive therapy (MCT). Participants were 404 adults with a primary diagnosis of anxiety disorder, receiving a standardized 8 weeks of inpatient treatment with CBT or MCT. Symptom severity was measured weekly with the Beck Anxiety Inventory (BAI) and additionally during the first assessment session, pre-treatment, post-treatment and 1-year follow-up. Sudden gains were identified as between-session symptom changes of ≥ 9 points on the BAI, which were relatively large (≥ 25% difference) and stable (did not reverse) in the weeks after the gain. The prevalence of sudden gains during treatment was 19%. Individuals experiencing sudden gains had significantly lower levels of anxiety immediately after treatment and at 1-year follow-up compared to those without. Sudden gains were present in both CBT and MCT, showing similar magnitudes and prevalence, but patients treated with MCT tended to experience sudden gains earlier than those with CBT. This study demonstrates that sudden gains also occur in a long-lasting and treatment-resistant anxiety disorder population treated with CBT and MCT.

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认知行为疗法和元认知疗法治疗复杂焦虑症的突然进展

本研究调查了大样本的复杂焦虑症患者突然获益的患病率，即长期和治疗难治性焦虑症。通过纵向设计，研究了两种治疗方式：认知行为疗法（CBT）和元认知疗法（MCT）。参与者是404名初步诊断为焦虑症的成年人，接受标准化的8周住院治疗，包括CBT或MCT。每周用贝克焦虑量表（BAI）测量症状严重程度，并在第一次评估期、治疗前、治疗后和1年随访期间进行测量。突然增益被定义为BAI≥9分的会话间症状变化，在增益后的几周内相对较大（差异≥25%）且稳定（未逆转）。治疗期间突然增加的患病率为19%。与未接受治疗的个体相比，经历突然获益的个体在治疗后和1年随访期间的焦虑水平显著降低。CBT和MCT均有突然获益，表现出相似的幅度和流行程度，但接受MCT治疗的患者往往比接受CBT治疗的患者更早出现突然获益。这项研究表明，在接受CBT和MCT治疗的长期和治疗抵抗性焦虑症人群中，也会出现突然的获益。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical psychology & psychotherapy PSYCHOLOGY, CLINICAL-

CiteScore

6.30

自引率

5.60%

发文量

106

期刊介绍： Clinical Psychology & Psychotherapy aims to keep clinical psychologists and psychotherapists up to date with new developments in their fields. The Journal will provide an integrative impetus both between theory and practice and between different orientations within clinical psychology and psychotherapy. Clinical Psychology & Psychotherapy will be a forum in which practitioners can present their wealth of expertise and innovations in order to make these available to a wider audience. Equally, the Journal will contain reports from researchers who want to address a larger clinical audience with clinically relevant issues and clinically valid research.