基于网络的认知行为疗法在治疗惊恐障碍中的应用进展
Advances in the Application of Internet-Based Cognitive Behavioral Therapy in the Treatment of Panic Disorder
DOI: 10.12677/jcpm.2025.44435, PDF,   
作者: 齐晗旭：延安大学延安医学院，陕西 延安
关键词: 惊恐障碍；互联网；认知行为疗法；ICBT；Panic Disorder； Internet； Cognitive Behavioral Therapy； ICBT
摘要: 当前互联网逐渐成为获取心理健康信息的重要渠道，并为那些面临心理健康挑战或问题的人们提供结构化的治疗计划。基于互联网提供的认知行为疗法(internet-delivered cognitive behavior therapy, ICBT)为治疗各种精神健康障碍提供了一种创新的治疗方法，其优势包括广泛的可及性、便捷的自我节奏安排，以及对那些不愿与治疗师直接接触的个体的吸引力。惊恐障碍是一种以反复的恐慌发作为特征的焦虑障碍，会降低患者的主观幸福感、生活质量及心理社会功能。基于网络的认知行为疗法是治疗焦虑相关疾病如惊恐障碍的一种有效的替代方案。本文主要聚焦于对惊恐障碍这一较为常见且致残风险极高的焦虑障碍的网络治疗研究进展。
Abstract: The internet has increasingly become an important channel for accessing mental health information and providing structured treatment plans for individuals facing mental health challenges or issues. Internet-delivered cognitive behavior therapy (ICBT) offers an innovative treatment approach for various mental health disorders, with advantages including widespread accessibility, convenient self-paced scheduling, and appeal to individuals who prefer not to interact directly with therapists. Panic disorder is an anxiety disorder characterized by recurrent panic attacks, which can reduce patients’ subjective well-being, quality of life, and psychosocial functioning. Internet-based cognitive behavioral therapy is an effective alternative treatment for anxiety-related disorders such as panic disorder. This article primarily focuses on the latest research developments in internet-based treatment for panic disorder, a relatively common and highly disabling anxiety disorder.
文章引用：齐晗旭. 基于网络的认知行为疗法在治疗惊恐障碍中的应用进展[J]. 临床个性化医学, 2025, 4(4): 194-200. https://doi.org/10.12677/jcpm.2025.44435

参考文献

[1] Baxter, A.J., Vos, T., Scott, K.M., Ferrari, A.J. and Whiteford, H.A. (2014) The Global Burden of Anxiety Disorders in 2010. Psychological Medicine, 44, 2363-2374. [Google Scholar] [CrossRef] [PubMed]
[2] Kessler, R.C., Chiu, W.T., Jin, R., Ruscio, A.M., Shear, K. and Walters, E.E. (2006) The Epidemiology of Panic Attacks, Panic Disorder, and Agoraphobia in the National Comorbidity Survey Replication. Archives of General Psychiatry, 63, 415-424. [Google Scholar] [CrossRef] [PubMed]
[3] Bandelow, B. and Michaelis, S. (2015) Epidemiology of Anxiety Disorders in the 21st Century. Dialogues in Clinical Neuroscience, 17, 327-335. [Google Scholar] [CrossRef] 
[4] de Jonge, P., Roest, A.M., Lim, C.C.W., Florescu, S.E., Bromet, E.J., Stein, D.J., et al. (2016) Cross-National Epidemiology of Panic Disorder and Panic Attacks in the World Mental Health Surveys. Depression and Anxiety, 33, 1155-1177. [Google Scholar] [CrossRef] [PubMed]
[5] Candilis, P.J., Mclean, R.Y.S., Otto, M.W., Manfro, G.G., Worthington, J.J., Penava, S.J., et al. (1999) Quality of Life in Patients with Panic Disorder. The Journal of Nervous & Mental Disease, 187, 429-434. [Google Scholar] [CrossRef] [PubMed]
[6] Lecrubier, Y. (1998) The Impact of Comorbidity on the Treatment of Panic Disorder. The Journal of Clinical Psychiatry, 59, 11-14.
