Abstract

Objective: This naturalistic study examined the outcomes of group schema therapy for patients with personality disorders (PD) and the effect of psychological symptoms, early maladaptive schemas (EMS) and schema modes on outcome.

Method: Assessments were made of 194 patients at baseline, during treatment, at treatment termination and at three-month follow-up. We used the Symptom Checklist-General Severity Index (SCL-GSI) to measure the remission-rate of global psychological distress and as a dependent variable in a multilevel model to conduct univariate and multiple variate analyses.

Results: The research sample achieved medium symptom reduction (pre–post d = 0.65, 95% CI [0.39–0.91]) and the remission rate was about 30% after 60 sessions. These results remained stable at three-month follow-up (pre-follow-up d = 0.61, 95% CI [0.29–0.94]; 28.9%). Higher baseline scores on the SCL scale interpersonal sensitivity, the EMS defectiveness/shame and all the maladaptive schema modes together predicted improvements in global psychological distress after treatment.

Conclusions: A long-term form of group schema therapy proved effective for a broad group of patients with PD. Internalizing symptoms seems predictive for improvement at outcome. Almost a third of the patients achieved remission. There is therefore room for improvement, possibly by increasing dose or intensity in combination with individual sessions.

摘要

目的：这项自然主义研究检查了人格障碍 (PD) 患者群体图式治疗的结果以及心理症状、早期适应不良图式 (EMS) 和图式模式对结果的影响。

方法：对 194 名患者在基线、治疗期间、治疗终止和三个月随访时进行了评估。我们使用症状清单-一般严重程度指数 (SCL-GSI) 来衡量全球心理困扰的缓解率，并作为多级模型中的因变量进行单变量和多变量分析。

结果：研究样本实现了中等症状减轻（前后d  = 0.65，95% CI [0.39-0.91]），60 次治疗后缓解率约为 30%。这些结果在三个月的随访中保持稳定（随访前d  = 0.61，95% CI [0.29–0.94]；28.9%）。SCL 量表人际敏感性、EMS 缺陷/羞耻感和所有适应不良图式模式的基线得分较高，共同预测治疗后整体心理困扰的改善。

结论：长期形式的团体图式治疗被证明对广泛的 PD 患者有效。内化症状似乎预示着结果的改善。几乎三分之一的患者获得了缓解。因此，有改进的余地，可能通过增加剂量或强度与单独的会话相结合。