基于暴露和传统的认知行为治疗纤维肌痛的共享和独特的效果介导体:随机对照试验的二次分析
Maria Hedman-Lagerlöf1, Monica Buhrman2, Erik Hedman-Lagerlöf3
1Center for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Stockholm, Region Stockholm, Sweden.
Behaviour research and therapy
|April 30, 2024
概括
基于暴露的CBT和纤维肌痛的传统CBT共享共同的调解者,如减少与疼痛相关的避免和灾难化. 这两种疗法都旨在通过针对这些关键心理因素来改善纤维肌痛症状.
科学领域:
- 心理学 心理学 心理学
- 疼痛管理 疼痛管理
- 临床试验 临床试验
背景情况:
- 纤维肌痛是一种慢性疼痛疾病,患者遭受重大痛苦和社会成本.
- 传统的认知行为疗法 (T-CBT) 已经成熟,而暴露疗法 (Exp-CBT) 显示出减少与疼痛相关的回避的承诺.
研究的目的:
- 研究在接受Exp-CBT与T-CBT的纤维肌痛患者中治疗效果的潜在调解者.
- 检查与疼痛相关的回避,灾难化,超警,节奏,过度和身体活动在治疗结果中的作用.
主要方法:
- 一个随机对照试验,有274名参与者比较Exp-CBT和T-CBT.
- 使用并行过程增长模型进行调解分析,每周进行11次测量.
- 每周的时间延迟效应用随机拦截交叉延迟面板模型进行测试.
主要成果:
- 减少回避行为,疼痛灾难化和高警觉性介导的Exp-CBT和T-CBT的变化.
- 在T-CBT中增加了节奏和减少了过度调节的变化;身体活动不是调节者.
- 时间延迟分析显示,在Exp-CBT中,避免和灾难化显著影响了随后的纤维肌痛严重程度,而在T-CBT中,过度做了.
结论:
- 纤维肌痛的Exp-CBT和T-CBT共享共同的调解者,包括与疼痛相关的回避,灾难化和超级警.
- 特定的调解者,如节奏和过度,可能会使T-CBT的效果有所不同.
- 了解这些共同和独特的调解者可以为纤维肌痛治疗的优化提供信息.
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