Elkjaer Henriette, Kristensen Ellids, Mortensen Erik L, Poulsen Stig, Lau Marianne
Stolpegaard Psychotherapy Centre, Mental Health Services, Capital Region of Denmark, Gentofte, Denmark; Department of Psychology, University of Copenhagen, Denmark.
Psychol Psychother. 2014 Jun;87(2):191-208. doi: 10.1111/papt.12011. Epub 2013 Sep 7.
This randomized prospective study examines durability of improvement in general symptomatology, psychosocial functioning and interpersonal problems, and compares the long-term efficacy of analytic and systemic group psychotherapy in women 1 year after completion of treatment for childhood sexual abuse.
Women (n = 106) randomly assigned to analytic or systemic psychotherapy completed the Symptom Checklist-90-R, Global Assessment of Functioning, Global Life Quality, Registration Chart Questionnaire, and Flashback Registration at pre-treatment, post-treatment, and at a 1-year follow-up.
Post-treatment gains were significant for both treatment modalities on all measures, but significantly larger after systemic therapy. Significant treatment response was maintained 1-year post-treatment, but different trajectories were observed: 1 year after treatment completion, improvements for analytic therapy were maintained, whereas they decreased after systemic therapy, resulting in no statistically significant difference in gains between the groups at the 1-year follow-up. Despite maintaining significant gains, more than half of the patients remained above cut-off for caseness concerning general symptomatology at post-treatment and at 1-year follow-up.
The findings stress the importance of long-term follow-up data in effect studies. Different trajectories were associated with the two treatments, but improvement in the two treatment groups did not differ significantly at the 1-year follow-up. Implications of the difference in trajectories for treatment planning are discussed.
Both analytic and systemic group therapy proved efficient in improving general symptomatology, psychosocial functioning, and interpersonal problems in women with a history of CSA and gains were maintained at a 1-year follow-up. Despite maintaining statistically significant gains at the 1-year follow-up, 54% of the patients remained above the cut-off for caseness with respect to general symptomatology, which may indicate a need for further treatment. Different pre-post follow-up treatment trajectories were observed between the two treatment modalities. Thus, while systemic group therapy showed a significantly better outcome immediately after termination, gains in the systemic treatment group decreased during follow-up, while gains were maintained during follow-up in analytic group therapy.
本随机前瞻性研究考察了一般症状学、心理社会功能和人际问题改善的持续性，并比较了童年期性虐待治疗结束1年后，分析性团体心理治疗和系统性团体心理治疗对女性的长期疗效。
106名女性被随机分配至分析性心理治疗组或系统性心理治疗组，她们在治疗前、治疗后及1年随访时完成了症状自评量表-90修订版、功能总体评定量表、总体生活质量量表、登记表问卷及闪回登记表。
两种治疗方式在所有测量指标上治疗后均有显著改善，但系统性治疗后的改善幅度显著更大。治疗后1年仍维持显著的治疗反应，但观察到不同的变化轨迹：治疗结束1年后，分析性治疗的改善得以维持，而系统性治疗后的改善有所下降，导致两组在1年随访时的改善程度无统计学显著差异。尽管仍维持显著改善，但超过半数患者在治疗后及1年随访时的一般症状学方面仍高于病例临界值。
研究结果强调了疗效研究中长期随访数据的重要性。两种治疗方式呈现出不同的变化轨迹，但在1年随访时两个治疗组的改善并无显著差异。文中讨论了变化轨迹差异对治疗计划的影响。
分析性团体心理治疗和系统性团体心理治疗均被证明能有效改善有童年期性虐待史女性的一般症状学、心理社会功能和人际问题，且在1年随访时仍维持改善效果。尽管在1年随访时仍维持统计学显著改善，但54%的患者在一般症状学方面仍高于病例临界值，这可能表明需要进一步治疗。两种治疗方式观察到不同的治疗前后随访变化轨迹。因此，虽然系统性团体心理治疗在结束治疗后立即显示出显著更好的结果，但系统性治疗组在随访期间的改善有所下降，而分析性团体心理治疗在随访期间维持了改善效果。
