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评估结构化评估和退伍军人自杀聚焦团体治疗的中介因素:最近从住院精神病学出院。

Evaluation of Structured Assessment and Mediating Factors of Suicide-Focused Group Therapy for Veterans Recently Discharged from Inpatient Psychiatry.

出版信息

Arch Suicide Res. 2019 Jan-Mar;23(1):15-33. doi: 10.1080/13811118.2017.1402722. Epub 2018 Feb 20.

DOI:10.1080/13811118.2017.1402722
PMID:29220609
Abstract

The current study investigated the impact of adding the Suicide Status Form (SSF) to a suicide-focused group therapy for veterans recently discharged from an inpatient psychiatry setting. A sample of 141 veterans was enrolled and randomized into a Usual Assessment Group Therapy or SSF-Assessment Group Therapy. Participants completed interviews at baseline, 1, and 3 months. No significant differences were observed between groups regarding group attendance (IRR = 1.01, Std. Err = 0.08, 95% CI = 0.87, 1.18) or client satisfaction (β = 0.23, Std. Err = 0.66, p = 0.73, d = -.25). No main effects were observed across the study on secondary outcomes of interest for suicidal ideation and overall symptom distress, although participants in both treatment conditions reported significant improvements on these outcomes over the course of the study. Patients in the Usual Assessment Group Therapy demonstrated greater reductions in overall symptom distress across the 3-month follow-up window (β = 6.08, Std. Err = 2.04, p = 0.003; f = 0.05). Follow-up path analyses revealed that more frequent session attendance was significantly related to less suicidal ideation at 1-month, higher working alliance between individual members and group facilitators was associated with greater suicidal ideation at 1-month, and higher group cohesion among group members at 1-month was significantly associated with less thwarted belongingness at 1-month. Although the SSF did not improve the impact of an existing suicide-focused group therapy, the study findings support future research on group treatments for suicidal veterans.

摘要

本研究调查了在最近从住院精神病学环境出院的退伍军人中,将自杀状况表(SSF)添加到以自杀为重点的小组治疗中对其的影响。招募了 141 名退伍军人并将其随机分为常规评估小组治疗或 SSF-评估小组治疗。参与者在基线、1 个月和 3 个月时完成了访谈。两组在小组出勤率(IRR=1.01,Std. Err=0.08,95%CI=0.87,1.18)或客户满意度(β=0.23,Std. Err=0.66,p=0.73,d=-.25)方面没有观察到显著差异。在自杀意念和总体症状困扰等次要结果上,研究过程中没有观察到主要效果,尽管两种治疗条件的参与者在研究过程中报告了这些结果的显著改善。在 3 个月的随访窗口中,常规评估组治疗中的患者在总体症状困扰方面的降低幅度更大(β=6.08,Std. Err=2.04,p=0.003;f=0.05)。随访路径分析显示,更频繁的小组出勤率与 1 个月时的自杀意念减少显著相关,小组成员与小组治疗师之间的工作联盟更高与 1 个月时的自杀意念增加相关,小组成员之间的小组凝聚力更高与 1 个月时的挫败感归属感降低显著相关。尽管 SSF 并没有改善现有的以自杀为重点的小组治疗的效果,但研究结果支持对有自杀倾向的退伍军人进行小组治疗的未来研究。

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