Abstract

Objective

Transdiagnostic psychotherapies have been proposed as an effective means for addressing the needs of patients with multiple, comorbid disorders. Yet, it remains unknown whether transdiagnostic approaches empirically outperform disorder-specific psychotherapies for patients with comorbid disorders. Thus, this study tested whether comorbidity moderated the efficacy of transdiagnostic behavior therapy (TBT) and behavioral activation (BA) for patients with various affective disorders.

Methods

Data derived from a randomized controlled trial in which 93 treatment-seeking veterans received 12 sessions of TBT (n = 46) or BA (n = 47). Baseline comorbidity was assessed with a diagnostic interview. Patients rated their symptoms and functioning throughout treatment, and therapists recorded premature treatment discontinuation.

Results

Multilevel models revealed significant interactive effects on changes in symptoms and functioning, but not on the posttreatment levels of these outcomes; whereas patients with more comorbidity experienced greater reductions in distress and symptom interference in TBT compared to BA, those with one disorder had better outcomes in BA. Similarly, whereas patients with more comorbidity were less likely to prematurely discontinue TBT compared to BA, those with one disorder were less likely to prematurely discontinue BA.

Conclusions

The results lend empirical support to previously untested hypotheses for potential benefits of transdiagnostic psychotherapies.

Trial registration: ClinicalTrials.gov identifier: NCT01947647.

中文翻译：

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合并症作为跨诊断行为疗法和行为激活对情感障碍的差异疗效的调节剂

摘要

客观的

跨诊断心理治疗已被提议作为解决患有多种合并症的患者需求的有效手段。然而，对于患有合并症的患者，跨诊断方法是否在经验上优于特定于疾病的心理治疗仍然未知。因此，本研究测试了合并症是否会调节跨诊断行为疗法 (TBT) 和行为激活 (BA) 对患有各种情感障碍的患者的疗效。

方法

数据来自一项随机对照试验，其中 93 名寻求治疗的退伍军人接受了 12 次 TBT ( n  = 46) 或 BA ( n  = 47)。通过诊断访谈评估基线合并症。患者在整个治疗过程中对他们的症状和功能进行评分，治疗师记录了过早停止治疗的情况。

结果

多层次模型揭示了对症状和功能变化的显着交互影响，但对这些结果的治疗后水平没有影响；与 BA 相比，患有更多合并症的患者在 TBT 中的痛苦和症状干扰的减少更大，而患有一种疾病的患者在 BA 中的结果更好。同样，与 BA 相比，合并症较多的患者过早停用 TBT 的可能性较小，而患有一种疾病的患者过早停用 BA 的可能性较小。

结论

结果为先前未经检验的关于跨诊断心理治疗的潜在益处的假设提供了实证支持。

试用注册： ClinicalTrials.gov 标识符：NCT01947647。