Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA.
Am J Addict. 2011 Nov-Dec;20(6):555-62. doi: 10.1111/j.1521-0391.2011.00174.x. Epub 2011 Oct 4.
Although therapeutic community (TC) treatment is a promising intervention for substance use disorders, a primary obstacle to successful treatment is premature attrition. Because of their prevalence within substance use treatment facilities, personality disorder (PD) diagnoses have been examined as predictors of treatment completion. Prior research on TC outcomes has focused almost exclusively on antisocial personality disorder (ASPD), and the results have been mixed. This study extends previous research by examining the impact of the 10 Axis II PDs on early (first 30 days) attrition as well as overall time to dropout in a 9-month residential TC. Survival analyses indicated that borderline was the only PD negatively related to overall program retention. In contrast, ASPD, as well as histrionic PD, were related to very early attrition, but not to overall program retention. Early assessment and identification of at-risk individuals may improve treatment retention and outcome for TC treatment.
尽管治疗性社区（TC）治疗是一种有前途的物质使用障碍干预措施，但治疗成功的主要障碍是过早退出。由于人格障碍（PD）诊断在物质使用治疗设施中很常见，因此已将其作为治疗完成的预测因素进行了检查。关于 TC 结果的先前研究几乎完全集中在反社会人格障碍（ASPD）上，结果喜忧参半。本研究通过在为期 9 个月的住院 TC 中检查 10 个轴 II PD 对早期（前 30 天）退出率以及总体辍学时间的影响，扩展了先前的研究。生存分析表明，边缘型是唯一与整体项目保留呈负相关的 PD。相比之下，ASPD 以及戏剧型 PD 与早期退出有关，但与整体项目保留无关。早期评估和识别高危个体可能会提高 TC 治疗的保留率和结果。
