Department of Psychology, University of Windsor.
Department of Psychiatry, University of Lausanne.
J Consult Clin Psychol. 2024 Sep;92(9):607-618. doi: 10.1037/ccp0000903.
We examined whether the emotions that clients experience within session are associated with treatment outcome in dialectical behavior therapy (DBT) for borderline personality disorder (BPD).
Participants were 52 adults who met criteria for BPD and were enrolled in a 12-month DBT treatment. The Classification of Affective-Meaning States, an observer-rated measure of discrete emotions, was used to code videos of individual DBT sessions. Raters coded three psychotherapy sessions for each participant: one session from each of the early, working, and late phases of psychotherapy. Self-report measures of BPD symptoms were used to assess treatment outcome.
More emotional experience overall during the early phase predicted fewer BPD symptoms at 12-month treatment outcome, explaining 19% of the variance in symptoms. However, increases across treatment in global distress predicted higher levels of BPD (24% of the variance explained) and depression symptoms (15% explained) at termination. Increases in emotional flexibility (i.e., variation between states) from the early to working phase predicted fewer depressive symptoms at termination (14% explained). Self-compassion coded during the working phase also predicted a better treatment outcome (explaining 19%-34%).
Clients' in-session emotional experiences predict treatment outcome 8-10 months later. Clients with BPD may benefit from more overall exploration of their emotional experiences early in DBT, as well as expression of self-compassion. Increases in nonspecific, intense negative affect anticipates poor prognosis, whereas increases in emotional flexibility during early treatment anticipates better prognosis. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
我们考察了在边缘型人格障碍（BPD）的辩证行为治疗（DBT）中，来访者在治疗过程中体验到的情绪是否与治疗结果相关。
52 名符合 BPD 标准并参加为期 12 个月的 DBT 治疗的成年人参与了该研究。采用情感-意义状态分类（Classification of Affective-Meaning States），一种离散情绪的观察者评定量表，对个体 DBT 治疗过程中的视频进行编码。评分者为每位参与者编码了三个心理治疗会话：每个治疗阶段的一个会话，即早期、工作期和后期。使用 BPD 症状的自我报告量表来评估治疗结果。
早期治疗中整体情绪体验的增加预测了 12 个月治疗结果时 BPD 症状的减少，解释了症状变化的 19%。然而，治疗过程中整体痛苦的增加预测了 BPD（解释了 24%的方差）和抑郁症状（解释了 15%的方差）在治疗结束时的更高水平。从早期到工作阶段的情绪灵活性（即状态之间的变化）的增加预测了治疗结束时抑郁症状的减少（解释了 14%的方差）。工作阶段自我同情的编码也预测了更好的治疗结果（解释了 19%-34%）。
来访者在治疗过程中的情绪体验预测了 8-10 个月后的治疗结果。BPD 患者可能受益于在 DBT 的早期更全面地探索他们的情绪体验，以及表达自我同情。非特定、强烈的负性情绪的增加预示着预后不良，而早期治疗中情绪灵活性的增加则预示着预后较好。
