元认知团体干预和系统脱敏对社交焦虑大学生干预效果评价
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摘要
目的探讨元认知团体干预对社交焦虑障碍大学生自我心理弹性的影响,为寻找改善大学生心理健康的手段提供参考。方法将48名存在社交焦虑障碍的大学生进行随机分组,对照组(24例)进行系统脱敏治疗,研究组(24例)接受元认知团体心理干预。对比2组干预前后的社交焦虑评分、心理健康水平及自我心理弹性评分变化。结果两组干预后的SCL-90总评分及各因子评分均较干预前降低(P值均<0.05),并且研究组的降幅更明显(P<0.05)。研究组末次随访的SCL-90总评分及各因子评分与干预后差异无统计学意义(P>0.05);对照组末次随访的SCL-90总评分及各因子评分均较干预后提高(P值均<0.05)。与干预前相比,2组干预后的LSAS,HAMA评分均降低,ER 89评分升高(P<0.05)。研究组末次随访的LSAS,HAMA,ER 89评分与干预后比较,差异均无统计学意义(P值均>0.05)。对照组末次随访的LSAS,HAMA评分高于干预后,ER 89评分低于干预后(P值均<0.05)。不论是干预后还是末次随访,研究组的LSAS,HA-MA评分均低于对照组,ER 89评分均高于对照组(P<0.05)。结论元认知团体心理干预能够有效改善社交焦虑障碍大学生的自我心理弹性,减轻焦虑症状,从而增强社交自信与主动性,改善社交焦虑障碍。
Objective To explore the influence of metacognitive group intervention on resilience of college students with social anxiety disorder.Methods Forty-eight college students with social anxiety disorder were randomized into two groups.The control group(24 patients) received systemic desensitization, and the experiment group(24 patients) received metacognitive group psychological intervention.Social anxiety score, mental health and resilience score were compared before and after intervention of two groups.Results The total scores of SCL-90 and the sub-scores of each dimension were significantly decreased after intervention, especially among the experiment group(P<0.05).No significant difference were found in the total score of SCL-90 and the scores of each factor at the last follow-up and after intervention in the experiment group(P > 0.05).For control group, the total scores of SCL-90 and sub-scores of each dimension increased at the last follow-up compared with after intervention.Compared with before intervention, the LSAS and HAMA scores of the two groups significantly decreased, and the ER 89 score increased(P <0.05).There were no significant differences in the LSAS, HAMA, and ER 89 scores at the last follow-up and after intervention in the experiment group(P>0.05).For control group, the LSAS and HAMA scores at the last follow-up increased, and the ER 89 score decreased compared with after intervention(P<0.05).The LSAS and HAMA scores in the experiment group were significantly lower, and the ER 89 score was significantly higher, than those of the control group after intervention and at the last follow-up(P<0.05).Conclusion Metacognitive group psychological intervention can effectively improve resilience among college students with social anxiety disorder, helps reducing anxiety symptoms and promote social self-confidence and initiative.
Objective To explore the influence of metacognitive group intervention on resilience of college students with social anxiety disorder.Methods Forty-eight college students with social anxiety disorder were randomized into two groups.The control group(24 patients) received systemic desensitization, and the experiment group(24 patients) received metacognitive group psychological intervention.Social anxiety score, mental health and resilience score were compared before and after intervention of two groups.Results The total scores of SCL-90 and the sub-scores of each dimension were significantly decreased after intervention, especially among the experiment group(P<0.05).No significant difference were found in the total score of SCL-90 and the scores of each factor at the last follow-up and after intervention in the experiment group(P > 0.05).For control group, the total scores of SCL-90 and sub-scores of each dimension increased at the last follow-up compared with after intervention.Compared with before intervention, the LSAS and HAMA scores of the two groups significantly decreased, and the ER 89 score increased(P <0.05).There were no significant differences in the LSAS, HAMA, and ER 89 scores at the last follow-up and after intervention in the experiment group(P>0.05).For control group, the LSAS and HAMA scores at the last follow-up increased, and the ER 89 score decreased compared with after intervention(P<0.05).The LSAS and HAMA scores in the experiment group were significantly lower, and the ER 89 score was significantly higher, than those of the control group after intervention and at the last follow-up(P<0.05).Conclusion Metacognitive group psychological intervention can effectively improve resilience among college students with social anxiety disorder, helps reducing anxiety symptoms and promote social self-confidence and initiative.
引文
[1]刘佳.摆脱焦虑,重建交友信心:元认知干预技术对社交焦虑障碍的个案干预[J].中小学心理健康教育,2017,18(35):51-53.
[2]唐继亮,余嘉元,宣宾,等.社交焦虑障碍“团体实证认知行为疗法”的构建[J].中国临床心理学杂志,2018,26(1):200-204,174.
[3]贺果扬,陈江江,李珏,等.系统脱敏疗法联合舍曲林治疗社交焦虑障碍的临床研究[J].基层医学论坛,2017,21(22):2936-2937.
[4]DEROGATIS L R,LIPMAN R S,COVI L.SCL-90:an outpatient psychiatric rating scale:preliminary report[J].Psychopharmacology Bull,1973,9(1):13-28.
