背景:关于创伤后应激障碍(PTSD)治疗中治疗师依从性与治疗成功之间关系的文献很少,结果喜忧参半。目的:探讨治疗师对创伤后应激障碍的辩证行为疗法(DBT-PTSD)和认知加工疗法(CPT)的依从性对创伤后应激障碍和儿童期人际关系虐待后情绪调节障碍的治疗效果的关系。方法:一项大型随机对照试验的160名女性参与者的视频治疗会议[Bohus,M、Kleindienst,N.,哈恩,C.,穆勒-恩格尔曼,M、卢德舍尔,P.,Steil,R、Fydrich,T.,Kuehner,C.,Resick,P.A.,Stiglmayr,C.,Schmahl,C.,&Priebe,K、(2020年)。在童年虐待的女性幸存者中,创伤后应激障碍(DBT-PTSD)的辩证行为疗法与认知加工疗法(CPT)相比。JAMA精神病学,77(12)、1235.jamapsychiat.2020.2148]被评级。使用两个专门开发的评定量表评估对CPT和DBT-PTSD的依从性。结果:较高的治疗师依从性与临床医生评估的PTSD症状严重程度的降低有关。与DBT-PTSD组相比,CPT组的这种作用更为明显。坚持也与自我评估的PTSD症状的减少有关,临界症状,和解离强度。结论:我们的结果表明,更高的治疗师依从性可以在PTSD治疗中导致更好的治疗结果,尤其是在CPT。
在童年虐待后,创伤后应激障碍(PTSD)的女性中,治疗师对认知加工疗法的依从性更高,与治疗收益更高相关。坚持与创伤后应激障碍症状严重程度的降低有关,临界症状,和解离强度。坚持对PTSD的辩证行为疗法与治疗结果没有很强的相关性。
Background: Literature on the association between therapist adherence and treatment success in the treatment of post-traumatic stress disorder (PTSD) is scarce, and the results are mixed.Objective: To examine the relationship between therapist adherence to dialectical behaviour therapy for PTSD (DBT-PTSD) and cognitive processing therapy (CPT) on treatment outcome in women with PTSD and emotion regulation difficulties after interpersonal childhood abuse.Method: Videotaped therapy sessions from 160 female participants of a large randomized controlled trial [Bohus, M., Kleindienst, N., Hahn, C., Müller-Engelmann, M., Ludäscher, P., Steil, R., Fydrich, T., Kuehner, C., Resick, P. A., Stiglmayr, C., Schmahl, C., & Priebe, K. (2020). Dialectical behavior therapy for posttraumatic stress disorder (DBT-PTSD) compared with cognitive processing therapy (CPT) in complex presentations of PTSD in women survivors of childhood abuse. JAMA Psychiatry, 77(12), 1235. jamapsychiatry.2020.2148] were rated. Adherence to CPT and DBT-PTSD was assessed using two specifically developed rating scales.Results: Higher therapist adherence was associated with a greater reduction of clinician-rated PTSD symptom severity. This effect was more pronounced in the CPT group than in the DBT-PTSD group. Adherence was also related to a greater reduction of self-rated PTSD symptoms, borderline symptoms, and dissociation intensity.Conclusion: Our results indicate that higher therapist adherence can lead to better treatment outcomes in PTSD treatments, especially in CPT.
Higher therapist adherence to cognitive processing therapy was associated with higher treatment gains in women with post-traumatic stress disorder (PTSD) after childhood abuse.Adherence was related to higher reductions in symptom severity of PTSD, borderline symptoms, and dissociation intensity.Adherence to dialectical behaviour therapy for PTSD did not show a strong association with treatment outcome.