认知行为疗法结合暗示疗法治疗躯体化障碍的样例研究

发布时间：2018-05-01 12:10

本文选题：躯体化障碍 + 认知行为疗法　；参考：《陕西师范大学》2014年硕士论文

【摘要】：躯体化障碍又称Briquet综合征,是个体在一种应激反应下出现了躯体不适的症状,主要表现为反复出现、多种多样、经常变化的躯体症状,这些躯体症状几乎在每一个系统都可能出现,没有任何合适的病理来阐述这种躯体的不适和症状,常导致患者把这种躯体不适的症状归结为躯体疾病,因此来寻求医学上的帮助。但是经过医生的检查又没有一定的病理根据来解释的躯体症状。患者往往不相信医生给出其自己并没有躯体障碍的诊断,反而会更多的把注意力放在自己的躯体上,不听医生的忠告,自行服用药物和不必要的医学检查。这样严重影响了患者的正常生活和工作,给患者的身心造成了不同程度的损害。因此对躯体化障碍的治疗已经成了研究者们研究的热点。本研究以西安市某医院的躯体化障碍患者为例做了如下研究：研究目的：采用多基线实验设计的个案研究和2个月追踪研究治疗躯体化障碍患者,以考查认知行为疗法结合暗示疗法治疗躯体化障碍的效果。研究方法：对9个躯体化障碍患者进行认知行为疗法结合暗示疗法进行治疗,在治疗前、治疗后和追踪期分别使用症状自评量表(SCL—90)、躯体化障碍量表(SSS)、抑郁自评量表(SDS)和焦虑自评量表(SAS)对患者进行评估。患者每周接受1次治疗,每次50-60分钟,治疗次数为8-10周。研究结果：对患者的多基线数据进行图形观察发现所有按治疗师制定方案完成治疗的患者,躯体化症状有减轻的趋势,焦虑和抑郁的情绪状态也有所缓解,其治疗效果在两个月的追踪得到了维持。Wilcoxon相关样本检验发现患者的SSS前后侧得分有显著差异。SCL-90中的躯体化、人际关系、抑郁和焦虑因子的前后侧得分也有显著差异研究结论：(1)认知行为疗法结合暗示疗法可以有效治疗躯体化障碍,患者的躯体化障碍量表(SSS)、抑郁自评量表(SDS)和焦虑自评量表(SAS)前后侧分数有差异。(2)患者躯体化症状的缓解能够促进患者情绪状态和人际关系的改善。患者在症状自评量表(SCL-90)的人际关系因子、焦虑因子、抑郁因子的前后测得分有差异。(3)认知行为疗法结合暗示疗法治疗躯体化障碍的疗效能够得到维持。
[Abstract]:Somatization disorder, also known as Briquet syndrome, is a symptom of body discomfort in an individual under a stress response. It is mainly manifested in repeated, varied and frequently changing physical symptoms. These physical symptoms can occur in almost every system, and there is no suitable pathology to describe the discomfort and symptoms of the body, often leading patients to attribute the symptoms of the physical discomfort to a physical disease. So seek medical help. But after the doctor's examination, there is no certain pathological basis to explain the physical symptoms. Patients often do not believe in doctors to make their own diagnosis of no physical disorders, but will pay more attention to their own body, do not listen to the doctor's advice, self-medication and unnecessary medical examination. This seriously affected the patient's normal life and work, and caused varying degrees of damage to the patient's body and mind. Therefore, the treatment of somatization disorder has become the focus of researchers. This study took patients with somatization disorders in a hospital in Xi'an as an example to do the following research: Objective: to investigate the efficacy of cognitive behavioral therapy combined with hint therapy in the treatment of somatization disorders with a multi-baseline design and a 2-month follow-up study. Methods: nine patients with somatization were treated with cognitive behavioral therapy combined with implied therapy. The patients were evaluated with symptom Checklist 90 (SCL 90), somatization Disorder scale (SSS), self rating Depression scale (SDS) and self rating anxiety scale (SAS) after treatment and follow-up period. Patients received 50-60 minutes of treatment once a week for 8-10 weeks. Results: a graphical observation of multiple baseline data showed that all patients who completed the treatment according to the therapist's plan had a tendency to reduce their somatization symptoms, as well as their anxiety and depression emotional states. The results of two months follow-up showed that there were significant differences in the scores of the patients with SSS before and after treatment. The scores of somatization, interpersonal relationships, depression and anxiety factors were also significantly different in SCL-90. Conclusion: 1) Cognitive Behavioral Therapy combined with implied Therapy can effectively treat somatization disorders. There were significant differences in the scores of somatization disorder scale (SSS), self rating depression scale (SDS) and self rating anxiety scale (SAS) before and after SAS). (2) the relief of somatization symptoms could promote the improvement of emotional state and interpersonal relationship of the patients. The scores of interpersonal factors, anxiety factors and depression factors in SCL-90 were significantly different (P < 0.05). The efficacy of cognitive behavioral therapy combined with implied therapy in the treatment of somatization disorders could be maintained.
【学位授予单位】：陕西师范大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：B849

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