辨证行为治疗是一种有效的心理治疗方法,包括个体、团体等多种形式。该文呈现了一名神经性贪食症患者在辩证行为治疗框架下,参与了6个阶段共12次团体技能训练。通过正念、情绪调节、痛苦忍受和人际沟通四大核心技能训练,该患者学会了更好地认识自我、调节情绪、承受生活中不可避免的痛苦以及建立良好的人际关系,从而改善了适应不良的行为。治疗结束后,患者在进食相关症状、焦虑和抑郁情绪方面均有明显改善,治疗师和患者均对治疗效果评价较好。研究提示了辩证行为治疗在改善神经性贪食症方面的潜力,并为后续采用该方法治疗其他精神障碍提供了借鉴。
Dialectical behavior therapy (DBT) is an effective method of psychotherapy which includes individual therapy, group therapy, and other forms. This study presents a patient with bulimia nervosa who participated in a 12-session, 6-stage group skills training within the framework of DBT. Through training in the four core skills of mindfulness, emotion regulation, distress tolerance, and interpersonal communication, the patient learned to better understand herself, regulate emotions, tolerate life’s inevitable distress, and build good interpersonal relationships, thereby improving maladaptive behaviors. After treatment, patients showed significant improvements in eating related symptoms, anxiety, and depression, with both therapist and patient evaluating the treatment effect as positive. The study suggests the potential of DBT in improving bulimia nervosa and provides a reference for the subsequent use of this approach in the treatment of other mental disorders.
[1] 陈珏. (2018). 辩证行为治疗简介. 心理学通讯, 1(2), 137-140. doi: 10.12100/j.issn.2096-5494.218011
[2] 古练, 陈珏, 黄悦, 亢清, 黄佳滨, 何燕玲, 肖泽萍. (2017). 进食障碍检查自评问卷6.0中文版在女性进食障碍患者中应用的效度和信度. 中国心理卫生杂志, 31(5), 350-355. doi: 10.3969/j.issn.1000-6729.2017.05.003
[3] 王向群, 王高华. (2015). 中国进食障碍防治指南. 北京: 中国医学电子音像出版社.
[4] 张靖, 陈珏.(2018). 辩证行为疗法在进食障碍中的应用. 精神医学杂志,31(4), 312-315. doi: CNKI:SUN:SDJB.0.2018-04-022
[5] Bankoff S. M., Karpel M. G., Forbes H. E., & Pantalone D. W. (2012). A systematic review of dialectical behavior therapy for the treatment of eating disorders. Eat Disord, 20, 196-215. doi: 10.1080/10640266.2012.668478
[6] Linardon J., Fairburn C. G., Fitzsimmons-Craft E. E., Wilfley D. E., & Brennan L. (2017). The empirical status of the third-wave behaviour therapies for the treatment of eating disorders: A systematic review.Clin Psychol Rev, 58, 125-140. doi: 10.1016/j.cpr.2017.10.005
[7] National Guideline Alliance (UK). (2017). Eating disorders: Recognition and treatment. National Institute for Health and Care Excellence (NICE).
[8] Rahmani M., Omidi A., Asemi Z., & Akbari H. (2018). The effect of dialectical behaviour therapy on binge eating, difficulties in emotion regulation and BMI in overweight patients with binge-eating disorder: A randomized controlled trial.Ment Health Prev, 9, 13-18. doi: 10.1016/j.mhp.2017.11.002
[9] Safer, D. L., Alder, S.& Masson, P. C. (2019). 告别情绪性进食的DBT方法 (陈珏, 朱卓影译).上海科学技术出版社.
[10] Scottish Intercollegiate Guidelines Network (SIGN). (2022). Eating disorders: A national clinical guideline (SIGN publication no. 164).
