Narud Kjersti, Mykletun Arnstein, Dahl Alv A
Department of Psychiatry, Aker University Hospital, Oslo, Norway.
Nord J Psychiatry. 2003;57(6):461-7. doi: 10.1080/08039480310003489.
Individual psychodynamic psychotherapy is a recommended, but controversial, treatment for patients with personality disorders (PDs). The aim of this study was to examine the relationship between demographic and professional characteristics of experienced psychotherapists and their attitudes and opinions towards aspects of this kind of psychotherapy. A questionnaire covering these issues of psychodynamic psychotherapy with patients belonging to all three DSM-IV clusters of PD was developed. A sample of 324 Norwegian psychiatrists and clinical psychologist with considerable experience in individual dynamic psychotherapy of patients with PDs filled in valid questionnaires. The therapists' age, gender, profession, postgraduate courses and degree of experience were examined as to their opinions on the following issues: alliances, aims, contraindications, needs to terminate, suicides, use of drugs, length of treatment, need for supervision and complaints to colleagues about patients' behaviour in such therapy with PD patients. Independent sample t-tests of the mean z-transformed group scores were the main statistical method applied. Therapist experience made the most significant differences as to treatment issues, while some differences also were found for age, gender and profession. The influence of postgraduate courses was negligible. Our study might have a selection bias towards therapist with strong psychodynamic orientation and particular interest in the psychotherapy of patients with PDs.
个体心理动力心理治疗是针对人格障碍（PD）患者推荐使用但存在争议的一种治疗方法。本研究旨在探讨经验丰富的心理治疗师的人口统计学和专业特征与他们对这类心理治疗各方面的态度和看法之间的关系。针对属于《精神疾病诊断与统计手册》第四版（DSM-IV）中所有三个PD类别的患者，编制了一份涵盖心理动力心理治疗这些问题的问卷。324名在PD患者个体动力心理治疗方面有丰富经验的挪威精神科医生和临床心理学家填写了有效问卷。就治疗师在以下问题上的看法，对其年龄、性别、职业、研究生课程和经验程度进行了考察：联盟、目标、禁忌症、终止治疗的必要性、自杀、药物使用、治疗时长、督导需求以及在这类针对PD患者的治疗中对患者行为向同事提出投诉等。主要应用的统计方法是对平均z转换组分数进行独立样本t检验。治疗师的经验在治疗问题上产生的差异最为显著，同时在年龄、性别和职业方面也发现了一些差异。研究生课程的影响可忽略不计。我们的研究可能对具有强烈心理动力取向且对PD患者心理治疗特别感兴趣的治疗师存在选择偏差。
