以完善自我为核心的社交焦虑障碍集体心理治疗对防御机制的影响

目的 评价在社交焦虑障碍(SAD)病理心理学机制上设计的以完善自我为核心的集体心理治疗疗效及其对防御机制的影响.方法 70例门诊及住院SAD来访者自愿参加,每个小组包括6～8例来访者及2名心理治疗师.集体治疗每周1次.每次2.0～2.5 h,共8周.疗效评定包括来访者的主观感受及自评Liebowitz社交焦虑评定量表(LSAS)、防御方式问卷(DSQ).结果 完成全部治疗者65例.来访者自述治疗后自我及社会功能改善,治疗后LSAS总分明显下降(Z=-5.673,P=0.000).DSQ部分防御机制的使用有变化,治疗后不成熟型防御机制及中间型防御机制总分明显低于治疗前(z=-4.866、-2.973.P=0.000、0.003),成熟型防御机制总分明显高于治疗前(Z=-2.780,P=0.005).结论 以完善自我为核心的集体心理治疗能够促进SAD来访者接纳自我及治疗社交焦虑症状,改善负性思维及不良防御机制,治疗后成熟防御机制应用增多,具有临床应用价值.

The Influence of Self-improving Based Group Psychotherapy in Defense Mechanisms for the Clients with Social Anxiety Disorder

Objective To evaluate the influence and therapeutic effect of self-improving based group psychotherapy which bases on pathopsychology mechanism of social anxiety disorder(SAD) in denfense mechanisms for the client with SAD.Methods 70 psychotherapy clients and inpatients with SAD were involved in this group psychotherapy voluntarily.Every group had six to eight clients with SAD and two psychotherapists.Psychotherapy was conducted once a week with 2 to 2.5 hours for a period of 8 weeks.The evaluation of the therapeutic effect contains the subjective perception of the clients with SAD,Liebowitz Social Anxiety Scale(LSAS),and Defense Style Questionnaire(DSQ).Results 65 clients with SAD completed the therapy.The clients reported self and social functions were improved after 8 weeks therapy.The total score of LSAS after the therapy was significantly lower than that of before the therapy(Z=-5.673,P=0.000).A significant decrease in immature defense machanism and in neurotic defense machanism were observed(Z=-4.866,-2.973;P=0.000,0.003 respectively).And a trend of increasing the use of mature defense machanism was also observed(Z=-2.780,P=0.005).Conclusion Self-improving based group psychotherapy can encourage the clients with SAD accept themselves and cure the social anxiety symptoms.And there was a increasing use of mature defense machanism.These imply the clinic application value of the studied group psychotherapy.