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Comparison of relaxation techniques for group cognitive behavioral therapy for generalized anxiety disorder.

机译：广泛性焦虑症团体认知行为疗法中放松技术的比较。

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摘要

Research has shown that individuals with generalized anxiety disorder (GAD) have rigid autonomic nervous systems, evidenced by low heart rate variability (HRV) and cardiac vagal tone. Cognitive behavioral therapy (CBT) is established as an effective method for treating GAD. However, there is a need for greater treatment effectiveness, especially given the high prevalence and disability rates for GAD. An HRV biofeedback intervention could enhance CBT for GAD by targeting the specific physiological dysfunction underlying GAD. This study investigated if CBT plus HRV biofeedback resulted in a greater reduction of GAD symptoms, improved autonomic reactivity, and an increase in cardiac vagal tone and HRV compared with CBT plus progressive muscle relaxation (PMR). Seventy-nine participants with GAD were randomized to use the StressEraser, a portable respiratory sinus arrhythmia (RSA; a measure of HRV) biofeedback device, or PMR, as part of an eight session CBT group. All patients completed psychological and physiological measures before, during and after treatment, and at 1 and 3 months follow-up. Statistical analyses showed no differential improvement in GAD symptoms for the StressEraser group compared to the PMR group at the end of treatment. However, significant within-group differences were found on measures of GAD, anxiety and depression from pre to post-treatment and throughout the 3 month follow-up assessment. This indicates that in combination with a CBT group use of the StressEraser is as effective as PMR; although, both could be equally ineffective since there was no control group to evaluate if the CBT group alone produced the symptom reductions. Despite significant changes on self-report measures and ample relaxation practice, neither group showed a clear pattern of improved autonomic reactivity, increase in cardiac vagal tone or HRV. Furthermore, the amount of StressEraser use was not significantly related to changes in GAD symptoms. These results suggest that changes in autonomic functioning do not need to occur in order to benefit from CBT and that the StressEraser might not have been an adequate HRV intervention. Based on these findings, further research should examine if other HRV interventions could increase HRV in GAD patients and if so, if increases in HRV augment CBT.
机译：研究表明，患有广泛性焦虑症（GAD）的人具有僵硬的自主神经系统，其低心率变异性（HRV）和心脏迷走神经张力可以证明这一点。建立认知行为疗法（CBT）作为治疗GAD的有效方法。但是，需要提高治疗效果，尤其是考虑到GAD的高患病率和致残率。 HRV生物反馈干预可以通过针对GAD潜在的特定生理功能障碍来增强GAD的CBT。这项研究调查了与CBT加进行性肌肉放松（PMR）相比，CBT加HRV生物反馈是否能更大程度地降低GAD症状，改善自主反应性并增强迷走神经张力和HRV。作为八节CBT组的一部分，随机将79名GAD参与者随机使用StressEraser，一种便携式呼吸道窦性心律不齐（RSA； HRV量度）生物反馈设备或PMR。所有患者在治疗前，治疗中和治疗后以及随访的1和3个月内均完成了心理和生理措施。统计分析表明，与治疗结束时的PMR组相比，StressEraser组的GAD症状没有差异。但是，在治疗前至治疗后以及整个3个月的随访评估中，GAD，焦虑和抑郁的测量结果均存在显着的组内差异。这表明与CBT组结合使用StressEraser与PMR一样有效。但是，由于没有对照组可以评估CBT组是否单独减轻了症状，因此两者都可能同样无效。尽管自我报告措施和充分的放松习惯发生了显着变化，但两组均未显示出明显的自主神经反应性改善，心脏迷走神经张力或HRV升高的模式。此外，StressEraser的使用量与GAD症状的变化没有显着相关。这些结果表明，为了受益于CBT，无需发生自主功能改变，并且StressEraser可能不是适当的HRV干预措施。基于这些发现，进一步的研究应该检查其他HRV干预措施是否可以增加GAD患者的HRV，如果可以，HRV的增加是否会增加CBT。

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  • 作者

    Murphy, Jennifer Ann Webb.;

  • 作者单位

    Alliant International University, San Diego.;

  • 授予单位 Alliant International University, San Diego.;
  • 学科 Psychology Clinical.;Psychology Physiological.
  • 学位 Ph.D.
  • 年度 2009
  • 页码 267 p.
  • 总页数 267
  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类 医学心理学、病理心理学;生理心理学;
  • 关键词

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