Fassino S, Daga G Abbate, Pierò A, Rovera G G
Department of Neurosciences, Psychiatry Section, Service for Eating Disorders, Turin University, Turin, Italy.
Psychother Psychosom. 2002 Jul-Aug;71(4):200-6. doi: 10.1159/000063645.
Dropout from psychotherapy is an important issue that has received little systematic attention. This study investigated the phenomenon of dropout from brief psychotherapy for anorexia nervosa (AN).
99 outpatients suffering from AN of the restrictor type (n = 53) or binge/purging type (n = 46) were evaluated. Their clinical and personal characteristics were recorded, and body mass index was calculated for participants. They were administered the Eating Disorder Inventory-II (EDI-II), the State-Trait Anger Expression Inventory (STAXI) and the Temperament and Character Inventory (TCI).
Significant differences in some baseline psychopathologic (EDI-II, STAXI) and personality (TCI) variables emerged from the comparison between dropouts and completers. Patients who dropped out of the treatment showed higher levels of anger temperament, anger expression-in and expression-out and lower scores for the dimensions of character (low self-directedness and low cooperativeness). No differences were found between the two groups regarding sociodemographic and clinical variables.
Dropout from brief psychotherapy seems to be related to either psychopathologic or personality aspects, such as the tendency to repress anger, which is encountered also in psychosomatic disorders, and the presence of more compromised dimensions of character, typical of subjects with personality disorders. This study of dropout from brief psychotherapy in AN provided interesting results that will need further confirmation. Possible implications for treatment are addressed.
心理治疗中的脱落问题是一个重要问题,但很少受到系统关注。本研究调查了神经性厌食症(AN)短期心理治疗中的脱落现象。
对99名限制型(n = 53)或暴饮暴食/清除型(n = 46)AN门诊患者进行评估。记录他们的临床和个人特征,并计算参与者的体重指数。对他们进行了进食障碍问卷-II(EDI-II)、状态-特质愤怒表达问卷(STAXI)和气质与性格问卷(TCI)测试。
脱落者与完成治疗者之间在一些基线心理病理学(EDI-II、STAXI)和人格(TCI)变量上存在显著差异。退出治疗的患者表现出更高的愤怒气质水平、愤怒内向和外向表达水平,以及性格维度得分较低(自我导向性低和合作性低)。两组在社会人口统计学和临床变量方面没有差异。
短期心理治疗中的脱落似乎与心理病理学或人格方面有关,例如在身心障碍中也会遇到的压抑愤怒的倾向,以及人格障碍患者典型的性格受损维度。这项关于AN短期心理治疗脱落的研究提供了有趣的结果,需要进一步证实。文中还讨论了对治疗可能产生的影响。