Previous Mental Health Service Utilization and Change in Clients' Depressive Symptoms
Previous Mental Health Service Utilization and Change in Clients' Depressive Symptoms
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DOI：
10.1037/a0028078
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发表时间：
2012-07-01
影响因子：
3.9
通讯作者：
Locke, Benjamin D.
中科院分区：
文献类型：
--
作者：
Boswell, James F.;McAleavey, Andrew A.;Locke, Benjamin D.
虽然一个潜在的重要因素，在案件的概念化和治疗计划，以前的治疗对随后的咨询反应的影响很少得到实证的关注。使用档案数据，本研究旨在（a）报告咨询人群中既往治疗使用的患病率，（B）检查治疗史中症状严重程度的潜在差异，（c）测试在咨询过程中症状的变化率是否受既往治疗使用的调节，同时考虑初始严重程度。在美国各地的大学/学院咨询中心接受治疗的1，262名大学生的样本提供了有关既往治疗史的信息，并完成了心理症状的咨询中心评估，在入学时和最多4个额外的时间点进行评估，平均评估间隔为3-5周。本研究使用了13项抑郁子量表的数据。一半的客户报告以前的咨询，三分之一的精神药物，十分之一的精神病住院治疗。既往治疗与基线抑郁症状严重程度增加相关。潜伏生长曲线模型的结果显示，以前的咨询和药物治疗与症状反应速度较慢相关，以前的咨询降低了被标记为治疗反应者的概率。在控制基线严重程度时，既往咨询仍然是咨询反应的重要预测因素。通过先前的治疗经验影响随后的治疗反应的假设机制仍然主要是理论上的，应该是未来研究的重点。
Although a potentially important factor in case conceptualization and treatment planning, the impact of previous treatment on subsequent counseling response has received little empirical attention. Using archival data, this study aimed to (a) report the prevalence of previous treatment utilization in a counseling population, (b) examine potential differences in symptom severity by treatment history, and (c) test whether the rate of change in symptoms over a course of counseling is moderated by previous treatment utilization, when also accounting for initial severity. A sample of 1,262 college students presenting for treatment in university/college counseling centers across the United States provided information on previous treatment history and completed the Counseling Center Assessment of Psychological Symptoms, administered at intake and up to 4 additional time points, with an average of 3-5 weeks between assessments. Data from the 13-item Depression subscale were used for the present study. Half the clients reported previous counseling, one third psychotropic medication, and one tenth psychiatric hospitalization. Previous treatment was associated with increased baseline depressive symptom severity. Results from latent growth curve models showed that previous counseling and medication correlated with a slower rate of symptom response, and previous counseling reduced the probability of being labeled a treatment responder. Previous counseling remained a significant predictor of counseling response when controlling for baseline severity. Hypothesized mechanisms through which previous treatment experience impacts subsequent treatment response remain largely theoretical and should be the focus of future research.