Increasing outcome measurement precision: Network analysis of items on the Outcome Questionnaire-45.

IF 2.6 2区 心理学 Q2 PSYCHOLOGY, CLINICAL Psychotherapy Pub Date : 2024-10-24 DOI:10.1037/pst0000546
Tim Kaiser, David M Erekson, Benjamin M Ogles
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Abstract

Psychotherapy outcome research mainly focuses on scale-level changes and constructs that were developed using cross-sectional statistical analysis, possibly concealing important findings on the level of single items, and limiting the clinical utility of outcome scales. Our goal was to explore changes in symptoms, interpersonal problems, and level of functioning in everyday life and to establish groups of items with similar rates of change that could be used to form more coherent targets for measuring different therapeutic outcomes. Triangulated maximally filtered graphs were used to model the network structure of the Outcome Questionnaire-45 in a data set of N = 12,075 university counseling center patients. Dynamic exploratory graph analysis was used to establish communities of items with similar rates of change. Five item communities (anxiety, hopelessness, interpersonal problems, well-being, and work impairment) were found. Compared to the original Outcome Questionnaire-45 subscales, they showed better fit to the data. The "hopelessness" community, which describes the extent of a patient's demoralization before the start of therapy, had a significantly higher rate of change compared to other communities. The discerned item communities provide clinicians with theoretically grounded, precise targets for outcome tracking, thereby enhancing the responsiveness and adaptability of treatment interventions to individual client trajectories. Such granularity enriches our understanding of therapeutic change, with direct implications for tailoring intervention strategies to maximize early therapeutic gains and sustain long-term recovery. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

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提高结果测量的精确度:对 45 号结果问卷项目的网络分析。
心理治疗结果的研究主要集中在量表层面的变化和使用横截面统计分析开发的结构上,这可能掩盖了单个项目层面的重要发现,并限制了结果量表的临床实用性。我们的目标是探索症状、人际关系问题和日常生活功能水平的变化,并建立具有相似变化率的项目组,用于形成更一致的目标,以衡量不同的治疗结果。在一个由 N = 12,075 名大学心理咨询中心患者组成的数据集中,使用三角最大滤波图对结果问卷-45 的网络结构进行建模。动态探索图分析用于建立具有相似变化率的项目群。结果发现了五个项目群(焦虑、绝望、人际关系问题、幸福感和工作障碍)。与最初的结果问卷-45 分量表相比,它们与数据的契合度更高。绝望 "项目群描述了患者在治疗开始前的沮丧程度,与其他项目群相比,该项目群的变化率明显更高。所发现的项目群为临床医生提供了有理论依据的、精确的结果跟踪目标,从而提高了治疗干预措施对客户个人轨迹的响应速度和适应性。这种粒度丰富了我们对治疗变化的理解,直接影响到干预策略的定制,以最大限度地提高早期治疗效果并维持长期康复。(PsycInfo Database Record (c) 2024 APA,保留所有权利)。
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来源期刊
Psychotherapy
Psychotherapy PSYCHOLOGY, CLINICAL-
CiteScore
4.60
自引率
12.00%
发文量
93
期刊介绍: Psychotherapy Theory, Research, Practice, Training publishes a wide variety of articles relevant to the field of psychotherapy. The journal strives to foster interactions among individuals involved with training, practice theory, and research since all areas are essential to psychotherapy. This journal is an invaluable resource for practicing clinical and counseling psychologists, social workers, and mental health professionals.
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