Vittengl Jeffrey R, Clark Lee Anna, Jarrett Robin B
Division of Social Science, Truman State University, Kirksville, MO 63501-4221, USA.
J Pers Assess. 2004 Dec;83(3):235-47. doi: 10.1207/s15327752jpa8303_07.
Using Benjamin's (2000) Structural Analysis of Social Behavior, we evaluated change in "self-directed" affiliation and autonomy and prediction of treatment response and relapse/recurrence among adult outpatients with recurrent major depressive disorder consenting to acute phase cognitive therapy (A-CT; Beck, Rush, Shaw, & Emery, 1979; N=156); A-CT responders randomized (N=84) to 8 months of continuation phase cognitive therapy (C-CT; Jarrett, 1989; Jarrett et al., 1998; Jarrett & Kraft, 1997) or assessment-only control; and C-CT and control patients entering a 16-month, assessment-only follow-up (N=74). Self-directed affiliation and autonomy increased after A-CT, and C-CT further increased affiliation and autonomy. Affiliation and autonomy did not predict A-CT response, but lower affiliation and higher autonomy pre-A-CT predicted relapse/recurrence post-A-CT. We discuss potential clinical implications of these results and present case examples to illustrate patterns of change.
我们运用本杰明（2000年）的社会行为结构分析方法，评估了复发性重度抑郁症成年门诊患者在接受急性期认知疗法（A-CT；贝克、拉什、肖和埃默里，1979年；N = 156）过程中“自我导向”的归属感和自主性的变化，以及治疗反应和复发/再发的预测情况；将A-CT治疗有反应者随机分为两组（N = 84），一组接受为期8个月的巩固期认知疗法（C-CT；贾勒特，1989年；贾勒特等人，1998年；贾勒特和克拉夫特，1997年），另一组仅接受评估对照；C-CT组和对照组患者进入为期16个月的仅评估随访阶段（N = 74）。A-CT治疗后自我导向的归属感和自主性有所增加，C-CT进一步提高了归属感和自主性。归属感和自主性并不能预测A-CT治疗反应，但A-CT治疗前较低的归属感和较高的自主性可预测A-CT治疗后的复发/再发。我们讨论了这些结果的潜在临床意义，并给出病例示例以说明变化模式。
