Mindfulness-Based Cognitive Therapy (MBCT) for Health Anxiety (Hypochondriasis): Rationale, Implementation and Case Illustration

详细信息    查看全文

• 作者：Christina Surawy (1)
  Freda McManus (2)
  Kate Muse (1)
  J. Mark G. Williams (1)
  
  1. Department of Psychiatry ; Warneford Hospital ; University of Oxford ; Oxford ; OX37JX ; UK
  2. Department of Psychiatry and Oxford Cognitive Therapy Centre ; Warneford Hospital ; University of Oxford ; Oxford ; OX37JX ; UK
  
• 关键词：MBCT ; Mindfulness ; Health anxiety ; Hypochondriasis
• 刊名：Mindfulness
• 出版年：2015
• 出版时间：April 2015
• 年：2015
• 卷：6
• 期：2
• 页码：382-392
• 全文大小：356 KB
• 参考文献：1. Barsky, AJ, Ahern, DK (2004) Cognitive behavior therapy for hypochondriasis. A randomized trial. Journal of the American Medical Association 291: pp. 1464-1470 CrossRef
  2. Beck, A.T. (1976). / Cognitive therapy and the emotional disorders. Oxford: International Universities Press.
  3. Borkovec, TD, Sharpless, B Generalized anxiety disorder: bringing cognitive-behavioral therapy into the valued present. In: Hayes, SC, Follette, VM, Linehan, MM eds. (2004) Mindfulness and acceptance: expanding the cognitive-behavioral tradition. Guilford Press, New York, pp. 209-242
  4. Butler, G., Fennell, M., & Hackmann, A. (2008). / Cognitive behavioural therapy for anxiety disorders: mastering clinical challenges. New York: Guilford Press.
  5. Gureje, O, Ustan, TB, Simon, GE (1997) The syndrome of hypochondriasis: a cross-national study in primary care. Psychological Medicine 27: pp. 1001-1010 CrossRef
  6. Greeven, A, Balkom, AJ, Visser, S, Merkelbach, JW, Rood, YR, Dyck, R (2007) Cognitive behavior therapy and paroxetine in the treatment of hypochondriasis: a randomized controlled trial. American Journal of Psychiatry 164: pp. 91-99 CrossRef
  7. Hargus, E, Crane, C, Barnhofer, T, Williams, JMG (2010) Effects of mindfulness on meta-awareness and specificity of describing prodromal symptoms in suicidal depression. Emotion 10: pp. 34-42 CrossRef
  8. Heeren, A, Philippot, P (2011) Changes in ruminative thinking mediate the clinical benefits of mindfulness: preliminary findings. Mindfulness 2: pp. 8-13 CrossRef
  9. Hofmann, SG, Sawyer, AT, Witt, AA, Oh, D (2010) The effect of mindfulness-based therapy on anxiety and depression: a meta-analytic review. Journal of Consulting and Clinical Psychology 78: pp. 169-183 CrossRef
  10. Kabat-Zinn, J (1990) Full catastrophe living: using the wisdom of your body and mind to face stress, pain and illness. Bantam Dell, New York
  11. Kuyken, W, Watkins, E, Holden, E, White, K, Taylor, RS, Byford, S (2010) How does mindfulness-based cognitive therapy work?. Behaviour Research and Therapy 48: pp. 1105-1112 CrossRef
  12. Lovas, DA, Barsky, AJ (2010) Mindfulness-based cognitive therapy for hypochondriasis, or severe health anxiety: a pilot study. Journal of Anxiety Disorders 24: pp. 931-935 CrossRef
  13. Marcus, DK, Hughes, KT, Arnau, RC (2008) Health anxiety, rumination, and negative affect: a mediational analysis. Journal of Psychosomatic Research 64: pp. 495-501 CrossRef
  14. Michalak, J, H枚lz, A, Teismann, T (2011) Rumination as a predictor of relapse in mindfulness-based cognitive therapy for depression. Psychology and Psychotherapy: Theory, Research and Practice 84: pp. 230-236 CrossRef
  15. McManus, F, Surawy, C, Muse, K, Vazquez-Montez, M, Williams, JMG (2012) A randomized clinical trial of mindfulness-based cognitive therapy versus unrestricted services for health anxiety (hypochondriasis). Journal of Consulting and Clinical Psychology 80: pp. 817-828 CrossRef
  16. Muse, K, McManus, F, Williams, M, Williams, JMG (2010) Intrusive imagery in severe health anxiety: prevalence, nature and links with memories and maintenance cycles. Behaviour research and therapy 48: pp. 792-798 CrossRef
  17. Orsillo, SM, Roemer, L (2011) The mindful way through anxiety. Guilford Press, New York
  18. Papageorgiou, C, Wells, A (1998) Effects of attention training on hypochondriasis: a brief case series. Psychological Medicine 28: pp. 193-200 CrossRef
  19. Piet, J, Hougaard, E (2011) The effect of mindfulness-based cognitive therapy for prevention of relapse in recurrent major depressive disorder: a systematic review and meta-analysis. Clinical Psychology Review 31: pp. 1032-1040 CrossRef
