Ford J D, Fisher P, Larson L
Department of Veterans Affairs, National Center for PTSD, White River Junction, Vermont 05009, USA.
J Consult Clin Psychol. 1997 Aug;65(4):547-59. doi: 10.1037//0022-006x.65.4.547.
The role of object relations as a predictor of outcome was evaluated in inpatient posttraumatic stress disorder (PTSD) treatment. Cohort outcome at discharge on psychometric indices was mixed, with limited evidence of reliable or clinically significant change. Treatment was associated with an overall reduction in utilization of inpatient psychiatric and residential domiciliary services. However, moderate (vs. low) levels of object relations were predictive of reliable change outcome, independent of demographics, Axis II diagnosis, symptomatic severity, or early childhood or war zone trauma exposure. The findings suggest that consideration should be given both to the manner in which patients seeking treatment for PTSD are screened and matched with a range of treatment or rehabilitation services and to how treatment outcome is conceptualized beyond symptom reduction. Rehabilitation of chronic posttraumatic symptomatology and associated psychosocial impairment may be facilitated by assessment, treatment design, and client-treatment matching on the basis of multidimensional psychological indices.
在住院创伤后应激障碍（PTSD）治疗中，评估了客体关系作为结果预测指标的作用。出院时心理测量指标的队列结果参差不齐，可靠或具有临床意义变化的证据有限。治疗与住院精神科和住院家庭护理服务利用率的总体降低相关。然而，客体关系处于中等（相对于低）水平可预测可靠的变化结果，且不受人口统计学、轴II诊断、症状严重程度或童年早期或战区创伤暴露的影响。研究结果表明，对于寻求PTSD治疗的患者进行筛查并与一系列治疗或康复服务进行匹配的方式，以及如何在症状减轻之外对治疗结果进行概念化，都应予以考虑。基于多维心理指标的评估、治疗设计和患者与治疗的匹配，可能有助于慢性创伤后症状及相关心理社会损害的康复。
