Target M, Fonagy P
Anna Freud Centre, London, UK.
J Am Acad Child Adolesc Psychiatry. 1994 Oct;33(8):1134-44. doi: 10.1097/00004583-199410000-00009.
This is the third report from a chart review of 763 cases of child psychoanalysis and psychotherapy at the Anna Freud Centre. This paper examines the way in which the age of a child or adolescent at the time of treatment in psychoanalytic psychotherapy relates to the outcome of that treatment.
One hundred twenty-seven children were selected from each of three age bands (younger than 6 years, 6 to 12 years, and adolescents); they were matched on broad diagnostic grouping, gender, socioeconomic status, global adaptation (Children's Global Assessment Scale), and frequency of sessions. Outcome was indicated by diagnostic change and clinically significant change in adaptation.
Younger children were more likely to show significant improvement. Children younger than 12 benefited from intensive (four or five times weekly) treatment more than from nonintensive (one or two times weekly) treatment; this was not true of adolescents. There were interactions between certain diagnostic categories, age, and outcome. Predictors of good and poor outcome were different for the three age groups, further highlighting the importance of a developmental perspective.
Within the limitations of a retrospective design, this study suggests that in psychodynamic treatment, younger age is an advantage and developmental factors considerably affect the outcome of this form of therapy.
这是对安娜·弗洛伊德中心763例儿童精神分析和心理治疗病例进行图表回顾得出的第三份报告。本文探讨了在精神分析心理治疗中，儿童或青少年接受治疗时的年龄与该治疗结果之间的关系。
从三个年龄组（6岁以下、6至12岁、青少年）中各选取127名儿童；他们在广泛的诊断分组、性别、社会经济地位、整体适应情况（儿童整体评估量表）和治疗频次方面进行了匹配。结果通过诊断变化和适应方面具有临床意义的变化来体现。
年龄较小的儿童更有可能显示出显著改善。12岁以下的儿童从强化治疗（每周四次或五次）中获益多于非强化治疗（每周一两次）；青少年则并非如此。某些诊断类别、年龄和结果之间存在相互作用。三个年龄组的良好和不良结果预测因素不同，这进一步凸显了发展视角的重要性。
在回顾性设计的局限性内，本研究表明在心理动力治疗中，年龄较小是一个优势，且发展因素会极大地影响这种治疗形式的结果。
