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洞察在治疗重度抑郁症的动态心理疗法中的作用机制。

Insight as a mechanism of change in dynamic therapy for major depressive disorder.

机构信息

Department of General Internal Medicine and Psychosomatics, Heidelberg University.

Department of Psychiatry, University of Pennsylvania.

出版信息

J Couns Psychol. 2021 Jul;68(4):435-445. doi: 10.1037/cou0000554. Epub 2021 May 10.

Abstract

This study aimed to investigate change in insight into maladaptive interpersonal patterns over the course of psychotherapy, as well as the specificity of insight as a change mechanism in dynamic treatments. A total of 100 patients received up to 16 sessions of either cognitive or dynamic therapy for major depressive disorder in a randomized clinical trial. Assessments of insight (Insight into Conflictual Relationship Patterns scale) and depression severity (Hamilton Depression Inventory) took place at the beginning of treatment, at month 2, and month 5. Patient insight significantly improved over the course of dynamic treatments. Gains in insight from the beginning to month 2 of treatment were a significant predictor of decreases of depressive symptoms from month 2 to month 5 of treatment in the dynamic, but not in the cognitive treatment group, despite a nonsignificant interaction. Results provide support for insight as a change factor in dynamic therapies. Better self-understanding of dysfunctional interaction patterns could help patients to find more adaptive ways of behaving, to form more satisfying relationships, and to improve their depression. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

摘要

本研究旨在探讨心理治疗过程中对适应不良人际模式的洞察力的变化,以及洞察力作为动态治疗中变化机制的特异性。在一项随机临床试验中,共有 100 名患有重度抑郁症的患者接受了最多 16 次认知或动力治疗。在治疗开始时、第 2 个月和第 5 个月对洞察力(冲突关系模式量表)和抑郁严重程度(汉密尔顿抑郁量表)进行评估。在动力治疗过程中,患者的洞察力显著提高。从治疗开始到第 2 个月的洞察力提高,是治疗第 2 个月到第 5 个月抑郁症状减轻的一个显著预测因素,但在认知治疗组中没有显著的交互作用。研究结果为洞察力作为动力治疗中的变化因素提供了支持。对功能失调的互动模式有更好的自我理解,可以帮助患者找到更适应的行为方式,形成更满意的关系,并改善他们的抑郁状况。

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The Role of Common Factors in Psychotherapy Outcomes.共同因素在心理治疗结果中的作用。
Annu Rev Clin Psychol. 2019 May 7;15:207-231. doi: 10.1146/annurev-clinpsy-050718-095424. Epub 2018 Dec 14.

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