Müller-Göttken Tanja, White Lars O, von Klitzing Kai, Klein Annette M
Prax Kinderpsychol Kinderpsychiatr. 2014;63(10):795-811. doi: 10.13109/prkk.2014.63.10.795.
Recent work implicates the capacity to mentalize as a predictor of therapeutic success of psychodynamically oriented psychotherapy for adults. However, little, if any, research focuses on similar associations in childhood. In the current study, we investigated the role of maternal reflective functioning (RF) in the treatment of 25 children with clinically diagnosed anxiety disorders and a high level of externalizing comorbidity in an outpatient setting. Before and after treatment of their children with short-term Psychoanalytic Child Therapy (PaCT), we assessed maternal RF using the Parent Development Interview and requested parents to report on symptoms of their 4-10-year-old children using the Child Behavior Checklist (CBCL). RF proved highly stable and showed no significant change from pre- to post-treatment over an average treatment interval of 41 weeks. While remission in internalizing symptoms was unrelated to pretreatment maternal RF, children with high-RF mothers showed significant remission of externalizing comorbidity in comparison to children with low-RF mothers both immediately after treatment as well as at six-month follow-up. These preliminary results support parental RF as a valuable prognostic criterion for successful treatment of externalizing symptoms with PaCT. These findings call for replication in large-scale follow-up studies with children diagnosed with externalizing disorders.
近期研究表明,心理化能力可作为成人心理动力学取向心理治疗成功与否的预测指标。然而,针对儿童的类似关联研究却极为稀少,即便有也寥寥无几。在本研究中,我们调查了母亲的反思功能(RF)在门诊环境中对25名临床诊断为焦虑症且具有高度外化共病的儿童治疗中的作用。在用短期儿童精神分析疗法(PaCT)治疗其子女之前和之后,我们使用《父母发展访谈》评估母亲的RF,并要求父母使用《儿童行为检查表》(CBCL)报告其4至10岁子女的症状。结果显示,RF高度稳定,在平均41周的治疗间隔内,治疗前后无显著变化。内化症状的缓解与治疗前母亲的RF无关,但与低RF母亲的孩子相比,高RF母亲的孩子在治疗后即刻以及六个月随访时,外化共病症状均有显著缓解。这些初步结果支持将父母的RF作为用PaCT成功治疗外化症状的一项有价值的预后标准。这些发现呼吁在对诊断为外化障碍的儿童进行大规模随访研究中予以重复验证。