谁容易违反规则?-在法医成治疗中,挑战患者行为的预测者
Dörte Berthold1, Jan Querengässer2,3
1Maßregelvollzugszentrum Niedersachsen, Fachkrankenhaus für forensische Psychiatrie und Psychotherapie Bad Rehburg, Rehburg-Loccum, Germany.
概括
在法医成治疗 (FAT) 中,可以使用患者病史和治疗师评估的组合来预测具有挑战性的治疗行为 (TCB). 识别这些风险因素可以改善物质使用障碍患者的治疗结果.
科学领域:
- 法医精神病学 法医精神病学
- 成 药物 药物 药物 药物
- 临床心理学 临床心理学
背景情况:
- 治疗挑战性行为 (TCB) 复杂化了物质使用障碍 (SUD) 治疗,特别是在法医环境中.
- 法医成治疗 (FAT) 在德国 (Sect. 德国刑事法典第64条) 面临的挑战是由于TCB,增加治疗失败的风险.
研究的目的:
- 在接受FAT的患者中确定TCB的预测指标.
- 开发一种模型,用于在法医成治疗期间对TCB的早期风险评估.
主要方法:
- 来自德国法医机构的548名患者记录 (12-24个月治疗时间) 的分析.
- 变量包括历史记录,社会人口统计数据,与疾病相关的数据和犯罪率数据 (A组),以及治疗师的评估 (B组).
- 后勤回归模型 (A组,B组,AB组组合) 用于预测TCB (定义为物质使用,逃跑或纪律事件).
主要成果:
- 34.1%的患者 (n=187) 呈现至少一个TCB.
- 综合患者病史和治疗过程变量组合的组合模型 (Set AB) 显著预测了TCB (p < .001).
- 这种综合模型确定了七个关键预测因素,并解释了超过三分之一的TCB差异.
结论:
- 结合历史记录和与治疗相关的数据,为FAT中TCB提供了卓越的预测模型.
- 早期识别TCB风险可以及时进行干预,并为处于风险的法医患者提供量身定制的治疗.
- 研究结果支持主动管理策略,以提高法医成治疗的成功率.
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