Đào Tạo Siêu Nhận Thức Cho Rối Loạn Ám Ảnh Cưỡng Chế: một giao thức nghiên cứu cho một thử nghiệm ngẫu nhiên có kiểm soát

BMC Psychiatry - Tập 20 - Trang 1-13 - 2020
Franziska Miegel1, Cüneyt Demiralay1, Steffen Moritz2, Janina Wirtz1, Birgit Hottenrott1, Lena Jelinek1
1Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
2Department of Psychiatry and Psychotherapy, University Medical Center Hamburg. Eppendorf, Hamburg, Germany

Tóm tắt

Một số lượng lớn bệnh nhân mắc rối loạn ám ảnh cưỡng chế (OCD) không nhận được liệu pháp nhận thức-hành vi với việc phơi bày và ngăn chặn hành vi, đây là phương pháp điều trị hiệu quả nhất cho OCD. Do đó, Đào Tạo Siêu Nhận Thức cho OCD (MCT-OCD) đã được phát triển, đây là một liệu pháp nhóm có cấu trúc nhằm sửa đổi các thành kiến (siêu) nhận thức, niềm tin và phong cách đối phó không hiệu quả. Nó có thể được thực hiện bởi những nhân viên ít được đào tạo hơn, từ đó có thể tiếp cận được nhiều bệnh nhân hơn. Một nghiên cứu thí điểm không đối chứng (phiên bản thí điểm MCT-OCD) đã cung cấp bằng chứng đầu tiên rằng đào tạo này được bệnh nhân chấp nhận rất cao; Các triệu chứng OC giảm với kích thước hiệu ứng lớn (η2partial = 0.50). Mục tiêu của nghiên cứu hiện tại là khắc phục những thiếu sót của nghiên cứu thí điểm (ví dụ: không có nhóm đối chứng) và đánh giá hiệu quả của phiên bản đã được chỉnh sửa của MCT-OCD trong khuôn khổ một thử nghiệm ngẫu nhiên có kiểm soát. Tám mươi bệnh nhân mắc OCD sẽ được tuyển chọn. Sau khi đánh giá mù ở thời điểm ban đầu (−t1), bệnh nhân sẽ được phân bổ ngẫu nhiên vào nhóm can thiệp (MCT-OCD; n = 40) hoặc nhóm đối chứng chăm sóc thông thường (n = 40). MCT-OCD nhằm nâng cao năng lực siêu nhận thức của bệnh nhân trong tám mô-đun bằng cách giải quyết các thành kiến (siêu) nhận thức và niềm tin không hiệu quả liên quan đến OCD (ví dụ: không thể chấp nhận sự không chắc chắn). Sau 8 tuần, bệnh nhân sẽ được mời tham gia đánh giá sau (t1), và sau đó họ sẽ nhận được bảng hỏi trực tuyến theo dõi sau 3 tháng kể từ t1 (t2). Kết quả chính là tổng điểm Y-BOCS, và các kết quả phụ bao gồm HDRS, OCI-R, OBQ-44, MCQ-30, WHOQOL-BREF, BDI-II, và các đánh giá chủ quan về MCT-OCD. Chúng tôi kỳ vọng rằng các triệu chứng OC sẽ giảm nhiều hơn ở nhóm can thiệp so với nhóm đối chứng chăm sóc thông thường từ –t1 đến t1 và những lợi ích điều trị sẽ được duy trì đến t2. Nghiên cứu được lập kế hoạch là nghiên cứu đầu tiên kiểm tra MCT-OCD, một phương pháp điều trị mới đầy hứa hẹn, trong một thử nghiệm ngẫu nhiên có kiểm soát. MCT-OCD có thể giúp vượt qua những rào cản điều trị hiện có cho bệnh nhân mắc OCD.

Từ khóa

#Rối loạn ám ảnh cưỡng chế #đào tạo siêu nhận thức #thử nghiệm ngẫu nhiên có kiểm soát #liệu pháp nhóm #thành kiến nhận thức.

Tài liệu tham khảo

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