Associations of Patient-Rated Emotional Bond and Vocally Encoded Emotional Arousal Among Clinicians and Acutely Suicidal Military Personnel
Associations of Patient-Rated Emotional Bond and Vocally Encoded Emotional Arousal Among Clinicians and Acutely Suicidal Military Personnel
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DOI：
10.1037/ccp0000295
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发表时间：
2018-04-01
影响因子：
5.9
通讯作者：
Rudd, M. David
中科院分区：
文献类型：
--
作者：
Bryan, Craig J.;Baucom, Brian R.;Rudd, M. David
目标：确定患者和临床医生之间的情绪唤醒和情感调节的同步性是否反映了紧急行为健康预约期间的情感联系。方法：对54名自杀现役士兵的自杀风险评估访谈和危机干预计划的录音进行了分析。情绪唤醒使用平均基频进行评估。使用工作联盟量表简表（Hatcher & Gillaspy，2014）评估患者评定的情感纽带。演员-合作伙伴的相互依存模型被用来确定临床医生和患者的情绪唤起之间的时刻到时刻的协方差模式。结果如下：在危机干预期间，临床医生和患者情绪唤醒的更大同步性与更高的情绪债券评级呈正相关，但与风险评估访谈无关。在风险评估访谈期间，更高的情感纽带与临床医生对患者情感唤起的失调效应相关（即，患者情绪激动的较大波动）。在干预过程中观察到相反的模式：更高的情感纽带与临床医生对患者情感唤起的调节作用相关（即，患者情绪激动的波动较小）。干预期间的情感纽带也与患者对临床医生情绪唤起的调节作用呈正相关。结论：急诊临床诊疗过程中的情感联系与患者-临床医生的情感状态同步性有关。在危机干预过程中，情感联系也与患者和临床医生之间的情感唤醒相互下调有关。
Objective: To determine if synchrony in emotional arousal and affective regulation between patients and clinicians reflect emotional bonding during emergency behavioral health appointments. Method: Audio recordings of suicide risk assessment interviews and crisis intervention planning with 54 suicidal active duty soldiers presenting to an emergency department or behavioral health clinic were analyzed. Emotional arousal was assessed using mean fundamental frequency. Patient-rated emotional bond was assessed with the Working Alliance Inventory, Short Form (Hatcher & Gillaspy, 2014). Actor-partner interdependence modeling was used to identify moment-to-moment patterns of covariance among clinician and patient emotional arousal. Results: Greater synchrony in clinician and patient emotional arousal was positively associated with higher emotional bond ratings during the crisis intervention but not the risk assessment interview. During the risk assessment interview, higher emotional bond was associated with a dysregulating effect of the clinician on the patient's emotional arousal (i.e., larger fluctuations in the patient's emotional arousal). The reverse pattern was seen during the intervention: Higher emotional bond was associated with a regulating effect of the clinician on the patient's emotional arousal (i.e., smaller fluctuations in the patient's emotional arousal). Emotional bond during the intervention was also positively associated with a regulating effect of the patient on the clinician's emotional arousal. Conclusion: Emotional bonding during emergency clinical encounters is associated with patient-clinician synchrony in emotional states. During crisis interventions, emotional bonding is also associated with mutual down-regulation of emotional arousal among patients and clinicians.