[7] Batelaan, N., Smit, F., Graaf, R.d., Balkom, A.v., Vollebergh, W. and Beekman, A. (2007) Economic Costs of Full-Blown and Subthreshold Panic Disorder. Journal of Affective Disorders, 104, 127-136. [Google Scholar] [CrossRef] [PubMed]
[8] Brettschneider, C., Bleibler, F., Hiller, T.S., Konnopka, A., Breitbart, J., Margraf, J., et al. (2019) The Allocation of Resources in the Care for Patients with Panic Disorder in Germany: An Excess Cost Analysis Informing Policy and Science. Cost Effectiveness and Resource Allocation, 17, Article No. 9. [Google Scholar] [CrossRef] [PubMed]
[9] Pompoli, A., Furukawa, T.A., Imai, H., Tajika, A., Efthimiou, O. and Salanti, G. (2016) Psychological Therapies for Panic Disorder with or without Agoraphobia in Adults: A Network Meta-Analysis. Cochrane Database of Systematic Reviews, 2016, CD011004. [Google Scholar] [CrossRef] [PubMed]
[10] Rickwood, D. and Bradford, (2012) The Role of Self-Help in the Treatment of Mild Anxiety Disorders in Young People: An Evidence-Based Review. Psychology Research and Behavior Management, 5, 25-36. [Google Scholar] [CrossRef] [PubMed]
[11] Andrews, G., et al. (2018) Computer Therapy for the Anxiety and Depression Disorders Is Effective, Acceptable and Practical Health Care: An Updated Meta-Analysis. Journal of Anxiety Disorders, 55, 70-78.
[12] Beck, A.T. (1964) Thinking and Depression II. Theory and Therapy. Archives of General Psychiatry, 10, 561-571. [Google Scholar] [CrossRef] [PubMed]
[13] Tolin, D.F. (2010) Is Cognitive-Behavioral Therapy More Effective than Other Therapies? A Meta-Analytic Review. Clinical Psychology Review, 30, 710-720. [Google Scholar] [CrossRef] [PubMed]
[14] Anonymous (2009) Practice Guideline for the Treatment of Patients with Panic Disorder: Second Edition. The American Journal of Psychiatry, 166, 1-65.
[15] Soares, T., Camargo, J. and Pizzinato, A. (2013) Effectiveness of Group Cognitive Behavior Therapies for Panic Disorder: Systematic Review and Meta-Analysis. Revista Brasileira de Terapia Comportamental e Cognitiva, 15, 50-65. [Google Scholar] [CrossRef] 
[16] DiMauro, J., Domingues, J., Fernandez, G. and Tolin, D.F. (2013) Long-Term Effectiveness of CBT for Anxiety Disorders in an Adult Outpatient Clinic Sample: A Follow-Up Study. Behaviour Research and Therapy, 51, 82-86. [Google Scholar] [CrossRef] [PubMed]
[17] Listed, N.A. (1998) Practice Guideline for the Treatment of Patients with Panic Disorder. Work Group on Panic Disorder. American Psychiatric Association. American Journal of Psychiatry, 155, 1-34.
[18] Bouton, M.E., Mineka, S. and Barlow, D.H. (2001) A Modern Learning Theory Perspective on the Etiology of Panic Disorder. Psychological Review, 108, 4-32. [Google Scholar] [CrossRef] [PubMed]
[19] Wolitzky-Taylor, K., Zimmermann, M., Arch, J.J., De Guzman, E. and Lagomasino, I. (2015) Has Evidence-Based Psychosocial Treatment for Anxiety Disorders Permeated Usual Care in Community Mental Health Settings? Behaviour Research and Therapy, 72, 9-17. [Google Scholar] [CrossRef] [PubMed]
[20] Wolitzky-Taylor, K., Fenwick, K., Lengnick-Hall, R., Grossman, J., Bearman, S.K., Arch, J., et al. (2018) A Preliminary Exploration of the Barriers to Delivering (and Receiving) Exposure-Based Cognitive Behavioral Therapy for Anxiety Disorders in Adult Community Mental Health Settings. Community Mental Health Journal, 54, 899-911. [Google Scholar] [CrossRef] [PubMed]
[21] Kessler, R.C. and Greenberg, P.E. (2002) The Economic Burden of Anxiety and Stress Disorders.
[22] Shapiro, D.A., Cavanagh, K. and Lomas, H. (2003) Geographic Inequity in the Availability of Cognitive Behavioural Therapy in Eng Land and Wales. Behavioural and Cognitive Psychotherapy, 31, 185-192. [Google Scholar] [CrossRef] 
[23] Kazdin, A.E. (2015) Clinical Dysfunction and Psychosocial Interventions: The Interplay of Research, Methods, and Conceptualization of Challenges. Annual Review of Clinical Psychology, 11, 25-52. [Google Scholar] [CrossRef] [PubMed]
[24] Beck, A.T. (1979) Cognitive Therapy and the Emotional Disorders. Penguin.
[25] Clark, D.M. (1986) A Cognitive Approach to Panic. Behaviour Research and Therapy, 24, 461-470. [Google Scholar] [CrossRef] [PubMed]
[26] Carlbring, P., Westling, B.E., Ljungstrand, P., Ekselius, L. and Andersson, G. (2001) Treatment of Panic Disorder via the Internet: A Randomized Trial of a Self-Help Program. Behavior Therapy, 32, 751-764. [Google Scholar] [CrossRef] 
[27] Titov, N., Andrews, G., Choi, I., Schwencke, G. and Mahoney, A. (2008) Shyness 3: Randomized Controlled Trial of Guided versus Unguided Internet-Based CBT for Social Phobia. Australian & New Zealand Journal of Psychiatry, 42, 1030-1040. [Google Scholar] [CrossRef] [PubMed]
[28] National Institute for Health and Care Excellence (NICE) (2019) Generalised Anxiety Disorder and Panic Disorder in Adults: Management.
