Department of Psychiatry, University of Rochester, Rochester, NY, United States.
J Affect Disord. 2011 May;130(3):478-82. doi: 10.1016/j.jad.2010.10.016. Epub 2010 Nov 3.
Deterioration in social functioning and depression are often intertwined, particularly for women with histories of childhood sexual abuse (CSA). Among women with CSA histories, some relationship domains may be more modifiable than others during time-limited depression treatment. Women with CSA histories often report long-standing interpersonal difficulties in close relationships. Thus, we expected that patients' relationships with immediate family and intimate partners would be less likely to improve during treatment than relationships with co-workers, friends, or extended family, unless patients received an interpersonally-focused intervention that targeted close relationships.
To examine domain-specific social functioning improvements and determine whether some domains were more likely than others to respond to an interpersonally-focused intervention, we analyzed data from a randomized controlled trial investigating Interpersonal Psychotherapy (IPT) vs. usual care (UC) in 69 depressed women with CSA histories. Participants completed the Social Adjustment Scale-SR at pretreatment, 10-, 24-, and 36-weeks.
Consistent with our hypotheses, patients reported significant improvements in work roles, leisure activities with friends, and relationships with extended family members over the course of treatment. Relationships with immediate family members and intimate partners did not improve in the overall sample. However, relationships with immediate family improved significantly more among IPT than UC patients.
The sample size is small and generalizability may be limited.
Social functioning improvements during depression treatment may be domain-specific among depressed women with CSA histories. IPT is more effective than UC at improving relationships with close family members in this population.
社会功能的恶化和抑郁常常交织在一起,尤其是对于有儿童期性虐待(CSA)史的女性。在有 CSA 病史的女性中,在限时抑郁治疗期间,某些关系领域可能比其他领域更具可改性。有 CSA 病史的女性通常报告在亲密关系中存在长期的人际困难。因此,我们预计,在治疗期间,患者与直系亲属和亲密伴侣的关系不太可能改善,除非患者接受了以亲密关系为重点的人际干预。
为了检查特定领域的社会功能改善,并确定某些领域是否比其他领域更有可能对人际为重点的干预做出反应,我们分析了一项随机对照试验的数据,该试验调查了人际心理治疗(IPT)与常规护理(UC)在 69 名有 CSA 病史的抑郁女性中的效果。参与者在治疗前、10 周、24 周和 36 周时完成了社会适应量表 - 简明版(SR)。
与我们的假设一致,患者在治疗过程中报告了工作角色、与朋友的休闲活动以及与大家庭成员的关系有显著改善。在整个样本中,与直系亲属和亲密伴侣的关系没有改善。然而,IPT 患者的直系亲属关系改善显著多于 UC 患者。
样本量较小,推广性可能有限。
在有 CSA 病史的抑郁女性中,抑郁治疗期间的社会功能改善可能是特定于领域的。IPT 在改善该人群中与近亲的关系方面比 UC 更有效。