Gurtman Michael B
Psychology Department, College of Arts and Sciences, University of Wisconsin-Parkside, Kenosha, 53141, USA.
J Pers Assess. 2004 Dec;83(3):248-55. doi: 10.1207/s15327752jpa8303_08.
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，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组（N = 84），分别接受为期 8 个月的延续期认知疗法（C-CT；贾勒特，1989 年；贾勒特等人，1998 年；贾勒特和克拉夫特，1997 年）或仅进行评估的对照治疗；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，而 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 的治疗反应，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/再发情况。我们讨论了这些结果潜在的临床意义，并给出病例示例以说明变化模式。
