Flückiger Christoph, Zinbarg Richard E, Znoj Hansjörg, Ackert Michael
Department of Psychology, University of Zürich.
Department of Psychology, Northwestern University.
Psychotherapy (Chic). 2014 Dec;51(4):535-545. doi: 10.1037/a0034119. Epub 2013 Dec 16.
Despite a long-standing need for patient-focused research on individuals with generalized anxiety disorder, there is little systematized knowledge about the in-session behaviors of these patients. The primary objective of this study was to describe the timing of expression of negative emotionality (level of explication) and the patients' focus on their own resources and how these indicators are associated with posttreatment outcome. Trained coders made minute-by-minute ratings of 1,100 min of video of 20 patient-therapist dialogues during Session 5. The results indicated that a higher level of explication generally observed at a later stage during the therapy sessions and the patients' focus on competencies (usually observed at an early stage) were positively associated with treatment outcome, independent of pretreatment distress, rapid response of well-being and symptom reduction, as well as the therapists' professional experience and treatment duration. However, positive reinterpretations and mentions of personal goals were negatively associated with outcome. If replicated, these results will highlight the importance of the in-session beginning phase in patients with generalized anxiety disorder.
尽管长期以来需要针对广泛性焦虑症患者开展以患者为中心的研究，但对于这些患者在治疗过程中的行为，几乎没有系统的认识。本研究的主要目的是描述负面情绪表达的时机（阐释水平）以及患者对自身资源的关注，以及这些指标与治疗后结果之间的关联。经过培训的编码员对第5次治疗期间20次患者-治疗师对话的1100分钟视频进行了逐分钟评分。结果表明，在治疗后期通常观察到较高的阐释水平，而患者对自身能力的关注（通常在早期观察到）与治疗结果呈正相关，这与治疗前的痛苦程度、幸福感的快速改善和症状减轻无关，也与治疗师的专业经验和治疗时长无关。然而，积极的重新诠释和对个人目标的提及与治疗结果呈负相关。如果这些结果得到重复验证，将凸显广泛性焦虑症患者治疗过程中起始阶段的重要性。
