Rachel Schoor, Jared M. Bruce, Vincent S. Staggs, Andrew T. Fox, Amanda Bruce, Sharon Lynch, Delwyn Catley
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引用次数: 0
摘要
目的：尽管疾病修饰疗法（DMT）对治疗复发性MS有疗效，但约40%的患者停止使用。本研究旨在了解动机访谈加认知行为治疗（MI-CBT）的作用机制，在一项先前进行的随机对照试验中，与常规治疗（TAU）相比，MI-CBT干预成功地促进了参与者的DMT重新启动。方法：本二次分析（N = 91）采用logistic回归探讨了动机（单项动机“标尺”[Mot∆]和简短动机量表[BMS∆]）、自主动机（AR∆）、个人控制（PC∆）、治疗控制（TC∆）和重新启动信心（Con∆）的变化作为治疗效果的潜在中介。结果：包括所有潜在介质在内的Logistic回归分析表明，BMS∆是唯一具有统计学意义的预测因子（OR = 1.61, p = 0.010）。当移除BMS∆时，Mot∆(OR = 1.22, p = 0.002)和PC∆(OR = 1.67, p = 0.002)是有统计学意义的起始预测因子。结论：MI-CBT干预似乎主要通过增加启动DMT的动机而起作用。
Mechanisms of Action of Combination Motivational Interviewing-Cognitive Behavior Therapy for Reversing Medication Non-Adherence in Patients With Multiple Sclerosis
Objective
Despite disease modifying therapies' (DMT) demonstrated efficacy for treating relapsing MS, around 40% of patients discontinue use. This study aimed to understand the mechanism of action of Motivational Interviewing plus cognitive behavioral therapy (MI-CBT) in a previously conducted randomized controlled trial in which the MI-CBT intervention successfully promoted DMT re-initiation of participants compared to a treatment as usual (TAU) condition.
Methods
This secondary analysis (N = 91) explored changes in motivation (a single item motivation “ruler” [Mot∆], and the Brief Motivation Scale [BMS∆]), autonomous motivation (AR∆), personal control (PC∆), treatment control (TC∆), and confidence to reinitiate (Con∆) as potential mediators of the treatment effect, using logistic regression.
Results
Logistic regression analysis including all potential mediators as predictors of initiation indicated the BMS∆ was the only statistically significant predictor (OR = 1.61, p = 0.010). When BMS∆ was removed Mot∆ (OR = 1.22, p = 0.002) and PC∆ (OR = 1.67, p = 0.002) were statistically significant predictors of initiation.
Conclusion
The MI-CBT intervention appeared to work primarily by increasing motivation to initiate DMT.
期刊介绍：
Founded in 1945, the Journal of Clinical Psychology is a peer-reviewed forum devoted to research, assessment, and practice. Published eight times a year, the Journal includes research studies; articles on contemporary professional issues, single case research; brief reports (including dissertations in brief); notes from the field; and news and notes. In addition to papers on psychopathology, psychodiagnostics, and the psychotherapeutic process, the journal welcomes articles focusing on psychotherapy effectiveness research, psychological assessment and treatment matching, clinical outcomes, clinical health psychology, and behavioral medicine.
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