The ability to mentalize has been discussed as potential change mechanism in psychotherapy. Reflective functioning (RF) offers an empirical framework for the assessment of mentalization in therapy sessions. In the present study, we assessed RF longitudinally and examined its association with symptomatic distress, symptom severity of depression and anxiety, and interpersonal problems over the course of treatment. Thirty-seven patients diagnosed with depression or anxiety disorders received 25 ± 3 sessions of integrative cognitive-behavioral therapy (CBT) in an outpatient setting. The observer-rated in-session Reflective Functioning Scale (RFS) was applied to transcripts of therapy Sessions 1, 8, 16, and 24. The effects of RF were investigated both within and between patients using hierarchical linear modeling. RF significantly increased over the course of treatment, and this improvement in RF was significantly associated with depressive symptoms. This means that after a session where patients positively deviated from their own average RF during treatment, they reported lower depression severity. In post hoc analyses, we found a significant interaction effect of the within- and between-patient RF effects on interpersonal problems. Patients with overall higher levels of RF and with positive deviations from their own average RF over the course of treatment tended to have less interpersonal problems during psychotherapy. The present study contributes to the preliminary evidence that changes in RF may serve as a common factor in psychotherapy in contrast to being a specific factor in psychodynamic therapies. More longitudinal studies are necessary to gain a better understanding of RF as a change mechanism in psychotherapy. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

中文翻译：

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对抑郁症和焦虑症患者的反思功能及其与心理治疗结果的关联进行纵向分析。

心理化的能力已被讨论为心理治疗中的潜在变化机制。反射功能 (RF) 为评估治疗过程中的心理化提供了一个经验框架。在本研究中，我们纵向评估 RF 并检查其与症状困扰、抑郁和焦虑症状严重程度以及治疗过程中的人际关系问题的关联。37 名被诊断患有抑郁症或焦虑症的患者在门诊接受了 25 ± 3 次综合认知行为疗法 (CBT)。观察者评定的会话中反射功能量表 (RFS) 应用于治疗会话 1、8、16 和 24 的记录。使用分层线性模型在患者内部和患者之间研究 RF 的影响。RF 在治疗过程中显着增加，RF 的这种改善与抑郁症状显着相关。这意味着在治疗期间患者积极偏离自己的平均 RF 的疗程后，他们报告的抑郁严重程度较低。在事后分析中，我们发现患者内部和患者之间的射频效应对人际关系问题有显着的交互作用。总体而言，RF 水平较高且在治疗过程中与自身平均 RF 有正偏差的患者在心理治疗期间的人际问题往往较少。本研究提供了初步证据，即 RF 的变化可能是心理治疗中的一个共同因素，而不是心理动力学治疗中的一个特定因素。需要更多的纵向研究来更好地理解射频作为心理治疗中的一种变化机制。（PsycInfo 数据库记录 (c) 2022 APA，保留所有权利）。