Liệu pháp nhóm tương tác đối với các rối loạn đau do stress

Psychotherapeut - Tập 63 - Trang 226-234 - 2018
Johannes Dobersch1, Martin grosse Holtforth2, Ulrich T. Egle3
1Praxis für Psychologische Schmerztherapie, Offenburg, Deutschland
2Psychosomatik, Lory-Haus, Inselspital Bern, Bern, Schweiz
3Dep. Psychosomatik, Klinik Barmelweid, Aarau, Schweiz

Tóm tắt

Bệnh nhân mắc các rối loạn đau gây ra bởi stress thường gặp phải những khó khăn nghiêm trọng trong mức độ chức năng hàng ngày, bên cạnh những cơn đau. Họ cũng có những mẫu tương tác không hiệu quả và mất chức năng rõ rệt. Các chương trình can thiệp nhận thức-hành vi để xử lý đau thường không đáp ứng đủ nhu cầu của nhóm bệnh nhân này. Liệu pháp nhóm tương tác (theo từng rối loạn) chính là một phương pháp để thay đổi những mẫu tương tác không hiệu quả, qua đó làm giảm gánh nặng stress và triệu chứng đau đi kèm. Bài báo trình bày các nền tảng và các khía cạnh trung tâm của phương pháp điều trị này.

Từ khóa

#đau do stress #liệu pháp nhóm #can thiệp nhận thức-hành vi #tương tác #rối loạn chức năng

