ABSTRACT

Objective Negative effects (NEs) in group treatments remain an under-researched area. This study aimed to explore the prevalence of various types of NEs in a multicomponent group-based treatment and to determine their predictors. Method: A total of 330 patients participating in a multicomponent group-based treatment were recruited across seven clinical sites. At the end of treatment, the Negative Effects Questionnaire (NEQ) was used to measure NEs. Item-level descriptive analysis was conducted to explore the prevalence of various types of NEs, and structural equation modeling was used to determine predictors of these NEs. Results: The most frequently reported type of NEs was the worsening of symptoms, and the single most frequently reported item was the resurfacing of unpleasant memories. Predictors of NEs included the overall distress level, alexithymia, attachment avoidance, low working alliance, problem actuation, and worse outcomes; psychological mindedness was a protective factor. Conclusion: Patients who experience higher levels of distress at the beginning of treatment, who perceive the group working alliance as problematic, and who experience high in-session emotional arousal related to their problem seem to be especially prone to reporting NEs. Furthermore, the findings do not support the assumption that NEs are a prerequisite for therapeutic change.

Trial registration: ISRCTN.org identifier: ISRCTN13532466.

摘要

客观团体治疗中的负面影响 (NEs) 仍然是一个研究不足的领域。本研究旨在探索多种类型的 NE 在基于多组分组的治疗中的流行并确定其预测因子。方法：在七个临床地点共招募了 330 名参与多组分治疗的患者。在治疗结束时，使用负面影响问卷 (NEQ) 来测量 NE。进行项目级描述性分析以探索各种类型 NE 的流行程度，并使用结构方程模型来确定这些 NE 的预测因子。结果：最常报告的 NE 类型是症状恶化，而最常报告的单个项目是不愉快记忆的重现。NE 的预测因素包括整体痛苦程度、述情障碍、依恋回避、低工作联盟、问题驱动和更糟糕的结果；心理素质是一个保护因素。结论：在治疗开始时经历更高程度的痛苦、认为团队工作联盟有问题以及在治疗期间经历与他们的问题相关的高情绪唤醒的患者似乎特别容易报告 NE。此外，研究结果不支持 NE 是治疗变化的先决条件的假设。

试用注册： ISRCTN.org 标识符：ISRCTN13532466.