Pattern destabilization and emotional processing in cognitive therapy for personality disorders.
Pattern destabilization and emotional processing in cognitive therapy for personality disorders.
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DOI：
10.3389/fpsyg.2015.00107
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发表时间：
2015
影响因子：
3.8
通讯作者：
Yasinski C
中科院分区：
文献类型：
--
作者：
Hayes AM;Yasinski C
人格障碍治疗的临床试验可以提供一种媒介，用于研究治疗变化的过程，特别是根深蒂固和自我延续的系统，并可能揭示系统过渡的重要原则。我们研究了在认知疗法人格障碍（CT-PD）试验中适应不良的人格模式不稳定的程度，以及不稳定与情绪处理和治疗结果的关系。动态系统理论被用作研究变化的理论框架。方法：参与者是27名被诊断为回避型或强迫型人格障碍（AVPD或OCPD）的患者，他们完成了CT-PD的开放试验。评分员使用编码系统对治疗过程进行编码，该系统可操作情绪处理，以及病理（消极）和更具适应性（积极）功能模式的认知，情感，行为和躯体成分。在治疗的早期阶段（第1阶段：第1-10节）和模式集中阶段（第2阶段：第11-34节），使用一个名为GridWare的程序计算模式不稳定（分散）评分。结果如下：更多的模式不稳定和情绪处理在计划为重点的阶段CT-PD预测人格障碍症状和积极的模式强度在治疗结束时的改善，而这些变量在第1阶段没有预测结果。结论：除了说明一个定量的方法来研究不稳定和变化的模式的精神病理学，我们目前的研究结果是一致的，最近更新的情绪处理理论和动态系统理论的原则。
Clinical trials of treatments for personality disorders can provide a medium for studying the process of therapeutic change with particularly entrenched and self-perpetuating systems and might reveal important principles of system transition. We examined the extent to which maladaptive personality patterns were destabilized in a trial of cognitive therapy personality disorders (CT-PD) and how destabilization was associated with emotional processing and treatment outcomes. Dynamic systems theory was used as a theoretical framework for studying change. Method: Participants were 27 patients diagnosed with Avoidant or Obsessive Compulsive Personality Disorder (AVPD or OCPD), who completed an open trial of CT-PD. Raters coded treatment sessions using a coding system that operationalizes emotional processing, as well as cognitive, affective, behavioral, and somatic components of pathological (negative) and more adaptive (positive) patterns of functioning. Pattern destabilization (dispersion) scores during the early phase of treatment (phase 1: session 1–10) and the schema-focused phase (phase 2: session 11–34) were calculated using a program called GridWare. Results: More pattern destabilization and emotional processing in the schema-focused phase of CT-PD predicted more improvement in personality disorder symptoms and positive pattern strength at the end of treatment, whereas these variables in phase 1 did not predict outcome. Conclusion: In addition to illustrating a quantitative method for studying destabilization and change of patterns of psychopathology, we present findings that are consistent with recent updates of emotional processing theory and with principles from dynamic systems theory.
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