Orfanos Stavros, Akther Syeda Ferhana, Abdul-Basit Muhammad, McCabe Rosemarie, Priebe Stefan
Unit for Social and Community Psychiatry (WHO Collaborating Centre for Mental Health Service Development), Queen Mary University of London, London, UK.
Mental Health Research Group, University of Exeter Medical School, Exeter, UK.
BMC Psychiatry. 2017 Feb 10;17(1):65. doi: 10.1186/s12888-017-1217-2.
Research has shown that interactions in group therapies for people with schizophrenia are associated with a reduction in negative symptoms. However, it is unclear which specific interactions in groups are linked with these improvements. The aims of this exploratory study were to i) develop and test the reliability of using video-annotation software to measure interactions in group therapies in schizophrenia and ii) explore the relationship between interactions in group therapies for schizophrenia with clinically relevant changes in negative symptoms.
Video-annotation software was used to annotate interactions from participants selected across nine video-recorded out-patient therapy groups (N = 81). Using the Individual Group Member Interpersonal Process Scale, interactions were coded from participants who demonstrated either a clinically significant improvement (N = 9) or no change (N = 8) in negative symptoms at the end of therapy. Interactions were measured from the first and last sessions of attendance (>25 h of therapy). Inter-rater reliability between two independent raters was measured. Binary logistic regression analysis was used to explore the association between the frequency of interactive behaviors and changes in negative symptoms, assessed using the Positive and Negative Syndrome Scale.
Of the 1275 statements that were annotated using ELAN, 1191 (93%) had sufficient audio and visual quality to be coded using the Individual Group Member Interpersonal Process Scale. Rater-agreement was high across all interaction categories (>95% average agreement). A higher frequency of self-initiated statements measured in the first session was associated with improvements in negative symptoms. The frequency of questions and giving advice measured in the first session of attendance was associated with improvements in negative symptoms; although this was only a trend.
Video-annotation software can be used to reliably identify interactive behaviors in groups for schizophrenia. The results suggest that proactive communicative gestures, as assessed by the video-analysis, predict outcomes. Future research should use this novel method in larger and clinically different samples to explore which aspects of therapy facilitate such proactive communication early on in therapy.
研究表明，精神分裂症患者的团体治疗中的互动与阴性症状的减轻有关。然而，尚不清楚团体中哪些特定互动与这些改善相关。本探索性研究的目的是：i）开发并测试使用视频注释软件测量精神分裂症团体治疗中互动的可靠性；ii）探索精神分裂症团体治疗中的互动与阴性症状的临床相关变化之间的关系。
使用视频注释软件对从九个视频记录的门诊治疗团体中选取的参与者的互动进行注释（N = 81）。使用个体团体成员人际过程量表，对在治疗结束时阴性症状有临床显著改善（N = 9）或无变化（N = 8）的参与者进行互动编码。互动是从首次和最后一次参与治疗的会话（>25小时治疗）中测量的。测量了两名独立评分者之间的评分者信度。使用二项逻辑回归分析来探索互动行为频率与阴性症状变化之间的关联，阴性症状变化使用阳性和阴性症状量表进行评估。
在使用ELAN注释的1275条陈述中，1191条（93%）具有足够的音频和视觉质量，可以使用个体团体成员人际过程量表进行编码。所有互动类别中的评分者一致性都很高（平均一致性>95%）。首次会话中自我发起陈述的频率较高与阴性症状的改善相关。首次参与治疗会话中提问和提供建议的频率与阴性症状的改善相关；尽管这只是一种趋势。
视频注释软件可用于可靠地识别精神分裂症团体中的互动行为。结果表明，通过视频分析评估的主动沟通姿态可预测治疗结果。未来的研究应在更大且临床情况不同的样本中使用这种新方法，以探索治疗的哪些方面在治疗早期促进了这种主动沟通。
