OBJECTIVE Termination in psychodynamic therapy (PDT) is a potentially conflictual and turbulent phase for patients, with a risk for increases in symptoms. However, few studies of PDT have assessed symptoms frequently enough during the treatment to determine whether such setbacks are in fact common in PDT. METHOD In a doubly randomized clinical preference trial, 217 adults, female = 163; M age = 34.8 (12.6), with panic disorder with or without agoraphobia were treated with panic-focused psychodynamic psychotherapy (PFPP) or panic control treatment (PCT), a form of cognitive behavioral therapy. Participants completed the Panic Disorder Severity Scale Self-Report (PDSS-SR) weekly during treatment (Weeks 1-12), and 6, 12, and 24 months after treatment. Using piecewise latent growth curve modeling, we tested the trajectories of change focusing on the termination phase in PFPP. RESULTS Week-to-week improvement on the PDSS-SR stopped (a termination setback [TS]) in PFPP during Weeks 10-12, whereas PCT participants continued to improve. Larger symptom reductions up to Week 10 in PFPP predicted a more severe TS. Less avoidant attachment and less severe interpersonal problems also predicted more severe TS. The TSs tended to last, as evidenced by inferior outcomes, up to the 12-month follow-up. CONCLUSIONS This study provides evidence of a TS in PDT. Resurgence of symptoms as termination approached was more common in PFPP than in PCT. Studies involving weekly assessment of primary and comorbid symptoms, as well as qualitative analyses of the patient experiences of the therapeutic process during termination, in different forms of PDT, are warranted. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

中文翻译：

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探索恐慌症心理动力学疗法中的终止挫折。

目的 心理动力学治疗 (PDT) 的终止对患者来说是一个潜在的冲突和动荡的阶段，有增加症状的风险。然而，很少有关于 PDT 的研究在治疗期间足够频繁地评估症状，以确定这种挫折在 PDT 中是否真的很常见。方法 在一项双随机临床偏好试验中，217 名成人，女性 = 163；M 年龄 = 34.8 (12.6)，伴有或不伴有广场恐怖症的恐慌症患者接受了以恐慌为中心的心理动力学心理治疗 (PFP​​P) 或恐慌控制治疗 (PCT)，这是一种认知行为疗法。参与者在治疗期间（第 1-12 周）以及治疗后 6、12 和 24 个月每周完成恐慌症严重程度量表自我报告（PDSS-SR）。使用分段潜在增长曲线建模，我们测试了专注于 PFPP 终止阶段的变化轨迹。结果 在第 10-12 周期间，PFPP 中 PDSS-SR 的每周改善停止（终止挫折 [TS]），而 PCT 参与者继续改善。在 PFPP 中，直至第 10 周的较大症状减轻预示着更严重的 TS。较少的回避依恋和较不严重的人际关系问题也预示着更严重的 TS。正如较差的结果所证明的那样，TS 往往会持续到 12 个月的随访。结论 本研究提供了 PDT 中 TS 的证据。PFPP 比 PCT 更常见随着终止的临近而再次出现症状。包括每周评估原发性和合并症症状的研究，以及在不同形式的 PDT 中对终止期间治疗过程的患者体验进行定性分析，是有保证的。（PsycInfo 数据库记录 (c) 2021 APA，保留所有权利）。