Kaiser Julia, Treml Julia, Hoffmann Rahel, Linde Katja, Nagl Michaela, Kersting Anette
University of Leipzig.
University of Leipzig.
Behav Ther. 2023 Jan;54(1):119-131. doi: 10.1016/j.beth.2022.07.008. Epub 2022 Aug 2.
Internet-based psychological interventions have proven effective in the treatment of prolonged grief disorder (PGD). Yet, some patients do not benefit from treatment in a clinically significant way. We aimed to examine predictors of symptom reduction in an Internet-based intervention for PGD after cancer bereavement, in order to identify possible treatment mechanisms and discern directions for future intervention design. A secondary analysis of data from a randomized wait-list controlled trial on an Internet-based intervention for PGD after cancer bereavement was conducted. Multiple regression models were used (1) to test for the influence of pretreatment PGD, working alliance, avoidance and gender on PGD symptom reduction; and (2) to explore further predictors of treatment success with a best subset selection protocol. The regression models explained 18% (Model 1) and 34% (Model 2) of variance in symptom reduction. Participants with more favorable symptom change had more severe pretreatment PGD scores and better working alliance. Those with lower social support and less posttraumatic growth experienced more PGD symptom change. In conclusion, therapeutic alliance is an important factor that should be monitored and fostered. Findings regarding social support and posttraumatic growth need further replication and clarification.
基于互联网的心理干预已被证明对治疗持续性悲伤障碍（PGD）有效。然而，一些患者并未从治疗中获得具有临床意义的益处。我们旨在研究癌症丧亲后基于互联网的PGD干预中症状减轻的预测因素，以确定可能的治疗机制并为未来干预设计指明方向。对一项关于癌症丧亲后基于互联网的PGD干预的随机等待列表对照试验的数据进行了二次分析。使用多元回归模型：（1）测试治疗前PGD、工作联盟、回避和性别对PGD症状减轻的影响；（2）采用最佳子集选择方案进一步探索治疗成功的预测因素。回归模型解释了症状减轻方差的18%（模型1）和34%（模型2）。症状变化更有利的参与者治疗前PGD评分更高，工作联盟更好。社会支持较低且创伤后成长较少的参与者PGD症状变化更大。总之，治疗联盟是一个应予以监测和促进的重要因素。关于社会支持和创伤后成长的研究结果需要进一步重复验证和阐明。
