Universitätsklinikum Jena, Institute of Psychosocial Medicine and Psychotherapy, Stoystr. 3, 07740 Jena Germany.
Technische Universität Dresden, Institute of Clinical Psychology and Psychotherapy, Hohe Straße 53, 01187 Dresden Germany.
J Anxiety Disord. 2020 Apr;71:102200. doi: 10.1016/j.janxdis.2020.102200. Epub 2020 Feb 22.
The use of trajectories and analysis of change patterns is a promising way toward better differentiation of subgroups in psychotherapy studies. Research on change patterns in social anxiety disorder (SAD) are still rare, although SAD is one of the most common mental disorders. In a secondary analysis of data from the SOPHO-NET-trial (ISRCTN53517394) this study aimed to investigate change patterns and their predictors in a sample of SAD patients.
Patients with SAD (N = 357) were randomly assigned to cognitive-behavioral or psychodynamic therapy. The Liebowitz Social Anxiety Scale (LSAS) was assessed at 1 session (pre), 8th session, 15th session and at the end of treatment (post). We used latent state variables and latent class analysis for the classification of change patterns and logistic regression for the identification of different predictors.
Analyses revealed three typical patterns: (i.) responders with a high initial impairment (N = 57), (ii.) responders with a moderate initial impairment (N = 225), and (iii.) patients with a high initial impairment and no remission (N = 75). Among other significant predicators, patient´s attachment anxiety and therapeutic alliance at session eight contributed to the prediction of change patterns.
Psychotherapy of SAD should consider patient's attachment and focus on the establishment of a solid therapeutic alliance in an early therapy stage.
轨迹的使用和变化模式的分析是一种有前途的方法，可以在心理治疗研究中更好地区分亚组。尽管社交焦虑障碍（SAD）是最常见的精神障碍之一，但关于 SAD 的变化模式的研究仍然很少。在 SOPHO-NET 试验（ISRCTN53517394）的数据的二次分析中，本研究旨在调查 SAD 患者样本中的变化模式及其预测因素。
SAD 患者（N=357）被随机分配到认知行为或心理动力学治疗。在 1 次会议（预）、第 8 次会议、第 15 次会议和治疗结束时（后）评估 Liebowitz 社交焦虑量表（LSAS）。我们使用潜在状态变量和潜在类别分析对变化模式进行分类，并使用逻辑回归对不同的预测因素进行识别。
分析显示了三种典型模式：（i.）初始损伤较高的反应者（N=57），（ii.）初始损伤中等的反应者（N=225），和（iii.）初始损伤高且无缓解的患者（N=75）。其他重要的预测因素包括患者的依恋焦虑和第 8 次会议的治疗联盟，这些因素有助于预测变化模式。
SAD 的心理治疗应考虑患者的依恋，并在早期治疗阶段注重建立稳固的治疗联盟。
