Ferkauf Graduate School of Psychology, Yeshiva University, New York, NY.
Department of Psychiatry, University of British Columbia, Vancouver, Canada.
J Clin Psychol. 2019 Dec;75(12):2079-2094. doi: 10.1002/jclp.22832. Epub 2019 Jul 23.
We aimed to investigate change in self-esteem through intensive group treatment for personality dysfunction, by exploring: (a) the relationship between patients' experience of therapeutic alliance and improvement in self-esteem during treatment, including patients' quality of object-relations (QOR) as a possible moderator; and (b) the association between improvement in self-esteem during treatment, and depressive symptoms 9 months later.
Eighty patients with personality dysfunction, consecutively enrolled in a group-oriented treatment program, were assessed at pretreatment, posttreatment, and 9 months follow-up.
Especially for patients with lower QOR, alliance predicted self-esteem change during treatment. In addition, change in self-esteem during treatment predicted follow-up depression severity, even when controlling for within-treatment symptom change.
Patients with impoverished inner relational representations may benefit more from a secure alliance in terms of improving their self-esteem. Change in self-esteem may also be important in preventing relapse of depressive symptoms in people with personality dysfunction.
通过强化团体治疗人格障碍来探究自尊的变化，我们旨在探索：(a)患者对治疗联盟的体验与治疗过程中自尊改善之间的关系，包括患者的客体关系质量(QOR)作为可能的调节因素；以及(b)治疗过程中自尊的改善与 9 个月后抑郁症状之间的关联。
80 名人格障碍患者连续入组参加团体导向治疗项目，在治疗前、治疗后和 9 个月随访时进行评估。
特别是对于 QOR 较低的患者，联盟预测了治疗过程中自尊的变化。此外，即使在控制治疗内症状变化的情况下，治疗过程中自尊的变化也可以预测随访时的抑郁严重程度。
内心关系表现贫乏的患者可能会从安全的联盟中更受益于自尊的改善。人格障碍患者自尊的变化对于预防抑郁症状的复发也可能很重要。
