心理治疗中依恋表征的变化：反思功能是关键因素吗？
Changes in Attachment Representation in Psychotherapy: Is Reflective Functioning the Crucial Factor?
作者信息
Tmej Anna, Fischer-Kern Melitta, Doering Stephan, Alexopoulos Johanna, Buchheim Anna
机构信息
Department of Psychoanalysis and Psychotherapy Medical University of Vienna Währinger Gürtel 18-20, A-1090 Wien Austria Department of Psychoanalysis and Psychotherapy,Medical University of Vienna.
Institute of Psychology University of Innsbruck Austria Institute of Psychology, University of Innsbruck.
出版信息
Z Psychosom Med Psychother. 2018 Sep;64(3):222-236. doi: 10.13109/zptm.2018.64.3.222.
OBJECTIVES
The study analyzed the interdependence of change in attachment representation and reflective functioning (RF) in psychotherapy.
METHODS
RF data from 63 female borderline personality disorder (BPD) patients were analyzed with respect to change of attachment representation (from insecure to secure and from unresolved to resolved) fromthree angles: (1) RF as a moderator variable, (2) RF as an outcome variable, and (3) RF changes over one year of treatment.
RESULTS
Patients who changed to a resolved attachment classification showed higher RF before treatment and at follow-up than patients who remained unresolved (RF = 3.0 vs. RF = 2.14, p = 0.039; and RF = 3.4 vs. RF = 2.36, p = 0.002). Similar results were found for changes from insecure to secure.
CONCLUSION
A higher RF level before psychotherapy proved to be a moderator for change in attachment representation. Patients with unresolved attachment and low-level RF at the outset had the least chance for representational change during the first year of psychotherapy.
目的
本研究分析了心理治疗中依恋表征变化与反思功能（RF）之间的相互依存关系。
方法
从三个角度分析了63名女性边缘型人格障碍（BPD）患者的RF数据，这些数据涉及依恋表征的变化（从不安全到安全，从未解决到已解决）：（1）RF作为调节变量；（2）RF作为结果变量；（3）治疗一年期间的RF变化。
结果
与未解决依恋问题的患者相比，转变为已解决依恋分类的患者在治疗前和随访时的RF更高（RF = 3.0对RF = 2.14，p = 0.039；RF = 3.4对RF = 2.36，p = 0.002）。从不安全依恋转变为安全依恋也发现了类似结果。
结论
心理治疗前较高的RF水平被证明是依恋表征变化的调节因素。在心理治疗的第一年，最初未解决依恋问题且RF水平较低的患者发生表征变化的机会最少。
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