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团体认知人际治疗(MIT-G)治疗人格障碍的年轻成年人:一项先导随机对照试验。

Metacognitive Interpersonal Therapy in group (MIT-G) for young adults with personality disorders: A pilot randomized controlled trial.

机构信息

Centro di Terapia Metacognitiva Interpersonale, Rome, Italy.

Studi Cognitivi Modena, Italy.

出版信息

Psychol Psychother. 2019 Sep;92(3):342-358. doi: 10.1111/papt.12182. Epub 2018 Apr 6.

DOI:10.1111/papt.12182
PMID:29624832
Abstract

Young adults with personality disorders (PD) other than borderline are in urgent need of validated treatments to help them in managing important life transitions. Therapeutic interventions focused upon social and interpersonal difficulties may facilitate these individuals in maximizing opportunities for employment, forming stable romantic relationships, and belong to social groups. It is also important that they are offered evidence-based, first-line time-limited treatments in order to maximize effectiveness and reduce costs. We developed a 16-session programme of group-based Metacognitive Interpersonal Therapy (MIT-G) including psychoeducation on the main interpersonal motives, an experiential component enabling practice of awareness of mental states; and use of mentalistic knowledge for purposeful problem-solving. We report a feasibility, acceptability, and clinical significance randomized clinical trial. Participants meeting inclusion criteria were randomized to receive MIT-G (n = 10) or waiting list+TAU (n = 10). Dropout rate was low and session attendance high (92.19%). Participants in the MIT-G arm had symptomatic and functional improvements consistent with large effect sizes. In the MIT-G arm similarly large effects were noted for increased capacity to understand mental states and regulate social interactions using mentalistic knowledge. Results were sustained at follow-up. Our findings suggest potential for applying MIT-G in larger samples to further test its effectiveness in reducing PD-related symptoms and problematic social functioning.

摘要

除边缘型外,其他人格障碍的年轻患者迫切需要经过验证的治疗方法,以帮助他们应对重要的生活转变。以社会和人际困难为重点的治疗干预措施可能会帮助这些人最大限度地利用就业、形成稳定的恋爱关系和融入社会团体的机会。为了提高疗效和降低成本,为他们提供基于证据的一线限时治疗也很重要。我们开发了一个 16 节的基于团体的元认知人际治疗(MIT-G)方案,包括主要人际动机的心理教育、体验式组件,使他们能够练习意识心理状态;并利用心理知识有针对性地解决问题。我们报告了一项可行性、可接受性和临床意义的随机临床试验。符合纳入标准的参与者被随机分配到接受 MIT-G(n=10)或等待名单+TAU(n=10)。脱落率低,出席率高(92.19%)。MIT-G 组的参与者的症状和功能均有改善,效果显著。在 MIT-G 组中,使用心理知识理解心理状态和调节社会互动的能力也有类似的显著提高。随访结果也保持不变。我们的研究结果表明,在更大的样本中应用 MIT-G 可能具有潜在的有效性,可以进一步测试它在减少与人格障碍相关的症状和社会功能障碍方面的效果。

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