社交焦虑障碍与认知团体行为治疗疗效及预后的影响因素

发布时间：2018-03-05 17:07

本文选题：社交焦虑障碍　切入点：认知行为治疗　出处：《四川大学学报(医学版)》2017年06期 　论文类型：期刊论文

【摘要】：目的研究社交焦虑障碍(social anxiety disorder,SAD)患者的症状及其预后的影响因素,分析认知团体行为治疗(group cognitive-behavioral therapy,GCBT)的作用机制和长期效果。方法对50例SAD患者进行治疗前的心理问卷评估,包括社交焦虑量表(Liebowitz social anxiety scale,LSAS)、自动思维问卷(automatic thoughts questionnaire,ATQ)、惧怕否定量表(fear of negative evaluation questionnaire,FNE)、社会支持量表(social support rating scale,SSRS)、三维人格问卷(tridimensional personality questionnaire,TPQ)和父母教养方式问卷(egna minnen barndoms uppfostran,EMBU),评价患者的思维方式、人格特点及外界的心理社会支持等因素,并与50例健康对照对比;30例SAD患者进行GCBT治疗(采取以改善自我为主、合并部分认知行为治疗的团体心理治疗方案,每周1次,每次2h,共8周),在治疗后1周内再次进行量表、问卷调查,评价症状改善和认知改变程度。并对40例SAD患者(其中22例进行了GCBT治疗,18例未治疗)进行为期1~5年的随访。结果 SAD患者在思维方式、人格特点、社会支持、父母教养方式等方面与对照组比较差异有统计学意义(P0.05)。GCBT治疗后社交焦虑(t=4.06,P=0.000)、负性思维(t=4.58,P=0.000)和惧怕否定(t=3.85,P=0.000)较治疗前明显减轻。随访发现SAD患者社交焦虑症状的减轻程度与患者的主观支持呈正相关(r=0.361,P=0.022),与父亲拒绝与否认的教育方式呈负相关(r=-0.431,P=0.005),参加治疗和未参加治疗的社交焦虑症状好转程度差异有统计学意义(P=0.033)。结论 GCBT治疗可通过改善SAD患者的负面认知缓解其症状,主观社会支持和父亲拒绝否定的教育方式会影响SAD患者的预后。
[Abstract]:Objective to study the symptoms and prognostic factors of patients with social anxiety disorder (anxiety disorderma), and to analyze the mechanism and long-term effect of cognitive group behavior therapy on group cognitive-behavioral. Methods 50 patients with SAD were assessed by psychological questionnaire before treatment. They include Liebowitz social anxiety scale, automatic thoughts questionnaire automatic thoughts questionnaire, fear of negative evaluation questionnaire, social support rating scale, three-dimensional personality questionnaire, tridimensional personality questionnaire, and parental rearing style questionnaire. Compared with 50 healthy controls, 30 patients with SAD were treated with GCBT (group psychotherapy regimen with self-improvement and partial cognitive behavior therapy, once a week). Each time for 2 hours, a total of 8 weeks, within 1 week after treatment, the scale again, questionnaire survey, To evaluate the improvement of symptoms and the degree of cognitive change, 40 patients with SAD were followed up for 1 ~ 5 years (22 of them were treated with GCBT and 18 untreated). Results the patients with SAD were in the mode of thinking, personality and social support. Compared with the control group, there were significant differences in parenting styles between the two groups. After treatment, social anxiety was 4.06%, negative thinking was 4.58%, and fear of negativeness was 3.85% (0.000). The results of follow-up showed that the degree of social anxiety in patients with SAD was less than that before treatment. There was a positive correlation with the subjective support of the patients, and a negative correlation with the education style of the father's refusal and denial. There was a significant difference in the improvement of social anxiety symptoms between those who participated in the treatment and those who did not attend the treatment. Conclusion the treatment of GCBT can be achieved through the treatment. Improve the negative cognition of patients with SAD to alleviate their symptoms, Subjective social support and the father's refusal to deny the education will affect the prognosis of patients with SAD.
【作者单位】：四川大学华西医院心理卫生中心;
【基金】：国家973计划(No.2008CB517407)资助
【分类号】：R749.72

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