Ulberg Randi, Johansson Paul, Marble Alice, Høglend Per
Department of Psychiatry, Vinderen, Diakonhjemmet Hospital, N-0319 Oslo, Norway.
Can J Psychiatry. 2009 Feb;54(2):78-86. doi: 10.1177/070674370905400205.
To examine whether men and women respond differentially to brief dynamic psychotherapy, with or without transference interpretations.
Data from the First Experimental Study of Transference Interpretation were used. Patients (n = 100) were randomized to receive 2 different dynamic psychotherapies during 1 year, with either a moderate level of transference interpretations or no transference interpretations. We used the following outcome measures: the Psychodynamic Functioning Scales, Inventory of Interpersonal Problems-Circumplex Version, Global Assessment of Functioning (GAF), and total mean score of Symptom Checklist-90-Revised (Global Severity Index [GSI]). Change was assessed using linear-mixed models.
On average, men and women responded equally across treatments. The moderator analyses, using the 2 secondary outcome measures, GAF and GSI, demonstrated that women responded better to therapy with transference interpretations, compared with men, whereas men responded better to therapy without transference interpretations, compared with women. When the moderator sex was combined with the moderator quality of object relations (QOR), a strong effect emerged: men with high QOR showed a large negative effect of transference interpretations, and women with low QOR showed a large positive effect.
In terms of symptom change, women responded better to therapy with transference interpretations, while men responded better to therapy without transference interpretations. Patient sex showed moderator effects over and above the moderator effects of QOR.
NCT00423462.
研究男性和女性对短期动态心理治疗(无论有无移情诠释)的反应是否存在差异。
使用来自移情诠释首次实验研究的数据。100名患者被随机分配在1年中接受两种不同的动态心理治疗,一种有适度水平的移情诠释,另一种没有移情诠释。我们使用了以下结局指标:心理动力功能量表、人际问题环形版本量表、功能总体评定量表(GAF)以及症状自评量表90修订版的总平均分(总体严重程度指数[GSI])。使用线性混合模型评估变化情况。
总体而言,男性和女性在各种治疗中的反应相同。使用两个次要结局指标GAF和GSI进行的调节分析表明,与男性相比,女性对有移情诠释的治疗反应更好;而与女性相比,男性对没有移情诠释的治疗反应更好。当调节因素性别与客体关系质量(QOR)这一调节因素相结合时,出现了显著效应:客体关系质量高的男性对移情诠释呈现出较大的负面效应,而客体关系质量低的女性对移情诠释呈现出较大的正面效应。
在症状变化方面,女性对有移情诠释的治疗反应更好,而男性对没有移情诠释的治疗反应更好。患者性别除了具有客体关系质量这一调节因素的调节效应外,还表现出调节效应。
NCT00423462。