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首页> 外文期刊>Psychotherapy >Competing Indirect Effects in a Comparative Psychotherapy Trial for Generalized Anxiety Disorder
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Competing Indirect Effects in a Comparative Psychotherapy Trial for Generalized Anxiety Disorder

机译：竞争广泛性焦虑症的比较心理治疗试验中的间接影响

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In a randomized trial for generalized anxiety disorder, cognitive-behavioral therapy (CBT) and CBT integrated with motivational interviewing (MI) promoted comparable worry reduction at posttreatment. whereas MI-CBT outperformed CBT over I2-month follow-up (Westra, Constantino. & Antony, 2016). Secondary analyses revealed competing mediators of the long-term treatment effect: MI-CBT related to lower patient resistance to the treatment. which promoted lower follow-up worry, whereas CBT related to greater increases in patient friendly submissiveness (FS), or compliance, which also promoted lower follow-up worry (that suppressed an even greater long-term advantage of MI-CBT). In this study, we tested these competing, though theoretically consistent, variables as mediators of the nonsignificant treatment effect on posttreatment worry, as there could also be treatment-specific means to arriving to these comparable ends. Eighty-five patients received 15 sessions of MI-CBT or CBT. Therapists rated patient FS through treatment, observers rated resistance at midtreatment, and patients rated worry at posttreatment. Bootstrap analyses indicated that MI-CBT patients exhibited less resistance, which promoted lower posttreatment worry, whereas CBT patients had greater increases in FS, which also promoted lower worry. CBT and MI-CBT achieved comparable posttreatment outcomes through separate indirect paths that each conferred an advantage for one treatment over the other (and had canceled out a direct treatment effect immediately after therapy). The composite trial findings have significance for understanding different pathways to personal change in both the short- and long terms, and for the importance of testing indirect effects both when direct treatment effects do and do not emerge.
机译：在随机试验中，针对广义焦虑症，与励志面试（MI）综合的认知行为治疗（CBT）和CBT促进了在后期的可比忧虑。虽然MI-CBT超越了I2-one随访的CBT（Westra，Constantoino。＆Antony，2016）。二次分析显示了长期治疗效果的竞争介质：MI-CBT与降低患者对治疗的抗性相关。这促进了较低的后续担心，而CBT与患者友好的顺从（FS）或合规性增加的CBT也促进了以下后续担心（抑制了MI-CBT的甚至更大的长期优势）。在这项研究中，我们测试了这些竞争，虽然理论上是一致的，变量作为对后处理担忧的不显着治疗效果的调解员，因为还有治疗特定的方法来抵达这些可比较的目的。八十五名患者接受了15个MI-CBT或CBT的一席。治疗师通过治疗额定患者FS，观察者在中间分发时抗性，患者在后处理令人担忧。 Bootstrap分析表明，MI-CBT患者的抵抗力较少，促进了较低的后处理担心，而CBT患者的FS增加了更大的FS，这也促进了较低的担忧。 CBT和MI-CBT通过单独的间接路径实现了可比的后处理结果，每个间接路径每个都赋予另一个处理的优势（并在治疗后立即取消直接治疗效果）。复合试验结果对既有短期和长条款的个人变革理解不同的途径，以及在直接治疗效果何时何地出现时对测试间接影响的重要性。

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