ABSTRACT

Objective:

To determine the treatment effect of psychodynamic therapy for adolescents in comparison to normative developmental progression in two groups without treatment: healthy adolescents and adolescents with juvenile diabetes.

Research Design and Methods:

In a 3-wave longitudinal study, n = 531 adolescents (n = 303 treated adolescents, n = 119 healthy, n = 109 with diabetes) and their parents filled out psychopathology questionnaires (Youth Self-Report [YSR] and Child Behaviour Checklist [CBCL]). Growth curve modeling (GCM) was used to examine within-person change in psychopathology while controlling for stable between-person differences.

Results:

GCM analyses revealed significant within-person reductions in patients’ YSR and CBCL (d = 1.02–1.99) at the end of treatment. When accounted for the control groups’ developmental progression (d = .14–.94), patients’ within-person change remained significantly higher (d = .48-.82). In all three groups, parents rated the severity of psychopathology significantly lower, and within-person change significantly higher than the adolescents him/herself.

Conclusions:

Psychodynamic therapy led to a significant symptom reduction in treated adolescents and was superior to development-related symptom changes occurring in the two control groups. Hence, clinically relevant symptoms in adolescents do not “grow out”, but require psychotherapeutic treatment. Differences between adolescents and their parents in the evaluation of symptom severity and change require attention in psychotherapy treatment and research.

中文翻译：

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青少年临床相关的精神病理学是否一定需要治疗，还是会“长大”？

摘要

客观的：

确定心理动力学治疗对青少年的治疗效果与未治疗的两组正常发育进展的比较：健康青少年和患有青少年糖尿病的青少年。

研究设计和方法：

在一项 3 波纵向研究中，n  = 531 名青少年（n  = 303 名接受治疗的青少年，n  = 119 名健康，n  = 109 名患有糖尿病）和他们的父母填写了精神病理学问卷（青少年自我报告 [YSR] 和儿童行为检查表 [ CBCL]）。生长曲线模型 (GCM) 用于检查人体内精神病理学的变化，同时控制稳定的人际差异。

结果：

GCM 分析显示，治疗结束时患者的 YSR 和 CBCL（d  = 1.02-1.99）显着降低。当考虑到对照组的发育进展 ( d  = .14-.94) 时，患者的个体变化仍然显着更高 ( d  = .48-.82)。在所有三组中，父母对精神病理学的严重程度的评价明显低于他/她自己的青少年，而个人内部的变化则明显高于他/她自己。

结论：

心理动力学治疗导致接受治疗的青少年症状显着减轻，并且优于两个对照组发生的发育相关症状变化。因此，青少年的临床相关症状不会“长大”，而是需要心理治疗。青少年及其父母在症状严重程度和变化的评价上存在差异，需要心理治疗和研究予以重视。