Jorgensen Randall S, Thibodeau Ryan
Center for Health and Behavior and Department of Psychology, Syracuse University, Syracuse, NY 13244, USA.
Harv Rev Psychiatry. 2007 Jan-Feb;15(1):9-17. doi: 10.1080/10673220601183923.
This article presents an exploration of a clinically meaningful interpersonal style labeled here as defensive avoidance of disapproval (DAD), which involves a motivated inattention to physiological, affective, or cognitive reactions arising from stressful social transactions, thereby safeguarding a self-image of social competence. First, we discuss conceptual antecedents of DAD derived from post-Freudian theories of twentieth-century psychodynamic and interpersonally oriented clinicians. Second, we highlight measurement issues as they relate to DAD. Third, we review research on the association of DAD with psychophysiological stress reactivity and diminished health. Finally, DAD-related clinical implications are considered. Our discussion of DAD invites the (1) assessment of phenomenological "blind spots" regarding the physiological, affective, and cognitive components of disapproval-induced stress, (2) development of strategies to decrease premature therapy termination that may result from a defensive avoidance of social disapproval, and (3) cultivation of interventions to increase the high DAD patient's acknowledgement, rather than rejection, of the signs of social stress.
本文探讨了一种具有临床意义的人际风格，在此标记为防御性避免不赞同（DAD），它涉及有意忽视因紧张的社交互动而产生的生理、情感或认知反应，从而维护社交能力的自我形象。首先，我们讨论源自20世纪后弗洛伊德精神动力学理论和人际导向临床医生理论的DAD概念先驱。其次，我们强调与DAD相关的测量问题。第三，我们回顾关于DAD与心理生理应激反应性及健康受损之间关联的研究。最后，考虑与DAD相关的临床意义。我们对DAD的讨论促使（1）评估关于不赞同引发的压力的生理、情感和认知成分的现象学“盲点”，（2）制定策略以减少可能因防御性避免社会不赞同而导致的过早治疗终止，以及（3）培养干预措施，以增加高DAD患者对社会压力迹象的承认而非排斥。
