Mattos Laurel A, Schmidt Adam T, Henderson Craig E, Hogue Aaron
Department of Psychology, Sam Houston State University.
Department of Psychological Sciences, Texas Tech University.
Psychotherapy (Chic). 2017 Jun;54(2):136-147. doi: 10.1037/pst0000093. Epub 2016 Nov 10.
Callous-unemotional (CU) traits designate a unique subset of youth with externalizing psychopathology who have a severe pattern of aggressive behavior and tend to have worse outcomes in treatment. However, little research has addressed how CU traits relate to different components of psychotherapy, such as the therapeutic alliance. The current study examined the role of CU traits in predicting therapeutic alliance in 59 adolescents (M age = 15.3, 51% female, 64% Hispanic American, 15% African American) who were part of a larger randomized naturalistic trial of outpatient behavioral psychotherapy. Multilevel regression analysis further investigated the role of therapeutic alliance in predicting treatment outcome (as measured by self-reported delinquency) and the moderating role of CU traits. Results suggested that regardless of the severity of their externalizing problems, youth with higher levels of CU traits reported more positive ratings of therapeutic alliance. In addition, a positive therapeutic alliance predicted reductions in delinquent behavior, and this association was even stronger for youth higher in CU traits. Our results suggest that CU traits are related to improvement in the formation of the therapeutic alliance among youth with externalizing psychopathology, perhaps because these youth lack many of the social and emotional deficits that other youth with conduct problems possess. Adolescents high in CU traits should not be viewed as untreatable. Indeed, the therapeutic alliance may be an important mechanism for affecting meaningful change in these adolescents' lives. (PsycINFO Database Record
冷酷无情(CU)特质指的是具有外化精神病理学特征的一类独特青少年群体,他们具有严重的攻击行为模式,且治疗效果往往较差。然而,很少有研究探讨CU特质与心理治疗的不同组成部分(如治疗联盟)之间的关系。本研究考察了CU特质在预测59名青少年(平均年龄 = 15.3岁,51%为女性,64%为西班牙裔美国人,15%为非裔美国人)治疗联盟中的作用,这些青少年是一项更大规模的门诊行为心理治疗随机自然主义试验的一部分。多层次回归分析进一步考察了治疗联盟在预测治疗结果(通过自我报告的犯罪行为衡量)中的作用以及CU特质的调节作用。结果表明,无论其外化问题的严重程度如何,CU特质水平较高的青少年对治疗联盟的评价更为积极。此外,积极的治疗联盟可预测犯罪行为的减少,且这种关联在CU特质较高的青少年中更强。我们的结果表明,CU特质与具有外化精神病理学特征的青少年治疗联盟形成的改善有关,这可能是因为这些青少年缺乏许多其他有品行问题的青少年所具有的社会和情感缺陷。CU特质高的青少年不应被视为无法治疗。事实上,治疗联盟可能是影响这些青少年生活中产生有意义变化的重要机制。(《心理学文摘数据库记录》