[5]GLISCHINSKI M V,WILLUTZKI U,STANGIER U,et al.Liebowitz Social Anxiety Scale(LSAS):Optimal cut points for remission and response in a German sample[J].Clin Psychol Psychother,2018,25(3):465-473.
[6]GARALEJIE,BOJOVIJOVID,DAMJANOVIA,et al.Hamilton anxiety scale(HAMA)in infertile women with endometriosis and its correlation with magnesium levels in peritoneal fluid[J].Psychiatr Danub,2010,22(1):64-67.
[7]ALESSANDRI G,VECCHIONE M,CAPRARA G,et al.The Ego Resiliency Scale revised:A crosscultural study in Italy,Spain,and the United States[J].Europ J Psychol Ass,2012,28(2):139-146.
[8]袁敏兰,任正伽,朱鸿儒,等.社交焦虑障碍认知行为治疗前后静息态局部一致性研究[J].四川大学学报(医学版),2016,47(6):898-903.
[9]李雨辰,孟雅静,袁敏兰,等.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[J].四川大学学报(医学版),2017,48(6):928-932.
[10]刘希童,王振,肖泽萍.自我注意对社交焦虑等精神障碍的影响[J].上海交通大学学报(医学版),2018,38(8):996,997-1000.
[11]MNSSON K N T,SALAMI A,CARLBRING P,et al.Structural but not functional neuroplasticity one year after effective cognitive behaviour therapy for social anxiety disorder[J].Behav Brain Res,2017,38(318):45-51.
[12]RABINAK C A,MORI S,LYONS M,et al.Luan Phan.Acquisition of CS-US contingencies during Pavlovian fear conditioning and extinction in social anxiety disorder and posttraumatic stress disorder[J].J Affect Disord,2017,38(207):76-85.
[13]栗艳,葛玲.自信心训练对社交焦虑患者应对方式的影响研究[J].校园心理,2016,14(2):92-93.
[14]张姗姗,宋利.大学生心理弹性与社交焦虑的关系研究[J].安徽理工大学学报(社会科学版),2016,18(5):70-74.
[15]马长林,陆铮,胡春水,等.文拉法辛配合元认知干预技术治疗社交焦虑障碍的研究[J].国际精神病学杂志,2017,44(3):454-456,466.
[2]唐继亮,余嘉元,宣宾,等.社交焦虑障碍“团体实证认知行为疗法”的构建[J].中国临床心理学杂志,2018,26(1):200-204,174.
[3]贺果扬,陈江江,李珏,等.系统脱敏疗法联合舍曲林治疗社交焦虑障碍的临床研究[J].基层医学论坛,2017,21(22):2936-2937.
[4]DEROGATIS L R,LIPMAN R S,COVI L.SCL-90:an outpatient psychiatric rating scale:preliminary report[J].Psychopharmacology Bull,1973,9(1):13-28.
[5]GLISCHINSKI M V,WILLUTZKI U,STANGIER U,et al.Liebowitz Social Anxiety Scale(LSAS):Optimal cut points for remission and response in a German sample[J].Clin Psychol Psychother,2018,25(3):465-473.
[6]GARALEJIE,BOJOVIJOVID,DAMJANOVIA,et al.Hamilton anxiety scale(HAMA)in infertile women with endometriosis and its correlation with magnesium levels in peritoneal fluid[J].Psychiatr Danub,2010,22(1):64-67.
[7]ALESSANDRI G,VECCHIONE M,CAPRARA G,et al.The Ego Resiliency Scale revised:A crosscultural study in Italy,Spain,and the United States[J].Europ J Psychol Ass,2012,28(2):139-146.
[8]袁敏兰,任正伽,朱鸿儒,等.社交焦虑障碍认知行为治疗前后静息态局部一致性研究[J].四川大学学报(医学版),2016,47(6):898-903.
[9]李雨辰,孟雅静,袁敏兰,等.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[J].四川大学学报(医学版),2017,48(6):928-932.
[10]刘希童,王振,肖泽萍.自我注意对社交焦虑等精神障碍的影响[J].上海交通大学学报(医学版),2018,38(8):996,997-1000.
[11]MNSSON K N T,SALAMI A,CARLBRING P,et al.Structural but not functional neuroplasticity one year after effective cognitive behaviour therapy for social anxiety disorder[J].Behav Brain Res,2017,38(318):45-51.
[12]RABINAK C A,MORI S,LYONS M,et al.Luan Phan.Acquisition of CS-US contingencies during Pavlovian fear conditioning and extinction in social anxiety disorder and posttraumatic stress disorder[J].J Affect Disord,2017,38(207):76-85.
[13]栗艳,葛玲.自信心训练对社交焦虑患者应对方式的影响研究[J].校园心理,2016,14(2):92-93.
[14]张姗姗,宋利.大学生心理弹性与社交焦虑的关系研究[J].安徽理工大学学报(社会科学版),2016,18(5):70-74.
[15]马长林,陆铮,胡春水,等.文拉法辛配合元认知干预技术治疗社交焦虑障碍的研究[J].国际精神病学杂志,2017,44(3):454-456,466.