认知行为疗法的创新与进展:来自实验精神病理学的见解

IF 1 4区 医学 Q4 PSYCHIATRY
Allison J. Ouimet, Ryan J. Ferguson
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In their selective review, Gagné, Kelly-Turner, and Radomsky (2018) focused on the science–practice bridge (rather than the gap) to understand both how research has informed the treatment of obsessive– compulsive disorder (OCD) and how clinical experience can inspire experimental research. They provided a broad overview of etiological models of OCD, with a particular focus on diverse cognitive models such as the cognitive appraisal model and the seeking proxies for internal states model. Through examples of experiments across checking, obsessions, contamination fear, and “just-right” symptom presentations, they provided ideas for future research and future practice. 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引用次数: 1

摘要

实验精神病理学的核心目标是了解导致、维持或以其他方式导致心理健康问题的过程或机制(例如,Zvolensky, Forsyth, & Johnson, 2013)。有无数的例子表明,这类研究如何在治疗心理障碍患者方面取得了重大进展。也许最著名的是Beck(1963)的发现,即抑郁症患者始终表现出系统性思维错误(即认知扭曲)和有意识的消极自动思维,这一发现彻底改变了我们帮助情绪障碍患者的方式(参见Beck, 2019,抑郁症认知疗法的历史)。事实上,只要花一点时间仔细阅读国家健康与护理卓越研究所(NICE)的治疗建议,就会很快清楚地发现,认知行为疗法(CBT)现在——而且已经有一段时间了——是几乎所有心理障碍的一线循证治疗方法。因此,很容易得出“我们的工作完成了”的结论。然而,许多人继续遭受心理健康问题的困扰,这些问题要么在CBT治疗后没有得到改善,要么在治疗后复发;更多的人无法获得循证护理。至关重要的是,了解仍需要针对哪些机制、针对哪些人、在哪些条件下进行治疗,并制定增加获得这些治疗的方法。实验精神病理学包含了一个框架,在这个框架中实现了这一点。因此,这个特别收藏的目的是汇集实验性精神病理学研究,继续推进CBT治疗各种心理障碍。作者被邀请提交描述以下内容的手稿:(1)精神病理学潜在机制的原创性研究,(2)新的(或新的变体)CBT干预措施的原创性研究,或(3)已发表的实验性精神病理学发现的综述/整合,这些发现导致了最近的创新或有可能导致CBT的创新。结果是一个令人兴奋的特别集合,涵盖了精神健康问题的范围,实验精神病理学方法(实验,案例研究设计和随机对照试验[rct]),包括临床和非临床参与者,以及实验精神病理学文献的特色综述。总之,这些文章表明,我们已经学到了很多东西,关于如何推进认知行为疗法及其对精神健康问题患者的可及性,我们还有很多要学的。gagn、Kelly-Turner和Radomsky(2018)在他们的选择性综述中,重点关注科学与实践之间的桥梁(而不是鸿沟),以了解研究如何为强迫症(OCD)的治疗提供信息,以及临床经验如何启发实验研究。他们对强迫症的病因模型进行了广泛的概述,特别关注了不同的认知模型,如认知评估模型和寻找内部状态代理模型。通过检查、强迫症、污染恐惧和“刚刚好”的症状表现等实验例子,他们为未来的研究和实践提供了思路。事实上,多年来,研究人员已经开展了许多聪明的研究,阐明了引起和维持强迫症的各种认知机制(例如,通过告诉实验组,如果他们想到“苹果”这个词,隔壁房间的人就会受到电击,从而诱导思想-行动融合;Rassin, Merckelbach, Muris, & Spaan, 1999),从而提供了可能富有成效的治疗靶点。在实验文献中也有重要的空白。最值得注意的是,“刚刚好”的体验在很大程度上没有得到充分研究;治疗这种特殊实验精神病理学杂志的临床建议2019年7月至9月:1-5 a作者(s) 2019文章重用指南:sagepub.com/journals-permissions DOI: 10.1177/2043808719874966 journals.sagepub.com/home/jepp
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Innovations and advances in cognitive behavioral therapy: Insights from experimental psychopathology
At its core, the goal of experimental psychopathology is to understand what processes or mechanisms cause, maintain, or otherwise contribute to mental health problems (e.g., Zvolensky, Forsyth, & Johnson, 2013). There are countless examples of how this type of research has led to important improvements in treatment for people with psychological disorders. Perhaps most famously, Beck’s (1963) findings that people with depression consistently exhibit systematic thinking errors (i.e., cognitive distortions) and conscious negative automatic thoughts revolutionized how we help people with emotional disorders (see Beck, 2019, for a history of cognitive therapy for depression). Indeed, by spending a bit of time perusing treatment recommendations by the National Institute for Health and Care Excellence (NICE), it becomes clear quickly that cognitive behavioral therapy (CBT) is now—and has been for a while—a first-line evidence-based treatment for almost every psychological disorder. As such, it would be easy to conclude that “our work is done.” However, many people continue to suffer with mental health problems that either are not improved following CBT or relapse following treatment; many more are unable to access evidence-based care. Understanding what