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分离性障碍患者治疗的六年随访研究

Six-year follow-up of the treatment of patients with dissociative disorders study.

作者信息

Myrick Amie C, Webermann Aliya R, Loewenstein Richard J, Lanius Ruth, Putnam Frank W, Brand Bethany L

机构信息

Family & Children's Services, Bel Air, MD, USA.

University of Maryland, Baltimore County, Catonsville, MD, USA.

出版信息

Eur J Psychotraumatol. 2017 Jun 28;8(1):1344080. doi: 10.1080/20008198.2017.1344080. eCollection 2017.

Abstract

: Literature on the treatment of dissociative disorders (DDs) suggests that these individuals require long-term and specialized treatment to achieve stabilization and functionality. There is considerable empirical support for specialized phasic, dissociation-focused treatment in reducing a myriad of psychological symptoms and self-harm in this population. However, until recently, there has been a paucity of longitudinal treatment research on DD patients. : In the present six-year follow-up study, 61 therapists who participated in the initial phase of the Treatment of Patients with Dissociative Disorders (TOP DD) study answered questionnaires about their study patient's stressors, quality of life, global functioning, victimization, and safety. These results provided a view of patients' progress six years since the beginning of the TOP DD study. : Longitudinal analyses demonstrated patients had significantly fewer stressors ( (6) = 18.76, < .01, canonical = .48,  = 76), instances of sexual revictimization ((1) = 107.05,  < .001) and psychiatric hospitalizations ((54) = 2.57,  < .05, Cohen's  = .43), as well as higher global functioning ( (2) = 59.27, < .001, canonical = .65,  = 111). : These findings continue to support the initial results of the TOP DD study that, despite marked initial difficulties and functional impairment, DD patients benefit from specialized treatment.

摘要

关于分离性障碍(DDs)治疗的文献表明,这些个体需要长期且专门的治疗才能实现病情稳定并恢复正常功能。有大量实证支持针对分离性障碍的专门阶段性治疗,这种治疗能减轻该人群的多种心理症状和自我伤害行为。然而,直到最近,针对DD患者的纵向治疗研究仍很匮乏。

在当前这项为期六年的随访研究中,参与分离性障碍患者治疗(TOP DD)研究初始阶段的61名治疗师回答了关于他们研究患者的压力源、生活质量、整体功能、受害情况和安全性的问卷。这些结果展现了自TOP DD研究开始六年后患者的进展情况。

纵向分析表明,患者的压力源显著减少(χ²(6)=18.76,p<.01,典型相关系数=.48,n=76),性再受害事件(χ²(1)=107.05,p<.001)和精神病住院次数(χ²(54)=2.57,p<.05,科恩d=.43)也显著减少,同时整体功能有所提高(χ²(2)=59.27,p<.001,典型相关系数=.65,n=111)。

这些发现继续支持TOP DD研究的初步结果,即尽管初始存在明显困难和功能损害,但DD患者能从专门治疗中获益。

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