Tài liệu tham khảo

Bernard H, Burlingame G, Flores P et al (2008) Clinical practice guidelines for group psychotherapy. Int J Group Psychother 58:455–542 Bogaerts K, Millen A, Li W et al (2008) High symptom reporters are less interoceptively accurate in a symptom-related context. J Psychosom Res 65:417–424. https://doi.org/10.1016/j.jpsychores.2008.03.019 Bogaerts K, Van Eylen L, Li W et al (2010) Distorted symptom perception in patients with medically unexplained symptoms. J Abnorm Psychol 119:226–234. https://doi.org/10.1037/a0017780 Bowlby J (1988) A secure base. Basic books, New York de C Williams AC, Eccleston C, Morley S (2012) Psychological therapies for the management of chronic pain (excluding headache). Cochrane Database Syst Rev. https://doi.org/10.1002/14651858.CD007407.pub3 Chase ND (1999) Parentification: an overview of theory, research, and societal issues. In: Burdened children: theory, research, and treatment of parentification, S 3–33 Davidson RJ, Begley S (2012) The emotional life of your brain: How its unique patterns affect the way you think, feel, and live--and how you can change them. Hudson Street Press, New York Davies KA, Macfarlane GJ, McBeth J et al (2009) Insecure attachment style is associated with chronic widespread pain. Pain 143:200–205. https://doi.org/10.1016/j.pain.2009.02.013 Davis DA, Luecken LJ, Zautra AJ (2005) Are reports of childhood abuse related to the experience of chronic pain in adulthood? A meta-analytic review of the literature. Clin J Pain 21:398–405 Dixon KE, Keefe FJ, Scipio CD et al (2007) Psychological interventions for arthritis pain management in adults: a meta-analysis. Health Psychol 26:241–250. https://doi.org/10.1037/0278-6133.26.3.241 Eccleston C, de C Williams AC, Morley S (2009) Psychological therapies for the management of chronic pain (excluding headache). Cochrane Database Syst Rev. https://doi.org/10.1002/14651858.CD007407.pub2 Egle UT, Nickel R (1998) Kindheitsbelastungsfaktoren bei Patienten mit somatoformen Störungen. Z Psychosom Med Psychoanal 44(1):21–36 Egle UT, Zentgraf B (2009) Mechanismenbezogene statt schulenspezifische psychosomatische Schmerztherapie. Schweiz Z Psychiatr Neurol 1:18–23 Fries E (2008) Hypercortisolemic disorders. In: Stress: the brain-body connection. Karger Medical and Scientific Publishers, Basel, S 60 Grawe K (1998) Psychologische Therapie. Hogrefe, Göttingen Grawe K (2004) Neuropsychotherapie. Hogrefe, Göttingen Grosse Holtforth M, Flückiger C (2012) Transformation in psychotherapy. Corrective experiences across cognitive behavioral, humanistic, and psychodynamic approaches. In: Castonguay LG, Hill CE (Hrsg) American psychological association, S 317–333 Heim C, Nater UM, Maloney E et al (2009) Childhood trauma and risk for chronic fatigue syndrome: association with neuroendocrine dysfunction. Arch Gen Psychiatry 66:72–80. https://doi.org/10.1001/archgenpsychiatry.2008.508 Van Houdenhove B, Stans L, Verstraeten D (1987) Is there a link between ’pain-proneness’ and ’action-proneness’? Pain 29:113–117 Van Houdenhove B, Neerinckx E, Onghena P et al (2001) Premorbid „overactive“ lifestyle in chronic fatigue syndrome and fibromyalgia. An etiological factor or proof of good citizenship? J Psychosom Res 51:571–576 Imbierowicz K, Egle UT (2003) Childhood adversities in patients with fibromyalgia and somatoform pain disorder. Eur J Pain 7:113–119. https://doi.org/10.1016/S1090-3801(02)00072-1 Jensen KB, Kosek E, Wicksell R et al (2012) Cognitive behavioral therapy increases pain-evoked activation of the prefrontal cortex in patients with fibromyalgia. Pain 153:1495–1503. https://doi.org/10.1016/j.pain.2012.04.010 Kerns RD, Sellinger J, Goodin BR (2011) Psychological treatment of chronic pain. Annu Rev Clin Psychol 7:411–434. https://doi.org/10.1146/annurev-clinpsy-090310-120430 Kessner S, Forkmann K, Ritter C et al (2014) The effect of treatment history on therapeutic outcome: psychological and neurobiological underpinnings. PLoS ONE 9:e109014. https://doi.org/10.1371/journal.pone.0109014 Lane RD, Weihs KL, Herring A et al (2015) Affective agnosia: expansion of the alexithymia construct and a new opportunity to integrate and extend freud’s legacy. Neurosci Biobehav Rev 55:594–611. https://doi.org/10.1016/j.neubiorev.2015.06.007 Lieberman MA, Yalom ID, Miles MB (1973) Encounter groups: first facts. Basic Books, New York Lind AB, Delmar C, Nielsen K (2014) Struggling in an emotional avoidance culture: a qualitative study of stress as a predisposing factor for somatoform disorders. J Psychosom Res 76:94–98. https://doi.org/10.1016/j.jpsychores.2013.11.019 Lumley MA (2011) Beyond cognitive-behavioral therapy for fibromyalgia: addressing stress by emotional exposure, processing, and resolution. Arthritis Res Ther 13:136. https://doi.org/10.1186/ar3511 Lupien SJ, McEwen BS, Gunnar MR, Heim C (2009) Effects of stress throughout the lifespan on the brain, behaviour and cognition. Nat Rev Neurosci 10:434–445. https://doi.org/10.1038/nrn2639 Luyten P, Abbass A (2013) What is the evidence for specific factors in the psychotherapeutic treatment of fibromyalgia? Comment on „is brief psychodynamic psychotherapy in primary fibromyalgia syndrome with concurrent depression an effective treatment? A randomized controlled trial“. Gen Hosp Psychiatry 35:675–676 Luyten P, Van Houdenhove B, Lemma A et al (2013) Vulnerability for functional somatic disorders: a contemporary psychodynamic approach. J