Naturalistic follow-up of a behavioral treatment for chronically parasuicidal borderline patients.
Naturalistic follow-up of a behavioral treatment for chronically parasuicidal borderline patients.
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DOI：
10.1001/archpsyc.1993.01820240055007
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发表时间：
1993-12
影响因子：
--
通讯作者：
M. Linehan;H. Heard;H. Armstrong
中科院分区：
文献类型：
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作者：
M. Linehan;H. Heard;H. Armstrong
背景 一项随机临床试验旨在评估辩证行为疗法（DBT）（一种边缘性人格障碍的心理社会治疗方法）与社区常规治疗相比，在治疗后一年的随访期间是否能保持其优越性能。方法 我们分析了 39 名符合边缘性人格障碍标准（根据 Gunderson 边缘性人格障碍诊断访谈和 DSM-III-R 标准定义）且有自杀行为史的女性。受试者被随机分配接受为期 1 年的 DBT（一种将个体心理治疗与团体行为技能训练相结合的认知行为疗法），或接受常规治疗，其中可能包括也可能不包括个体心理治疗。疗效通过自杀行为（自杀历史访谈）、精神病住院天数（治疗历史访谈）、愤怒（状态特质愤怒量表）、整体功能（整体评估量表）和社会适应（社会适应量表-访谈和社会适应量表-自我报告）来衡量。受试者在随访年的 6 个月和 12 个月时接受评估。结果两种情况的比较显示，在整个后续一年中，DBT 受试者的总体评估量表得分显着较高。在随访的最初 6 个月中，DBT 受试者的自杀行为明显减少，愤怒减少，自我报告的社会适应能力也更好。在最后 6 个月中，DBT 受试者的精神科住院天数显着减少，访谈者评价的社会适应能力也更好。结论 总体而言，之前的研究在 1 年治疗结束时发现 DBT 相对于常规治疗的优越性在 1 年随访期间得到保留。
BACKGROUND A randomized clinical trial was conducted to evaluate whether the superior performance of dialectical behavior therapy (DBT), a psychosocial treatment for borderline personality disorder, compared with treatment-as-usual in the community, is maintained during a 1-year posttreatment follow-up. METHODS We analyzed 39 women who met criteria for borderline personality disorder, defined by Gunderson's Diagnostic Interview for Borderline Personality Disorder and DSM-III-R criteria, and who had a history of parasuicidal behavior. Subjects were randomly assigned either to 1 year of DBT, a cognitive behavioral therapy that combines individual psychotherapy with group behavioral skills training, or to treatment-as-usual, which may or may not have included individual psychotherapy. Efficacy was measured on parasuicidal behavior (Parasuicide History Interview), psychiatric inpatient days (Treatment History Interview), anger (State-Trait Anger Scale), global functioning (Global Assessment Scale), and social adjustment (Social Adjustment Scale--Interview and Social Adjustment Scale--Self-Report). Subjects were assessed at 6 and 12 months into the follow-up year. RESULTS Comparison of the two conditions revealed that throughout the follow-up year, DBT subjects had significantly higher Global Assessment Scale scores. During the initial 6 months of the follow-up, DBT subjects had significantly less parasuicidal behavior, less anger, and better self-reported social adjustment. During the final 6 months, DBT subjects had significantly fewer psychiatric inpatient days and better interviewer-rated social adjustment. CONCLUSION In general, the superiority of DBT over treatment-as-usual, found in previous studies at the completion of 1 year of treatment, was retained during a 1-year follow-up.