认知行为治疗与成人注意缺陷多动障碍:认知模式及情绪症状在治疗中的中介作用  

Cognitive Behavioral Therapy in Medicated Adults with Attention-Deficit/Hyperactivity Disorder:The Mediating Role of Changes in Cognitive Patterns and Emotional Symptoms

作　　者：潘美蓉 张诗雨 邱孙伟 刘璐[1,2] 李海梅[1,2] 赵梦婕[1,2] 董敏 司飞飞[1,2] 王玉凤 钱秋谨 PAN Mei-rong;ZHANG Shi-yu;QIU Sun-wei;LIU Lu;LI Hai-mei;ZHAO Meng-jie;DONG Min;SI Fei-fei;WANG Yu-feng;QIAN Qiu-jin(Peking University Sixth Hospital,PekingUniversity Institute of Mental Health,Beijing100191,China;NHC Key Laboratory of Mental Health(PekingUniversity),National Clinical Research Center for Mental Disorders(Peking University SixthHospital),Beijing 100191,China)

机构地区：[1]北京大学第六医院,北京大学精神卫生研究所,北京100191 [2]国家卫生健康委员会精神卫生学重点实验室[北京大学],国家精神心理疾病临床医学研究中心[北京大学第六医院],北京100191

出　　处：《中国临床心理学杂志》2022年第1期200-206,共7页Chinese Journal of Clinical Psychology

基　　金：首都卫生发展科研专项(项目编号:首发2020-2-4112,首发2016-2-4113);国家自然科学基金(81571340)。

摘　　要：目的:探讨认知行为治疗(CBT)对成人注意缺陷多动障碍(ADHD)患者核心症状的直接影响,以及认知模式和情绪症状改变的中介作用。方法:研究纳入既往随机对照试验入组的98名成人ADHD患者,对结果进行二次分析,选取治疗前(T1)、治疗12周结束后(T2)及48周随访(T3)时的核心症状、认知模式及情绪症状得分,构建链式中介模型。结果:CBT可通过焦虑、抑郁情绪症状得分变化影响T2及T3时核心症状得分,也可依次通过认知模式(自动思维和功能失调得分)变化及情绪症状变化影响T3时核心症状得分。结论:CBT短期主要通过改善情绪进而改善ADHD核心症状,同时长期可依次通过认知模式的中介作用影响情绪变化,进而影响ADHD核心症状。Objective:The study was a secondary analysis of previous randomized controlled trial(RCT)study,aiming to explore the direct effects of cognitive-behavioral therapy(CBT)on the core symptoms of ADHD,and the mediating role of changes in cognitive patterns and emotional symptoms with the use of serial multiple mediator models.Methods:98 adult ADHD were randomly allocated to the CBT combined with medication(CBT+M)group or the medication(M)only group.The CBT+M group received CBT for 12 weeks,and the M-only group received stable medication.ADHD core symptoms,cognitive patterns,and emotional symptoms were evaluated in the two groups before treatment(T1),at the end of the12-week CBT(T2),and the follow-up at week 48(T3).Results:The influence of CBT on ADHD core symptoms through emotional symptoms changes was statistically significant at T2 and T3.The effect of CBT on ADHD core symptoms was statistically significant through the changes of cognitive patterns and then the changes of emotional symptom scores at T3 but not immediately at T2.Conclusion:The research indicated that CBT could affect ADHD core symptoms through the reduction of anxiety and depression symptoms both in the short-term and long-term follow-up.Meanwhile,CBT could in turn affect the changes of anxiety and depression through the mediation of cognitive patterns and then affect ADHD core symptoms of in the long-term follow-up.

关 键 词：认知行为治疗 成人注意缺陷多动障碍 中介效应 认知模式 情绪 

分 类 号：R395.5[哲学宗教—心理学]