Psychother Integr 23:250 Malone JC, Cohen S, Liu SR et al (2013) Adaptive midlife defense mechanisms and late-life health. Pers Individ Dif 55:85–89. https://doi.org/10.1016/j.paid.2013.01.025 Marmarosh CL, Markin RD, Spiegel EB (2013) Attachment in group psychotherapy. American Psychological Association, Washington Mattila AK, Kronholm E, Jula A et al (2008) Alexithymia and somatization in general population. Psychosom Med 70:716–722. https://doi.org/10.1097/PSY.0b013e31816ffc39 McEwen BS (2006) Protective and damaging effects of stress mediators: central role of the brain. Dialogues Clin Neurosci 8:367–381 McGowan PO, Sasaki A, D’Alessio AC et al (2009) Epigenetic regulation of the glucocorticoid receptor in human brain associates with childhood abuse. Nat Neurosci 12:342–348. https://doi.org/10.1038/nn.2270 McWilliams LA, Bailey SJ (2010) Associations between adult attachment ratings and health conditions: evidence from the national comorbidity survey replication. Health Psychol 29:446–453. https://doi.org/10.1037/a0020061 Mikulincer M, Shaver PR, Pereg D (2003) Attachment theory and affect regulation: the dynamics, development, and cognitive consequences of attachment-related strategies. Motiv Emot 27:77–102 Nemeroff CB (2004) Neurobiological consequences of childhood trauma. J Clin Psychiatry 65(Suppl 1):18–28 Nickel R, Egle U (1999) Therapie somatoformer Schmerzstörungen Nickel R, Egle UT (2001) Coping with conflict as pathogenetic link between psychosocial adversities in childhood and psychic disorders in adulthood. Z Psychosom Med Psychother 47:332–347 Nickel R, Ademmer K, Egle UT (2010) Manualized psychodynamic-interactional group therapy for the treatment of somatoform pain disorders. Bull Menninger Clin 74:219–237. https://doi.org/10.1521/bumc.2010.74.3.219 Van Oosterwijck J, Meeus M, Paul L et al (2013) Pain physiology education improves health status and endogenous pain inhibition in fibromyalgia: a double-blind randomized controlled trial. Clin J Pain 29:873–882 Piper WE, Ogrodniczuk JS, Joyce AS et al (2007) Group composition and group therapy for complicated grief. J Consult Clin Psychol 75:116–125. https://doi.org/10.1037/0022-006X.75.1.116 Roozendaal B, McEwen BS, Chattarji S (2009) Stress, memory and the amygdala. Nat Rev Neurosci 10:423–433. https://doi.org/10.1038/nrn2651 Roth G, Egle U (2016) Neurobiologie von Schmerz und Stress. Arztl Psychother Psychosom Med 11:120–129 Saariaho TH, Saariaho AS, Karila IA, Joukamaa MI (2011) Early maladaptive schemas in Finnish adult chronic pain patients and a control sample. Scand J Psychol 52:146–153. https://doi.org/10.1111/j.1467-9450.2010.00849.x Schier K, Herke M, Nickel R et al (2015) Long-term sequelae of emotional parentification: a cross-validation study using sequences of regressions. J Child Fam Stud 24:1307. https://doi.org/10.1007/s10826-014-9938-z Schroeter C, Ehrenthal JC, Giulini M et al (2015) Attachment, symptom severity, and depression in medically unexplained musculoskeletal pain and osteoarthritis: a cross-sectional study. PLoS ONE 10:e119052. https://doi.org/10.1371/journal.pone.0119052 Seminowicz DA, Shpaner M, Keaser ML et al (2013) Cognitive-behavioral therapy increases prefrontal cortex gray matter in patients with chronic pain. J Pain 14:1573–1584. https://doi.org/10.1016/j.jpain.2013.07.020 Stewart JA, Egloff N, von Känel R et al (2017) Motivation for psychological treatment predicts favorable outcomes in multimodal interdisciplinary treatment for chronic somatoform pain. Psychother Psychosom 86:60–61. https://doi.org/10.1159/000449471 Stonnington CM, Locke DEC, Hsu C‑H et al (2013) Somatization is associated with deficits in affective theory of mind. J Psychosom Res 74:479–485. https://doi.org/10.1016/j.jpsychores.2013.04.004 Streeck U (2010) Psychoanalytisch-interaktionelle Gruppentherapie. In: Gruppenpsychotherapie, S 273–279 Subic-Wrana C, Beutel ME, Knebel A, Lane RD (2010) Theory of mind and emotional awareness deficits in patients with somatoform disorders. Psychosom Med 72:404–411. https://doi.org/10.1097/PSY.0b013e3181d35e83 Tak LM, Cleare AJ, Ormel J et al (2011) Meta-analysis and meta-regression of hypothalamic-pituitary-adrenal axis activity in functional somatic disorders. Biol Psychol 87:183–194. https://doi.org/10.1016/j.biopsycho.2011.02.002 Vaillant GE (2011) Involuntary coping mechanisms: a psychodynamic perspective. Dialogues Clin Neurosci 13:366–370 Waldinger RJ, Schulz MS, Barsky AJ, Ahern DK (2006) Mapping the road from childhood trauma to adult somatization: the role of attachment. Psychosom Med 68:129–135. https://doi.org/10.1097/01.psy.0000195834.37094.a4 Waller E, Scheidt CE (2006) Somatoform disorders as disorders of affect regulation: a development perspective. Int Rev Psychiatry 18:13–24 Wright MO, Crawford E, Del Castillo D (2009) Childhood emotional maltreatment and later psychological distress among college students: The mediating role of maladaptive schemas. Child abuse and neglect 33:59–68 Yalom ID, Leszcz M (2005) Theory and practice of group psychotherapy. Basic books, New York Zeigler-Hill V, Chadha S, Osterman L (2008) Psychological defense and self-esteem instability: Is defense style associated with unstable self-esteem? J Res Pers 42:348–364 Zunhammer M, Halski A, Eichhammer P, Busch V (2015) Theory of mind and emotional awareness in chronic somatoform pain patients. PLoS ONE 10:e140016. https://doi.org/10.1371/journal.pone.0140016