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惊恐障碍患者对惊恐控制治疗和以惊恐为焦点的心理动力学心理治疗的偏好——谁选择哪种治疗以及为什么?

Preferences for panic control treatment and panic focused psychodynamic psychotherapy for panic disorder - who chooses which and why?

机构信息

Department of Psychology, Lund University, Lund, Sweden.

出版信息

Psychother Res. 2021 Jun;31(5):644-655. doi: 10.1080/10503307.2020.1839686. Epub 2020 Nov 5.

Abstract

Few studies have examined factors associated with patient's choice of particular psychological treatments. The present study explores possible associations to, and the reasons given for, patient's choice of Panic Control Treatment (PCT) or Panic-Focused Psychodynamic Psychotherapy (PFPP) for Panic Disorder with or without Agoraphobia (PD/A). Both quantitative and qualitative analyses were applied to data obtained from 109 adults with PD/A who were randomized to the Choice condition in the doubly randomized controlled preference trial from which this data are drawn. The strongest associations were between treatment credibility ratings and the treatment choice ( = -1.00 and 1.31,  < .01, for PCT and PFPP respectively). Treatment choice was also moderately associated with patient characteristics, treatment helpfulness beliefs, and learning style. Qualitative analysis revealed that patients gave contrasting reasons for their treatment choice; either a focus on the present, symptom reduction and problem-solving for those who chose PCT or a focus on the past, symptom understanding and reflection for those who chose PFPP. When offered a choice between two evidence-based psychotherapies for PD/A, the resulting choice was primarily a function of the patient's beliefs about the chosen therapy, its potential for success, and their preferred learning style.

摘要

很少有研究探讨过与患者选择特定心理治疗相关的因素。本研究探讨了惊恐障碍伴或不伴广场恐怖症(PD/A)患者选择惊恐控制治疗(PCT)或惊恐聚焦心理动力学心理治疗(PFPP)的可能关联及其原因。本研究对来自这项数据的双随机对照偏好试验中选择条件的 109 名 PD/A 成年人的数据进行了定量和定性分析。治疗可信度评分与治疗选择之间存在最强关联(PCT 和 PFPP 分别为-1.00 和 1.31, < .01)。治疗选择也与患者特征、治疗效果信念和学习风格中度相关。定性分析显示,患者对治疗选择有不同的理由;选择 PCT 的患者更关注当下、症状减轻和解决问题,而选择 PFPP 的患者则更关注过去、症状理解和反思。当在两种针对 PD/A 的循证心理治疗之间进行选择时,选择的结果主要取决于患者对所选治疗的信念、其成功的可能性以及他们首选的学习风格。

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