Department of Psychology.
Gordon F. Derner School of Psychology.
Psychotherapy (Chic). 2019 Dec;56(4):514-525. doi: 10.1037/pst0000215. Epub 2019 Mar 14.
In panic-focused psychodynamic psychotherapy (PFPP), exploration and interpretation of avoided and conflicted emotions and fantasies surrounding anxiety are thought to promote panic-specific reflective functioning (PSRF), which drives panic disorder improvements. Patient emotional expression within a session may be a marker of engaged processing and experiencing of affectively charged material. Degree of in-session expressed emotion, indicating both verbal and nonverbal emotions, was examined across three early therapy sessions for prediction of subsequent outcomes. We further investigated whether personality disorder traits, theorized to relate to constricted (obsessive-compulsive) or heightened (borderline) emotions, moderated this relationship. Emotional expression in Sessions 2, 5, and 10 of a 24-session PFPP protocol was assessed by blinded observers in 44 patients randomized to PFPP in a two-site randomized controlled trial of psychotherapies for panic disorder. Robust regressions were conducted to examine the relationship between average emotional expression across the measured sessions and symptom and PSRF changes subsequent to the sampled sessions, as well as moderation by personality disorder criteria, controlling for early outcomes. Higher levels of emotional expression across the early sessions predicted greater subsequent symptom and PSRF improvement. Elevations in expression of grief/sadness drove the symptomatic finding. Patients meeting more borderline criteria experienced a smaller and potentially negative relationship between emotional expression and symptom improvement. Emotional expression in PFPP may be an indicator of positive therapy process for patients without comorbid borderline personality traits, predicting prospective improvements in both a key mediator (PSRF) and symptoms. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
在以惊恐为焦点的心理动力学心理治疗（PFPP）中，人们认为探索和解释焦虑相关的回避和冲突情绪和幻想可以促进惊恐特定的反思功能（PSRF），从而改善惊恐障碍。患者在治疗过程中的情绪表达可能是其积极参与处理和体验情绪相关材料的标志。在三个早期治疗疗程中，我们检查了疗程中的表达情绪的程度，以预测后续结果。我们进一步研究了人格障碍特征是否调节了这种关系，这些特征被认为与受限（强迫症）或增强（边缘型）情绪有关。在惊恐障碍心理治疗的两项随机对照试验中，44 名患者被随机分配到 PFPP 组，由盲法观察者在 24 次疗程的 PFPP 方案的第 2、5 和 10 次疗程中评估情绪表达。进行稳健回归分析，以检验测量疗程中情绪表达的平均值与随后采样疗程中症状和 PSRF 变化之间的关系，以及人格障碍标准的调节作用，同时控制早期结果。在早期疗程中情绪表达水平较高预示着后续症状和 PSRF 改善程度更大。悲伤/难过情绪表达的升高导致了症状方面的发现。符合更多边缘型标准的患者，情绪表达与症状改善之间的关系更小，且可能呈负面关系。PFPP 中的情绪表达可能是无共病边缘型人格障碍特征的患者积极治疗过程的指标，预测了关键中介物（PSRF）和症状的未来改善。（PsycINFO 数据库记录（c）2019 APA，保留所有权利）。
