Blatt Sidney J, Besser Avi, Ford Richard Q
Department of Psychiatry, Yale University School of Medicine, Suite 901, 300 George St., New Haven, CT 06511, USA.
Am J Psychiatry. 2007 Oct;164(10):1561-7. doi: 10.1176/appi.ajp.2007.05111853.
Change in three types of thought disorder as measured by Rorschach responses (contaminations, confabulations, and fabulized combinations) were assessed during intensive, long-term, psychodynamically oriented inpatient treatment.
Rorschach protocols for 90 seriously disturbed, treatment-resistant patients, 42 of whom were primarily preoccupied with primitive issues of interpersonal relatedness and used avoidant defenses (anaclitic patients) and 48 primarily preoccupied with primitive issues of self-definition and self-worth and used counteractive defenses (introjective patients), were evaluated at the beginning of treatment and, on average, 15 months into treatment.
Change in anaclitic patients occurred primarily in more pathological forms of thought disorder (contaminations and confabulations) that express boundary disturbances; change in introjective patients occurred primarily in the less disturbed thought disorder (fabulized combinations) that expresses tendencies toward referential thinking.
Seriously disturbed anaclitic and introjective patients expressed therapeutic progress in different but theoretically consistent ways.
在强化、长期、以心理动力学为导向的住院治疗期间，评估通过罗夏墨迹测验反应（污染、虚构和幻想性组合）所测量的三种思维障碍类型的变化。
对90名严重困扰、难治性患者的罗夏墨迹测验记录进行评估，其中42名主要关注人际关联的原始问题并采用回避防御（依赖型患者），48名主要关注自我定义和自我价值的原始问题并采用对抗防御（内摄型患者），在治疗开始时以及平均治疗15个月时进行评估。
依赖型患者的变化主要发生在表达边界障碍的更具病理性的思维障碍形式（污染和虚构）中；内摄型患者的变化主要发生在表达参照思维倾向的干扰较小的思维障碍（幻想性组合）中。
严重困扰的依赖型和内摄型患者以不同但理论上一致的方式表现出治疗进展。