[29] McNally, R.J. (2002) Anxiety and Its Disorders: The Nature and Treatment of Anxiety and Panic, 2nd Ed. American Journal of Psychiatry, 159, 1453-1453. [Google Scholar] [CrossRef] 
[30] Hedman, E., Ljótsson, B. and Lindefors, N. (2012) Cognitive Behavior Therapy via the Internet: A Systematic Review of Applications, Clinical Efficacy and Cost-Effectiveness. Expert Review of Pharmacoeconomics & Outcomes Research, 12, 745-764. [Google Scholar] [CrossRef] [PubMed]
[31] Andersson, G., Titov, N., Dear, B.F., Rozental, A. and Carlbring, P. (2019) Internet‐Delivered Psychological Treatments: From Innovation to Implementation. World Psychiatry, 18, 20-28. [Google Scholar] [CrossRef] [PubMed]
[32] Berger, T., Hohl, E. and Caspar, F. (2009) Internet‐Based Treatment for Social Phobia: A Randomized Controlled Trial. Journal of Clinical Psychology, 65, 1021-1035. [Google Scholar] [CrossRef] [PubMed]
[33] Klein, B., Meyer, D., Austin, D.W. and Kyrios, M. (2011) Anxiety Online—A Virtual Clinic: Preliminary Outcomes Following Completion of Five Fully Automated Treatment Programs for Anxiety Disorders and Symptoms. Journal of Medical Internet Research, 13, e89. [Google Scholar] [CrossRef] [PubMed]
[34] Kaltenthaler, E., Brazier, J., De Nigris, E., Tumur, I., Ferriter, M., Beverley, C., et al. (2006) Computerised Cognitive Behaviour Therapy for Depression and Anxiety Update: A Systematic Review and Economic Evaluation. Health Technology Assessment (Winchester, England), 10, iii-168. [Google Scholar] [CrossRef] [PubMed]
[35] Carlbring, P., Andersson, G., Cuijpers, P., Riper, H. and Hedman-Lagerlöf, E. (2017) Internet-Based vs. Face-to-Face Cognitive Behavior Therapy for Psychiatric and Somatic Disorders: An Updated Systematic Review and Meta-Analysis. Cognitive Behaviour Therapy, 47, 1-18. [Google Scholar] [CrossRef] [PubMed]
[36] Titov, N., Dear, B.F., Schwencke, G., Andrews, G., Johnston, L., Craske, M.G., et al. (2011) Transdiagnostic Internet Treatment for Anxiety and Depression: A Randomised Controlled Trial. Behaviour Research and Therapy, 49, 441-452. [Google Scholar] [CrossRef] [PubMed]
[37] Bakker, D., Kazantzis, N., Rickwood, D. and Rickard, N. (2016) Mental Health Smartphone Apps: Review and Evidence-Based Recommendations for Future Developments. JMIR Mental Health, 3, e7. [Google Scholar] [CrossRef] [PubMed]
[38] Lindner, P., Miloff, A., Fagernäs, S., Andersen, J., Sigeman, M., Andersson, G., et al. (2019) Therapist-Led and Self-Led One-Session Virtual Reality Exposure Therapy for Public Speaking Anxiety with Consumer Hardware and Software: A Randomized Controlled Trial. Journal of Anxiety Disorders, 61, 45-54. [Google Scholar] [CrossRef] [PubMed]
[39] Fitzpatrick, K.K., Darcy, A. and Vierhile, M. (2017) Delivering Cognitive Behavior Therapy to Young Adults with Symptoms of Depression and Anxiety Using a Fully Automated Conversational Agent (Woebot): A Randomized Controlled Trial. JMIR Mental Health, 4, e19. [Google Scholar] [CrossRef] [PubMed]
[40] Erbe, D., Eichert, H., Riper, H. and Ebert, D.D. (2017) Blending Face-to-Face and Internet-Based Interventions for the Treatment of Mental Disorders in Adults: Systematic Review. Journal of Medical Internet Research, 19, e306. [Google Scholar] [CrossRef] [PubMed]
[41] 李晨, 白越, 胡明月, 等. 网络认知行为疗法在精神障碍患者中的研究现状[J]. 护理学杂志, 2017, 32(11): 101-104.
[42] 缑梦克, 陈慧菁, 钱铭怡. 社交焦虑的网络认知行为干预及其在中国文化下的应用(综述) [J]. 中国心理卫生杂志, 2019, 33(9): 672-678.