在认知疗法,基于正念的减压和慢性疼痛行为疗法中,治疗机制和结果脱效应
James Gerhart1,2, John W Burns1, Beverly Thorn3
1Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, United States.
Pain
|September 3, 2024
概括
认知疗法,基于正念的压力减轻和慢性疼痛的行为疗法可以通过随着时间的推移将与疼痛相关的想法与负面后果脱而出,从而改善结果. 这表明在治疗期间对疼痛发作有学会的弹性.
科学领域:
- 心理学 心理学 心理学
- 行为医学是一种行为医学.
- 疼痛管理 疼痛管理
背景情况:
- 认知疗法 (CT),基于正念的减压 (MBSR) 和行为疗法 (BT) 都用于慢性疼痛.
- 改善被认为是通过改变治疗机制而发生的.
- 一个替代假设表明,治疗可能会将机制与结果脱.
研究的目的:
- 检查治疗机制与治疗结果之间的关系在整个治疗过程中如何变化.
- 调查这种脱效应是否在活性治疗和通常治疗 (TAU) 之间有所不同.
主要方法:
- 一个随机对照试验,比较CT,MBSR,BT和TAU在521个慢性腰痛患者中.
- 八个每周的会议,对机制和结果进行评估.
- 滞后分析以检查随时间推移的机制-结果关联.
主要成果:
- 机制和结果变量之间的关联在治疗早期很强,但随着时间的推移显著减弱.
- 这种脱效应在CT,MBSR和BT中观察到,但在TAU组中没有.
- 在最后三分之一的活跃治疗中,机制与结果的联系变得无关紧要.
结论:
- 慢性疼痛的积极心理治疗似乎随着治疗的进展,将治疗机制与治疗结果脱.
- 参与者可能会学到与疼痛相关的想法或尖端不需要导致负面后果.
- 这表明,在治疗后期独立于特定机制变化的情况下,人们已经学会了管理与疼痛相关的痛苦的能力.
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