Department of Educational and Counselling Psychology, McGill University, Montreal, QC, Canada.
Department of Clinical Psychology, University of Calgary, Calgary, AB, Canada.
Psychother Res. 2020 Feb;30(2):170-182. doi: 10.1080/10503307.2018.1543976. Epub 2018 Nov 13.
Individuals' use of self-statements reflecting self-criticism, a sense of inadequacy, and low self-worth has been linked to the incidence, severity, and recurrence of major depressive disorder [de Graaf, L. E., Huibers, M. J. H., Cuijpers, P., & Arntz, A. (2010). Minor and major depression in the general population: Does dysfunctional thinking play a role? , (3), 266-274. doi:10.1016/j.comppsych.2009.08.006; Riso, L. P., du Toit, P. L., Blandino, J. A., Penna, S., Dacey, S., Duin, J. S., … Ulmer, C. S. (2003). Cognitive aspects of chronic depression. , (1), 72-80. doi:10.1037/0021-843X.112.1.72]. The present study used an observer-rated measure, the Structural Analysis of Social Behavior [Benjamin, L. S. (1974). Structural Analysis of Social Behavior. , (5), 392-425. doi:10.1037/h0037024], to examine patients' self-directed communication over the course of psychotherapy. Self-talk in early and late therapy sessions was examined using cases ( = 44) from the cognitive therapy arm of Jacobson and colleagues' component study of cognitive therapy for depression [Jacobson, N. S., Dobson, K. S., Truax, P. A., Addis, M. E., Koerner, K., Gollan, J. K., … Prince, S. E. (1996). A component analysis of cognitive-behavioral treatment for depression. , (2), 295-304. doi:10.1037/0022-006x.64.2.295, Jacobson, N. S., Dobson, K. S., Truax, P. A., Addis, M. E., Koerner, K., Gollan, J. K., … Prince, S. E. (2000). A component analysis of cognitive-behavioral treatment for depression. , (1). doi:10.1037/1522-3736.3.1.323a]. We identified changes at treatment termination, and used hierarchical multiple regression to examine whether improvements in patient self-talk influenced treatment outcome up to 24 months post-termination. Trends indicate that patients used friendlier and less critical self-statements at the end of treatment. Decreased self-critical behaviour was associated with fewer symptoms at the end of treatment and up to one year later; increased self-acceptance was linked to symptom improvement a year and a half after termination. Consistent with cognitive theory, reduced self-criticism was associated with better treatment outcomes. Longer-term improvement was linked to the development of friendlier and more accepting self-referential behaviour.
个体使用反映自我批评、不称职感和低自尊的自我陈述与重度抑郁症的发生率、严重程度和复发有关[de Graaf，L. E.，Huibers，M. J. H.，Cuijpers，P.，& Arntz，A.（2010）。一般人群中的轻度和重度抑郁症：思维功能障碍是否起作用？，（3），266-274。doi：10.1016/j.comppsych.2009.08.006；Riso，L. P.，du Toit，P. L.，Blandino，J. A.，Penna，S.，Dacey，S.，Duin，J. S.， … Ulmer，C. S.（2003）。慢性抑郁症的认知方面。，（1），72-80。doi：10.1037/0021-843X.112.1.72]。本研究使用了一种观察者评定的测量方法，即结构分析社会行为[Benjamin，L. S.（1974）。社会行为的结构分析。，（5），392-425。doi：10.1037/h0037024]，来检查患者在心理治疗过程中的自我导向沟通。使用雅各布森和同事的认知治疗成分研究中的认知治疗臂的病例（ = 44）来检查早期和晚期治疗阶段的自我谈话[Jacobson，N. S.，Dobson，K. S.，Truax，P. A.，Addis，M. E.，Koerner，K.，Gollan，J. K.， … Prince，S. E.（1996）。认知行为治疗抑郁症的成分分析。，（2），295-304。doi：10.1037/0022-006x.64.2.295，Jacobson，N. S.，Dobson，K. S.，Truax，P. A.，Addis，M. E.，Koerner，K.，Gollan，J. K.， … Prince，S. E.（2000）。认知行为治疗抑郁症的成分分析。，（1）。doi：10.1037/1522-3736.3.1.323a]。我们确定了治疗结束时的变化，并使用分层多元回归来检查患者自我谈话的改善是否会影响治疗结束后 24 个月的治疗结果。趋势表明，患者在治疗结束时使用更友好、批评性更小的自我陈述。自我批评行为的减少与治疗结束时和一年后症状减少有关；自我接受度的增加与治疗结束一年半后症状的改善有关。与认知理论一致，减少自我批评与更好的治疗结果有关。长期改善与更友好和更接受自我参照行为的发展有关。
