自助有危险吗?基于互联网的肢体重复行为心理自助干预的不良影响研究(免费来自 BFRB)

IF 3.4 2区 心理学 Q2 PSYCHIATRY
Anna Baumeister, Stella Schmotz, Sarah Weidinger, Steffen Moritz
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引用次数: 0

摘要

尽管心理治疗对精神障碍的疗效已得到证实,但仍可能出现不良事件或不必要的影响。然而,人们很少对不良反应进行评估。在通常没有治疗师支持的自助干预中,尽管需要特别注意与误用等相关的意外效应,但此类效应受到的关注却更少。在本研究中,我们提出了新开发的基于互联网干预的心理治疗积极和消极影响量表(PANEPS-I),并研究了基于互联网的自助干预对以身体为中心的重复行为(BFRBs)患者可能产生的不良影响,该干预综合了三种不同的技术:习惯逆转训练(HRT)、去耦合(DC)和感官去耦合(DC-is)。一些HRT使用者担心,抑制问题行为可能会导致反弹效应,但这一问题尚未得到严格研究。在基线评估之后,141 名至少有一次 BFRB 的参与者被随机分配到两个干预组,这两个干预组仅在授课方式(视频、人工)上有所不同;授课内容相同。6 周后进行后评估。使用 PANEPS-I 对意外影响进行评估。共有 70% 的参与者(两个治疗组合计)报告了干预措施带来的至少一种积极影响。14%-92%的参与者报告了负面影响,具体取决于哪种影响。同意率最高的是 "没有积极的目标导向"(52.5%)、"没有解决个人问题"(48.8%)、"时间/成绩压力"(20.9%)、羞耻感(16.3%)和对数据隐私的担忧(14.3%)。人工干预组的受试者比视频干预组的受试者更常报告不道德的程序(如数据隐私问题)(Cohen's d = .44)。应答者报告了更多的积极效果,而非应答者报告了更多的不当行为(分别为 |d| = .80, .54)。在负面影响方面,HRT 使用者(自我报告)与非使用者没有明显差异。逐步分层回归分析表明,报告的积极影响与不良行为之间存在剂量-反应关系。任何一种干预措施都可能产生副作用。与不使用 HRT 相比,使用 HRT 并不会导致更多的负面影响。为了提高质量和有效性,确保使用者(尤其是使用数字自助干预的使用者)的安全,定期评估意外效果非常重要,因为在无指导的自助干预中,患者没有监督。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Is Self-Help Dangerous? Examination of Adverse Effects of a Psychological Internet-Based Self-Help Intervention for Body-Focused Repetitive Behavior (Free From BFRB)

Despite the proven effectiveness of psychotherapy for psychiatric disorders, adverse events or unwanted effects may occur. Unwanted effects, however, are rarely assessed. In self-help interventions, which usually are not supported by a therapist, such effects have received even less attention even though special caution is needed regarding unwanted effects such as those related to misapplication. For the present study, we present the newly developed Positive and Negative Effects of Psychotherapy Scale for Internet-Based Intervention (PANEPS-I) and examine possible unwanted effects of an internet-based self-help intervention in individuals with body-focused repetitive behaviors (BFRBs), aggregating three different techniques: habit reversal training (HRT), decoupling (DC), and decoupling in sensu (DC-is). Some HRT users have expressed concern that the suppression of the problematic behavior could lead to rebound effects, but this has not been examined rigorously. Following baseline assessment, 141 participants with at least one BFRB were randomly assigned to two intervention groups that differed only with respect to the delivery mode (video, manual); the content was the same. After 6 weeks, a post-assessment was conducted. Unwanted effects were assessed using the PANEPS-I. A total of 70% of the participants (both treatment groups combined) reported at least one positive effect of the intervention. Negative effects were reported by 14–92% of participants, depending on the effect. The highest agreement rates were found for “no positive goal orientation” (52.5%), “did not address personal problems” (48.8%), “time/performance pressure” (20.9%), shame (16.3%), and concerns about data privacy (14.3%). Participants in the manual intervention group reported unethical procedures (e.g., data privacy concerns) more often (Cohen’s d = .44) than those in the video intervention group. Responders reported more positive effects and nonresponders more malpractice (|d| = .80, .54, respectively). HRT users (self-report) showed no significant differences compared to nonusers regarding negative effects. Stepwise hierarchical regression analyses indicated a dose-response relationship for reported positive effects and malpractice. Side effects may occur in any kind of intervention. Usage of HRT did not lead to more reported negative effects compared to nonusage. To improve the quality and effectiveness and ensure the safety of the user, especially those using digital self-help interventions, it is important to regularly assess unintended effects since there is no supervision of the patient in unguided self-help interventions.

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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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