Background and objectives

Transdiagnostic mechanisms of change (txMOC) specific to cognitive behaviour therapy are poorly understood. Salkovskis (1996) proposed one such mechanism in terms of the shift towards an alternative, less negative view of their problems or cognitive flexibility. This hypothesis has been described as involving a shift in beliefs, from “theory A″ to “theory B”. The objective of this research was to evaluate this hypothesis.

Methods

Effectiveness of a novel txCBT and temporal changes in process and symptom measures were evaluated using a non-concurrent multiple baseline design and Tau-U calculations with thirteen participants (five with obsessive-compulsive disorder, two with panic disorder with agoraphobia and six with major depressive disorder). As a secondary analysis authors calculated Kendall's – Tau correlation between process and symptom measures, performed the Wilcoxon signed-rank test to assess treatment modules effect on negative thought and calculated Reliable change index (RCI).

Results

The txCBT was clearly effective for eight participants. The results varied dependent on the stimuli evaluated as negative or threatening. Level and trend of the ratings of belief in theory A followed the level and trend of symptom measures to a greater extent than the (inverse) level and trend of belief in theory B.

Limitations

Only thirteen participants were recruited and evaluated.

Conclusions

The results are consistent with the view that effective treatment may involve a txMOC characterized by the ability to shift from a relatively fixed negative view of their experience to a less negative psychologically focused alternative.

中文翻译：

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基于单例实验设计的跨诊断认知行为治疗变化机制评价

背景和目标

认知行为疗法特有的跨诊断变化机制 (txMOC) 知之甚少。Salkovskis (1996) 提出了一种这样的机制，即对他们的问题或认知灵活性转向另一种、较少消极的看法。这个假设被描述为涉及信念的转变，从“理论 A”到“理论 B”。这项研究的目的是评估这一假设。

方法

使用非并发多基线设计和 Tau- U计算评估了新的 txCBT 的有效性以及过程和症状测量的时间变化，其中包括 13 名参与者（5 名患有强迫症，2 名患有伴有广场恐惧症的恐慌症，6 名患有重度抑郁症）紊乱）。作为次要分析，作者计算了过程和症状测量之间的 Kendall's - Tau 相关性，执行了 Wilcoxon 符号秩检验以评估治疗模块对消极思想的影响并计算出可靠变化指数 (RCI)。

结果

txCBT 对八名参与者显然有效。结果因评估为负面或威胁的刺激而异。理论 A 的信念等级和趋势比理论 B 的信念水平和趋势在更大程度上跟随症状测量的水平和趋势。

限制

仅招募和评估了 13 名参与者。

结论

结果与以下观点一致，即有效治疗可能涉及 txMOC，其特征是能够从对其经历的相对固定的负面看法转变为不太消极的心理关注替代方案。