mechanisms still need to be targeted, for whom, under which conditions, and developing ways to increase access to these treatments is vital. Experimental psychopathology comprises a framework in which to make that happen. The goal of this Special Collection was thus to bring together experimental psychopathology research that continues to advance CBT for various psychological disorders. Authors were invited to submit manuscripts describing (1) original investigations of underlying mechanisms of psychopathology, (2) original investigations of new (or new variations of) CBT interventions, or (3) reviews/integrations of a body of published experimental psychopathology findings that have led to recent innovations or have the potential to lead to innovations in CBT. The result is an exciting special collection that runs the gamut of mental health problems, experimental psychopathology methods (experiments, case-study designs, and randomized controlled trials [RCTs]), includes both clinical and nonclinical participants, and features reviews of experimental psychopathology literature. Together, these articles suggest that we have learned much, and that we have much to learn about how to advance CBT and its accessibility for people with mental health problems. In their selective review, Gagné, Kelly-Turner, and Radomsky (2018) focused on the science–practice bridge (rather than the gap) to understand both how research has informed the treatment of obsessive– compulsive disorder (OCD) and how clinical experience can inspire experimental research. They provided a broad overview of etiological models of OCD, with a particular focus on diverse cognitive models such as the cognitive appraisal model and the seeking proxies for internal states model. Through examples of experiments across checking, obsessions, contamination fear, and “just-right” symptom presentations, they provided ideas for future research and future practice. Indeed, throughout the years, researchers have developed many clever studies that shed light on the diverse cognitive mechanisms that cause and maintain OCD (e.g., inducing thought– action fusion by telling an experimental group that if they think the word “apple,” a person in the next room will receive a shock; Rassin, Merckelbach, Muris, & Spaan, 1999) and thus provide potentially fruitful treatment targets. There are also important gaps in the experimental literature. Most notably, “just-right” experiences have been largely understudied; clinical suggestions for treating this particular Journal of Experimental Psychopathology July-September 2019: 1–5 a The Author(s) 2019 Article reuse guidelines: sagepub.com/journals-permissions DOI: 10.1177/2043808719874966 journals.sagepub.com/home/jepp
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来源期刊
Journal of Experimental Psychopathology
Journal of Experimental Psychopathology Medicine-Psychiatry and Mental Health
CiteScore
2.00
自引率
0.00%
发文量
19
审稿时长
11 weeks
期刊介绍: The Journal of Experimental Psychopathology (EPP) is an open access, peer reviewed, journal focused on publishing cutting-edge original contributions to scientific knowledge in the general area of psychopathology. Although there will be an emphasis on publishing research which has adopted an experimental approach to describing and understanding psychopathology, the journal will also welcome submissions that make significant contributions to knowledge using other empirical methods such as correlational designs, meta-analyses, epidemiological and prospective approaches, and single-case experiments.
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