In the current study, we used a naturalistic design to examine how client attachment orientations affect changes in client mental health over the course of treatment. We evaluated session-by-session changes in overall maladjustment levels (derived from the Outcome Questionnaire 45.2) in a sample of 105 adult clients who were seeking therapy at a large, university-based, outpatient psychology training clinic. The primary goal of this study was to investigate how client attachment orientations affected patterns of change in client overall maladjustment scores across time. Because previous findings have suggested that client attachment orientations may be associated with different patterns or differential rates of change, beyond linear changes, we also extended previous research by testing more complex models involving quadratic and cubic changes over the course of therapy. Multilevel modeling analysis revealed that client overall maladjustment scores significantly improved throughout therapy. Results further indicated that client attachment anxiety predicted change in maladjustment during therapy. Attachment avoidance did not predict change in symptoms. With respect to attachment anxiety, we found different patterns of recovery or symptom change throughout therapy for clients with high versus low attachment anxiety. Clients low in attachment anxiety showed consistent improvements and those high in attachment anxiety exhibited low levels of therapeutic change throughout the middle of therapy despite their overall improvements. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

中文翻译：

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服务对象的依恋和心理治疗期间心理健康的变化。

在当前的研究中，我们使用一种自然主义的设计来检查客户依恋取向如何在治疗过程中影响客户心理健康的变化。我们评估了105名成年客户的样本中总体失调水平的逐次变化（根据结果问卷45.2得出），这些成年客户正在一家大型的，基于大学的门诊心理学培训诊所寻求治疗。这项研究的主要目的是调查客户依恋取向如何影响客户总体适应不良分数随时间变化的模式。由于先前的调查结果表明，客户依恋倾向可能与线性变化以外的不同模式或变化率相关，我们还通过测试在治疗过程中涉及二次方和三次方变化的更复杂的模型来扩展先前的研究。多级建模分析显示，在整个治疗过程中，客户的总体适应不良评分均得到显着改善。结果进一步表明，服务对象依恋焦虑可预测治疗过程中适应不良的变化。避免依恋并不能预测症状的改变。关于依恋焦虑，我们发现高和低依恋焦虑者在整个治疗过程中都有不同的恢复或症状改变模式。依恋焦虑程度低的患者表现出持续的改善，而依恋焦虑程度高的患者尽管在总体上有所改善，但在整个治疗过程中的治疗改变水平较低。（PsycInfo数据库记录（c）2020 APA，保留所有权利）。