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首页> 外文期刊>Journal of psychiatric practice. >Treatment-disrupting behaviors during psychotherapy of patients with personality disorders: the predictive power of psychodynamic personality diagnosis.
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Treatment-disrupting behaviors during psychotherapy of patients with personality disorders: the predictive power of psychodynamic personality diagnosis.

机译：人格障碍患者心理治疗期间破坏治疗的行为：心理动力型人格诊断的预测能力。

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BACKGROUND: Behavioral dyscontrol and violations of treatment contracts are serious clinical problems during psychotherapy, especially in treating patients with personality disorders. However, little is known about predictors of these treatment-interfering phenomena. OBJECTIVE: To identify psychodynamic personality characteristics that can interfere with the psychotherapy process as indicated by treatment-disrupting behaviors. METHODS: Sociodemographic characteristics, descriptive psychiatric diagnoses, and psycho-dynamic characteristics were assessed in 89 inpatients with personality disorders in psychotherapeutic treatment. Psychodynamic characteristics were assessed with the Develop mental Profile (DP). DP variables were used to predict impulsive acts, anger outbursts, para-suicidal behaviors, and contract violations. Incremental value was established. RESULTS: In this sample, 4 out of 5 patients engaged in treatment-interfering behaviors during the first 3 months of therapy. In general, treatment-disrupting behaviors were not predicted by baseline DSM-IV Axis I or II disorders. In contrast, impulsive behaviors, anger outbursts, and contract violations were significantly predicted by psychodynamic variables, especially the DP levels Fragmentation and Egocentricity. DP variables accounted for an incremental predictive value of 23% for treatment-disrupting behaviors, over and above demographics and descriptive diagnoses. Para-suicidal gestures were not predicted by either DSM-IV diagnoses or psychodynamic variables. CONCLUSION: Psychodynamic personality variables significantly predicted impulsive behaviors, outbursts of anger, and treatment contract violations during psychotherapeutic treatment. The amount of explained variance and incremental value was substantial. These findings support the relevance of psychodynamic assessment in clinical practice. (Journal of Psychiatric Practice. 2011;17:21-34).
机译：背景：行为失控和违反治疗合同是心理治疗期间的严重临床问题，尤其是在治疗人格障碍患者中。但是，对于这些治疗干扰现象的预测因素知之甚少。目的：确定干扰治疗行为的心理动力学人格特征，这些特征会干扰心理治疗过程。方法：对89名接受心理治疗的人格障碍患者的社会人口统计学特征，描述性精神病学诊断和心理动力学特征进行了评估。心理心理特征通过发展心理特征（DP）进行评估。 DP变量用于预测冲动行为，愤怒爆发，自杀倾向和违反合同行为。增量值已确定。结果：在该样本中，在治疗的前三个月中，五分之四的患者发生过干扰治疗的行为。通常，基线DSM-IV轴I或II障碍无法预测破坏治疗的行为。相反，冲动行为，愤怒爆发和违约行为是由心理动力学变量特别是DP水平“破碎”和“自我中心”预测的。在人口统计学和描述性诊断之上，DP变量占治疗干扰行为的递增预测值达23％。 DSM-IV诊断或心理动力学变量均无法预测自杀前的手势。结论：心理动力人格变量显着预测了心理治疗过程中的冲动行为，愤怒爆发和违反治疗合同的情况。解释的方差和增量值的数量很大。这些发现支持了心理动力学评估在临床实践中的相关性。 （Journal of Psychiatric Practice。2011; 17：21-34）。

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