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A Group's Level of Defensive Functioning Affects Individual Outcomes in Group Psychodynamic-Interpersonal Psychotherapy

PSYCHOTHERAPY(2022)

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摘要
Clinical Impact Statement Question: We studied the impact of the individual group member's and other group therapy members' defense mechanisms on an individual group member's treatment outcome (i.e., binge-eating frequency and interpersonal/social functioning). Findings: When other members of a therapy group used more adaptive defense mechanisms, the individual group member's interpersonal functioning improved; but when the group used less adaptive defense mechanisms, the individual's interpersonal functioning worsened. Meaning: The other group members' defense mechanisms impacted the individual member's interpersonal functioning. The group's characteristics are important for individual treatment outcomes. Next Steps: Future research should study the effect of defense mechanisms in other types of group therapy. Furthermore, therapists should consider the group's composition, as individual members who significantly differ from the group may not benefit from treatment. We used an actor-partner interdependence model (APIM) to study the association between the individual group member and other group therapy members' defensive functioning on an individual group member's treatment outcome. We hypothesized that (a) more adaptive individual defensive functioning at pretreatment will be significantly related to better treatment outcomes (i.e., lower binge-eating and interpersonal distress) at 6 months post-treatment; and (b) more adaptive other group members' defensive functioning at pretreatment will be significantly related to better treatment outcomes at 6 months post-treatment. Participants (N = 136) were individuals with BED enrolled in group psychodynamic-interpersonal psychotherapy (GPIP). Participants completed attachment interviews and were assessed on interpersonal distress and days binged at pretreatment and 6 months post-treatment. The interview audio recordings were transcribed and used to code defensive functioning. We found that individual overall defensive functioning (ODF) scores at pretreatment were not significantly associated with binge-eating frequency or interpersonal distress at 6 months post-treatment. Other group members' mean ODF scores at pretreatment were significantly associated with individual interpersonal distress at 6 months post-treatment. However, the other group members' mean ODF scores were not significantly associated with individual binge-eating outcomes at 6 months post-treatment. Defensive functioning of other members of a therapy group may be particularly important for improving interpersonal functioning in individuals with BED.
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关键词
binge-eating disorder,defensive functioning,group therapy,interpersonal functioning,actor-partner interdependence model
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