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评估重度分离性障碍患者的治疗变化:治疗进展问卷、治疗师及患者测量方法

Assessing therapeutic change in patients with severe dissociative disorders: the progress in treatment questionnaire, therapist and patient measures.

作者信息

Schielke Hugo, Brand Bethany, Marsic Angelika

机构信息

Psychology Department, California Department of State Hospitals, Napa, CA, USA.

Psychology Department, Towson University, Towson, MD, USA.

出版信息

Eur J Psychotraumatol. 2017 Oct 13;8(1):1380471. doi: 10.1080/20008198.2017.1380471. eCollection 2017.

Abstract

: Treatment research for dissociative identity disorder (DID) and closely related severe dissociative disorders (DD) is rare, and has been made more difficult by the lack of a reliable, valid measure for assessing treatment progress in these populations. : This paper presents psychometric data for therapist and patient report measures developed to evaluate therapeutic progress and outcomes for individuals with DID and other DD: the Progress in Treatment Questionnaire - Therapist (PITQ-t; a therapist report measure) and the Progress in Treatment Questionnaire - Patient (PITQ-p; a patient self-report measure). : We examined the data of 177 patient-therapist pairs (total = 354) participating in the TOP DD Network Study, an online psychoeducation programme aimed at helping patients with DD establish safety, regulate emotions, and manage dissociative and posttraumatic symptoms. : The PITQ-t and PITQ-p demonstrated good internal consistency and evidence of moderate convergent validity in relation to established measures of emotional dysregulation, dissociation, posttraumatic stress disorder, and psychological quality of life, which are characteristic difficulties for DD patients. The measures also demonstrated significant relationships in the hypothesized directions with positive emotions, social relations, and self-harm and dangerous behaviours. The patient-completed PITQ-p, which may be used as an ongoing assessment measure to guide treatment planning, demonstrated evidence of stronger relationships with established symptom measures than the PITQ-t. : The PITQ-t and PITQ-p merit use, additional research, and refinement in relation to the assessment of therapeutic progress with patients with DD.

摘要

分离性身份障碍(DID)及密切相关的严重分离性障碍(DD)的治疗研究很少见,而且由于缺乏一种可靠、有效的测量方法来评估这些人群的治疗进展,使得研究变得更加困难。本文介绍了为评估DID和其他DD患者的治疗进展及结果而开发的治疗师和患者报告测量工具的心理测量数据:治疗进展问卷 - 治疗师版(PITQ-t;一种治疗师报告测量工具)和治疗进展问卷 - 患者版(PITQ-p;一种患者自我报告测量工具)。我们研究了参与TOP DD网络研究的177对患者 - 治疗师的数据(共354人),该网络研究是一个在线心理教育项目,旨在帮助DD患者建立安全感、调节情绪以及管理分离性症状和创伤后症状。PITQ-t和PITQ-p表现出良好的内部一致性,并且在与情绪失调、分离、创伤后应激障碍以及心理生活质量的既定测量方法相关方面,有中度收敛效度的证据,这些都是DD患者的典型困难。这些测量工具还在假设的方向上与积极情绪、社会关系以及自我伤害和危险行为表现出显著关系。患者完成的PITQ-p可作为一种持续的评估工具来指导治疗计划,与PITQ-t相比,它与既定症状测量方法的关系更强。PITQ-t和PITQ-p在评估DD患者的治疗进展方面值得使用、进一步研究和完善。

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