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精神分裂型人格障碍的评估和治疗计划:一种元认知导向的观点。

Assessment and treatment planning for schizotypal personality disorder: A metacognitively oriented point of view.

机构信息

School of Education Science.

出版信息

Psychiatr Rehabil J. 2020 Dec;43(4):335-343. doi: 10.1037/prj0000429. Epub 2020 May 28.

Abstract

OBJECTIVE

The aim of this study was to pilot test a novel assessment and treatment plan for patients with a schizotypal personality disorder by integrating the (5th ed.) alternative model of personality disorders, metacognitively oriented psychotherapies, and recovery approaches.

METHOD

I recruited 12 patients diagnosed with schizotypal personality disorder. I report results from the global assessment including measures on symptoms, maladaptive traits, Big Five personality traits, schizophrenia proneness, and metacognition. I also describe how I planned treatment to promote an individualized understanding of a person's agenda and recovery. The treatment plans were also evaluated through in-depth qualitative interviews at the end of the intervention. Interviews were analyzed through a phenomenological framework and a computer-aided qualitative analysis software.

RESULTS

Assessment results and qualitative interviews highlight the importance of a multilevel, progressive treatment plan aimed at considering the personality functioning from a recovery-oriented, nonpathologizing approach. On 1 hand, an assessment that focuses on both healthy and maladaptive traits fosters a progressive redefinition of the therapeutic agenda. On the other hand, a constant and recursive evaluation of metacognition and personality traits offers a treatment strategy that supports my core assumption that recovery from schizotypal personality disorder is possible.

CONCLUSIONS AND IMPLICATIONS FOR PRACTICE

A twofold focus on personality traits and metacognition seems to represent a viable strategy for treating patients with schizotypal personality disorder. A metacognitively oriented rehabilitation may be a flexible, personalized and effective approach toward recovery. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

摘要

目的

本研究旨在通过整合(第 5 版)人格障碍替代模型、元认知导向心理治疗和康复方法,对分裂型人格障碍患者进行新型评估和治疗计划的试点测试。

方法

我招募了 12 名被诊断为分裂型人格障碍的患者。我报告了包括症状、适应不良特征、大五人格特质、精神分裂症倾向和元认知在内的整体评估结果。我还描述了如何计划治疗以促进对个人议程和康复的个性化理解。治疗计划也通过干预结束时的深入定性访谈进行了评估。访谈通过现象学框架和计算机辅助定性分析软件进行了分析。

结果

评估结果和定性访谈强调了多层次、渐进式治疗计划的重要性,该计划旨在从康复为导向、非病理化的方法考虑人格功能。一方面,既关注健康特征又关注适应不良特征的评估促进了治疗议程的逐步重新定义。另一方面,对元认知和人格特征的持续和递归评估提供了一种治疗策略,支持我关于从分裂型人格障碍中康复是可能的核心假设。

结论和对实践的启示

对人格特征和元认知的双重关注似乎是治疗分裂型人格障碍患者的可行策略。元认知导向的康复可能是一种灵活、个性化和有效的康复方法。(PsycInfo 数据库记录(c)2020 APA,保留所有权利)。

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