Horowitz M J, Marmar C, Weiss D S, DeWitt K N, Rosenbaum R
Arch Gen Psychiatry. 1984 May;41(5):438-48. doi: 10.1001/archpsyc.1984.01790160024002.
We studied the relationship of dispositional and process variables with outcome in 52 bereaved patients given time-limited dynamic psychotherapy. Outcomes were generally favorable in symptom relief and improvement in relationship and occupational functioning. Patients' symptoms improved more than did their social and work functioning. Pretreatment levels of impairment or distress were significantly related to outcome, but most demographic and dispositional variables did not predict outcome. Process variables examined in relation to outcome--therapeutic alliance and actions by the therapist--were not significantly related to either type of outcome. When we considered the same process variables in interaction with two dispositional variables, motivation for dynamic therapy and developmental level of the self-concept, we found significant predictions of outcome. The major findings suggest that more exploratory actions were more suitable for highly motivated and/or better-organized patients and less suitable for patients with lower levels of motivation or organization of self-concept. More supportive actions were more suitable for patients at lower dispositional levels and less therapeutic for patients at higher levels.
我们对52名接受限时动态心理治疗的丧亲患者进行了研究，探讨了特质变量和过程变量与治疗结果之间的关系。总体而言，治疗结果在症状缓解以及人际关系和职业功能改善方面较为理想。患者症状的改善程度超过了其社交和工作功能的改善程度。治疗前的损伤或痛苦水平与治疗结果显著相关，但大多数人口统计学和特质变量并不能预测治疗结果。与治疗结果相关的过程变量——治疗联盟和治疗师的行为——与任何一种治疗结果均无显著关联。当我们考虑相同的过程变量与两个特质变量（动态治疗动机和自我概念的发展水平）的相互作用时，我们发现了对治疗结果的显著预测。主要研究结果表明，更多的探索性行动更适合动机强烈和/或自我概念组织较好的患者，而不太适合动机水平较低或自我概念组织较差的患者。更多的支持性行动更适合特质水平较低的患者，而对特质水平较高的患者治疗效果较差。