  20. Raes, F, Dewulf, D, Heeringen, CV, Williams, JMG (2009) Mindfulness and reduced cognitive reactivity to sad mood: evidence from a correlational study and a non-randomized waiting list controlled study. Behaviour Research and Therapy 47: pp. 623-627 CrossRef
  21. Rassin, E, Muris, P, Franken, I, Straten, M (2008) The feature-positive effect and hypochondriacal concerns. Behaviour Research and Therapy 46: pp. 263-269 CrossRef
  22. Salkovskis, P, Warwick, H Making sense of hypochondriasis: a cognitive theory of health anxiety. In: Asmundson, G, Taylor, S, Cox, BJ eds. (2001) Health anxiety: clinical and research perspectives on hypochondriasis and related conditions. Wiley, New York, pp. 46-64
  23. Salkovskis, P., Rimes, K.A., Warwick, H.M.C., Clark, D.M. (2002). The health anxiety inventory:development,and validation of scales for the measurement of health anxiety and hypochondriasis. / Psychological Medicine, 32, 843鈥?53.
  24. Segal, Z. V., Williams, J. M. G., & Teasdale, J. D. (2002). / Mindfulness-based cognitive therapy for depression: a new approach to preventing relapse. London: Guildford Press.
  25. Sorensen, P., Birket-Smith, M., Wattar, U., Buemann, I., Salkovskis, P.M. (2011). A randomised clinical trial of cognitive behavioural therapy versus short term psychodynamic psychotherapy versus no intervention for patients with hypochondriasis. / Psychological Medicine, 41, 431鈥?41.
  26. Teasdale, JD, Segal, Z, Williams, JMG (1995) How does cognitive therapy prevent depressive relapse and why should attentional control (mindfulness) training help. Behavior Research and Therapy 33: pp. 25-39 CrossRef
  27. Teasdale, JD, Segal, ZV, Williams, JMG (2003) Mindfulness training and problem formulation. Clinical Psychology: Science and Practice 10: pp. 157-160
  28. Thomson, AB, Page, LA (2007) Psychotherapies for hypochondriasis. Cochrane Database of Systematic Reviews 4: pp. 1-43
  29. Wattar, U, Sorensen, P, Buemann, I, Birket-Smith, M, Salkovskis, PM, Albertsen, M (2005) Outcome of cognitive-behavioural treatment for health anxiety (hypochondriasis) in a routine clinical setting. Behavioural and Cognitive Psychotherapy 33: pp. 165-175 CrossRef
  30. Way, B.M., Creswell, J.D., Eisenberger, N.I., Lieberman, M.D. (2010). Dispositional mindfulness and depressive symptomatology: correlations with limbic and self referential neural activity during rest. / Emotion, 10(1), 12鈥?4.
  31. Wells, A Hypochondriasis and health anxiety. In: Wells, A eds. (1997) Cognitive therapy of anxiety disorders. Wiley, Chichester
  32. Williams, JMG (2010) Mindfulness and psychological process. Emotion 10: pp. 1-7 CrossRef
  33. Williams, MJ, McManus, F, Muse, K, Williams, JMG (2011) Mindfulness-based cognitive therapy for severe health anxiety (hypochondriasis): an interpretative phenomenological analysis of patients鈥?experiences. British Journal of Clinical Psychology 50: pp. 379-397 CrossRef
  
• 刊物主题：Cognitive Psychology; Pediatrics; Child and School Psychology; Psychology, general; Public Health; Social Sciences, general;
• 出版者：Springer US
• ISSN：1868-8535

文摘

Recent research has shown that mindfulness-based cognitive therapy (MBCT) could be a useful alternative approach to the treatment of health anxiety and deserves further investigation. In this paper, we outline the rationale for using MBCT in the treatment of this condition, namely its hypothesised impact on the underlying mechanisms which maintain health anxiety, such as rumination and avoidance, hypervigilance to body sensations and misinterpretation of such sensations. We also describe some of the adaptations which were made to the MBCT protocol for recurrent depression in this trial and discuss the rationale for these adaptations. We use a case example from the trial to illustrate how MBCT was implemented and outline the experience of one of the participants who took part in an 8-week MBCT course. Finally, we detail some of the more general experiences of participants and discuss the advantages and possible limitations of this approach for this population, as well as considering what might be useful avenues to explore in future research.