Abstract

Objective

Therapeutic process factors including alliance and motivation are considered to play a key role in the treatment of post-traumatic stress disorder (PTSD). Yet, our understanding of change processes in therapy is mostly based on theoretical considerations with limited empirical evidence. In order to identify process characteristics of successful inpatient treatments of PTSD, we investigated the intraindividual, interindividual, and temporal associations of daily assessments of therapy process factors like motivation, alliance, and insight.

Method

Therapy process questionnaire (TPQ) assessments were collected from 101 inpatients with PTSD over 50 days, resulting in 5050 assessments. Multilevel vector autoregressive (mlVAR) modelling was applied to investigate the networks of the TPQ factors in a subgroup with good outcome regarding PTSD symptomatology and a subgroup with less favourable outcome.

Results

The two subgroups differed markedly in their network models, suggesting that therapy processes might be different for those with good and those with poor treatment outcomes.

Conclusions

Our results suggest that good treatment outcome is linked to a specific therapy process dynamic where mindfulness and insight lead to the kind of temporary well-being required to effectively engage with problems and negative emotions, while motivation to change ensures the continuity of confronting negative emotions and problems.

中文翻译：

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是什么让 PTSD 的住院治疗有效？调查日常治疗过程因素

摘要

客观的

包括联盟和动机在内的治疗过程因素被认为在创伤后应激障碍（PTSD）的治疗中起关键作用。然而，我们对治疗变化过程的理解主要是基于经验证据有限的理论考虑。为了确定成功的 PTSD 住院治疗的过程特征，我们调查了治疗过程因素（如动机、联盟和洞察力）的日常评估的个体内、个体间和时间关联。

方法

治疗过程问卷 (TPQ) 评估从 101 名 PTSD 住院患者中收集超过 50 天，产生 5050 次评估。应用多级向量自回归 (mlVAR) 模型研究 TPQ 因素的网络，其中一个亚组在 PTSD 症状学方面具有良好结果，另一个亚组结果较差。

结果

这两个亚组在他们的网络模型中存在显着差异，这表明治疗效果好和治疗效果差的人的治疗过程可能不同。

结论

我们的研究结果表明，良好的治疗结果与特定的治疗过程动态相关，其中正念和洞察力导致有效处理问题和负面情绪所需的暂时幸福感，而改变的动机确保面对负面情绪的连续性和问题。