Hyatt Courtland S, Sleep Chelsea E, Hemmy Asamsama Octaviana, Reger Mark A
VA Puget Sound Health Care System, Seattle Division.
Cincinnati VA Medical Center.
Psychol Serv. 2024 May;21(2):379-387. doi: 10.1037/ser0000782. Epub 2023 Jun 26.
We surveyed = 84 mental health care providers (i.e., psychiatrists, psychologists, social workers) working across two Veterans Affairs health care sites about their experiences working with Veteran patients with antagonism-based clinical presentations (e.g., callous, aggressive, grandiose features), as well as negative affect-based clinical presentations (e.g., depressive, anxious, self-conscious features). Providers reported on aspects of these clinical interactions, including assessments and interventions used, treatment outcomes, interpersonal experiences, and training and preparedness to treat this type of presentation in the future. Compared to treatment experiences with patients with predominant negative affect, providers reported that treatment experiences with antagonistic (ANT) patients tended to be shorter ( = -.60), less effective at improving psychological functioning ( = -.61), more emotionally draining ( = 1.03), and more often marked by relationship ruptures (instance of ≥1 rupture = 72.6% vs. 15.5%). Providers also reported less professional training to treat antagonism ( = -1.56) and less preparedness to treat ANT patients in the future ( = -1.81). These results highlight the important role of patient characteristics in providers' experiences and underscore the need for more training and resources to support mental health providers working with ANT patients. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
我们对在两个退伍军人事务医疗站点工作的84名心理健康护理提供者（即精神科医生、心理学家、社会工作者）进行了调查，了解他们与具有基于对抗的临床表现（如冷漠、攻击性、夸大特征）以及基于消极情绪的临床表现（如抑郁、焦虑、自觉特征）的退伍军人患者合作的经历。提供者报告了这些临床互动的各个方面，包括所使用的评估和干预措施、治疗结果、人际体验，以及未来治疗此类表现的培训和准备情况。与主要具有消极情绪的患者的治疗经历相比，提供者报告称，与对抗性（ANT）患者的治疗经历往往更短（=-0.60），在改善心理功能方面效果更差（=-0.61），情感上更耗竭（=1.03），并且更常以关系破裂为特征（≥1次破裂的发生率=72.6%对15.5%）。提供者还报告称，治疗对抗性问题的专业培训较少（=-1.56），未来治疗ANT患者的准备也较少（=-1.81）。这些结果凸显了患者特征在提供者经历中的重要作用，并强调需要更多培训和资源来支持与ANT患者合作的心理健康提供者。（PsycInfo数据库记录（c）2024美国心理学会，保留所有权利）
