Department of Psychology, Pennsylvania State University, PA, USA.
J Consult Clin Psychol. 2011 Aug;79(4):552-63. doi: 10.1037/a0024069.
The present article aimed to demonstrate that the establishment of dynamic patterns during the course of psychotherapy can create attractor states for continued adaptive change following the conclusion of treatment.
This study is a secondary analysis of T. D. Borkovec and E. Costello (1993). Of the 55 participants in the original study, 33 were retained for the present analysis due to the homogeneity of psychotherapy outcome among these participants. Of these 33, the majority were White (88%) and female (70%), and the average age was 35.44 years (SD = 14.46). Participants participated in 12 weeks of either cognitive behavioral therapy or applied relaxation. Daily diary entries from the treatment period were subjected to time series analyses in order to determine the degree of order versus disorder present within individual dynamic systems. These idiographic data were then aggregated for nomothetic analysis of treatment outcome via linear mixed effect models.
Spectral power due to daily to intradaily oscillations in thrice-daily diary data significantly moderated reliable change over posttreatment follow-up such that lesser power predicted increases in reliable change over the 1-year follow-up period. Additionally, residual variance for dynamic factor models significantly moderated the slope for change over the follow-up period, such that lesser variance--and thus greater order in dynamic systems--predicted increases in reliable change.
The degree of order in dynamic systems established during therapy acted as an adaptive attractor state, promoting continued positive gains 1 year after the conclusion of therapy. The present study represents an important innovation in the study of dynamic systems in psychotherapy.
本文旨在证明心理治疗过程中动态模式的建立可以为治疗结束后持续的适应性变化创造吸引状态。
本研究是对 T.D. Borkovec 和 E. Costello(1993 年)的二次分析。在最初的研究中,共有 55 名参与者,由于这些参与者的心理治疗结果具有同质性,因此保留了其中的 33 名参与者进行本分析。在这 33 名参与者中,大多数为白人(88%)和女性(70%),平均年龄为 35.44 岁(SD=14.46)。参与者参加了 12 周的认知行为疗法或应用放松疗法。从治疗期间的每日日记条目进行时间序列分析,以确定个体动态系统中存在的秩序与无序程度。这些个体数据随后通过线性混合效应模型汇总为治疗结果的Nomothetic 分析。
三次每日日记数据中每日到日内波动的频谱功率显著调节了治疗后随访中的可靠变化,即较小的功率预测在 1 年随访期间可靠变化的增加。此外,动态因素模型的剩余方差显著调节了随访期间的变化斜率,即较小的方差——以及动态系统中的更大秩序——预测可靠变化的增加。
治疗期间建立的动态系统的有序程度充当了适应性吸引状态,促进了治疗结束后 1 年持续的积极收益。本研究代表了心理治疗中动态系统研究的一个重要创新。