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Therapeutic Interventions in the Treatment of Eating Disorders: A Naturalistic Study

机译：饮食失调的治疗干预：一项自然主义的研究

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This study used naturalistic data from psychodynamic (PD) and cognitive-behavioral (CB) clinicians in the community to offer a portrait of treatments for eating disorder (ED) patients as provided in everyday clinical practice. The research aims were (1) to examine the therapeutic interventions reported by PD and CB clinicians working with ED patients; and (2) to assess the impact of different variables (such as patient personality styles, ED symptomatology, and therapists' theoretical orientation and experience) on the technique use reported by clinicians. A national sample of PD and CB clinicians (N = 105) completed the Shedler-Westen Assessment Procedure-200 (SWAP-200; Westen & Shedler, 1999a, 1999b) to assess personality disorders of a female patient with EDs in their care, as well as the Comparative Psychotherapy Process Scale-Bulimia Nervosa (CPPS-BN; Thompson-Brenner & Westen, 2005) to describe the characteristic interventions used in their treatments. Results showed that PD clinicians tended to use primarily PD interventions, while CB clinicians employed CB techniques supplementing them with a wider range of PD strategies. However, clinicians from both theoretical orientations used adjunctive treatment techniques for EDs at a similar level. In addition, use of PD interventions was strongly associated with the personality styles of ED patients regardless of therapists' orientation, primarily being used more often when patients exhibited dysregulated and impulsive styles. Conversely, use of CB interventions was primarily related to a clinicians' CB orientation, patients with more explicit symptoms of anorexia nervosa, and negatively related to clinicians' years of experience. The clinical implications of these findings were discussed.
机译：这项研究利用社区中心理动力学（PD）和认知行为（CB）临床医生的自然数据，提供了日常临床实践中所提供的饮食失调（ED）患者治疗方法的画像。研究目的是（1）研究PD和CB临床医生对ED患者进行的报道的治疗干预措施; （2）评估不同变量（例如患者的人格风格，ED症状，治疗师的理论取向和经验）对临床医生报告的技术使用的影响。全国PD和CB临床医生样本（N = 105）完成了Shedler-Westen评估程序200（SWAP-200; Westen＆Shedler，1999a，1999b），以评估在其护理下患有EDs的女性患者的人格障碍。以及比较心理治疗过程量表-神经性贪食症（CPPS-BN; Thompson-Brenner＆Westen，2005年）来描述治疗中所采用的典型干预措施。结果表明，PD临床医生倾向于主要使用PD干预，而CB临床医生则采用CB技术补充了更广泛的PD策略。然而，来自两个理论方向的临床医生都在相似的水平上使用了辅助治疗技术。此外，PD干预的使用与ED患者的性格风格密切相关，而与治疗师的取向无关，主要是在患者表现出失调和冲动型时更常使用。相反，使用CB干预措施主要与临床医生的CB方向，神经性厌食症症状更为明显的患者相关，而与临床医生的经验负相关。讨论了这些发现的临床意义。

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