ABSTRACT
Antecedentes: identificar subgrupos de pacientes que demuestren diferentes trayectorias de cambio terapéutico durante psicoterapia en contextos realistas es relevante para el desarrollo de procesos terapéuticos personalizados y efectivos. Objetivos: El presente estudio tuvo como objetivos (a) identificar trayectorias de cambios terapéutico en pacientes chilenos (b) explorar variables que puedan predecir la probabilidad de pertenecer a ciertas trayectorias y (c) examinar si estas diferentes trayectorias desembocan en distintos resultados terapéuticos. Método: se llevaron a cabo análisis de modelos de crecimientos mixto (Growth Mixture Modeling - GMM) y regresiones logísticas multinominales en una muestra de 400 pacientes chilenos recibiendo psicoterapia en un centro de salud mental privado. Resultados: se identificaron tres trayectorias de cambio terapéutico (a) disfunción inicial moderada con leve deterioro, (b) disfunción inicial leve con cambio favorable y (c) disfunción inicial severa con rápido cambio favorable. La edad de los pacientes fue considerada un factor predictor de trayectoria significativa, sugiriendo una peor prognosis para pacientes de mayor edad. Además, todas las trayectorias fueron predictoras del resultado terapéutico. Conclusiones: estos resultados pueden ser utilizados para desarrollar intervenciones enfocadas en el paciente, basadas en las trayectorias de cambio que exhiban.
Background: Identifying subgroups of patients that may show distinct trajectories of change during psychotherapy in realistic settings is relevant for the development of personalized therapeutic processes. Aims: The present study sought to (a) identify trajectories of change in Chilean patients; (b) explore variables that may predict the likelihood of belonging to certain trajectories; and (c) examine whether these different trajectories result in differences in treatment outcomes. Method: Growth mixture modeling (GMM) and multinomial logistic regression analysis were carried out on the data of 400 patients receiving psychotherapy at a private outpatient clinic in Chile. Results: Three trajectories of change were identified: (a) moderate initial dysfunction with slight deterioration, (b) mild initial dysfunction with favorable change, and (c) high initial dysfunction with rapid favorable change. Patient's age was found to be a significant predictor of trajectory assigned, suggesting a poorer prognosis for older patients. Moreover, the trajectories were significant predictors of treatment outcome. Conclusions: These results can be used to develop patient-specific therapeutic interventions based on the trajectories they exhibit.
Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Psychotherapy, Brief , Psychotherapeutic Processes , Chile , Surveys and Questionnaires , Regression Analysis , Treatment Outcome , Ambulatory CareABSTRACT
There are many risk factors that make the transition to parenthood difficult, even in the best of circumstances. One such risk factor is the experience of parental childhood trauma, which has the potential to affect the parent/child relationship, both in terms of attachment style parental reflective functioning. This study aims to expand on the line of research concerned with the effects that trauma has once that child transitions into adulthood and into parenthood by looking at the role that the experience of trauma and adult attachment has in relation to parental reflective functioning. This study assessed mothers (N = 125) by using the CTQ (childhood experience of trauma), ECR (adult attachment), and the PRFQ (parental RF). Our study found that in the presence of physical neglect, insecure attachment had a particularly deleterious effect on maternal reflective functioning. This relationship was not as strong in the absence of physical neglect.
