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Lego SR, Raykos BC, Tonta KE, Erceg-Hurn DM, Waller G, McEvoy PM. Validation of the Interpersonal Relationships in Eating Disorders (IR-ED) Scale in an Eating Disorder Sample. Int J Eat Disord 2024. [PMID: 39016107 DOI: 10.1002/eat.24259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Revised: 06/25/2024] [Accepted: 06/25/2024] [Indexed: 07/18/2024]
Abstract
OBJECTIVE Interpersonal problems have been identified as a plausible mechanism underlying the onset and maintenance of eating disorders. The Interpersonal Relationships in Eating Disorders (IR-ED) scale is the first eating disorders-specific measure of interpersonal problems, which was developed in a nonclinical sample. The aims of the current study were to (a) confirm the factor structure of the IR-ED within a large clinical sample, (b) investigate measurement invariance of the IR-ED across nonclinical and clinical samples, (c) examine the convergent validity of the IR-ED using a generic measure of interpersonal problems, and (d) investigate the incremental clinical utility of the IR-ED in uniquely predicting eating disorder symptomatology. METHOD Treatment-seeking individuals (N = 437) completed the IR-ED at their initial assessment appointment at a specialist eating disorder outpatient service. RESULTS A multiple-group confirmatory factor analysis supported an invariant bifactor structure comprising a general interpersonal problems factor and two group factors-Avoidance of Body Evaluation and Food-Related Interpersonal Tension. Convergent validity was demonstrated by a large, statistically significant correlation with a generic measure of interpersonal problems (r = 0.62, p < 0.001). A series of structural equation models further revealed unique incremental predictive utility of the IR-ED for eating disorder symptomatology. DISCUSSION The IR-ED has strong psychometric properties and may prove beneficial in the assessment, formulation, and treatment of eating-specific interpersonal problems among patients with eating disorders.
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Affiliation(s)
- Sophia R Lego
- Discipline of Psychology, Perth, Western Australia, Australia
| | - Bronwyn C Raykos
- Centre for Clinical Interventions, North Metropolitan Health Service, Perth, Western Australia, Australia
| | - Kate E Tonta
- Discipline of Psychology, Perth, Western Australia, Australia
- Centre for Clinical Interventions, North Metropolitan Health Service, Perth, Western Australia, Australia
- Curtin enAble Institute, Curtin University, Bentley, Western Australia, Australia
| | - David M Erceg-Hurn
- Centre for Clinical Interventions, North Metropolitan Health Service, Perth, Western Australia, Australia
| | - Glenn Waller
- Department of Psychology, University of Sheffield, Sheffield, UK
| | - Peter M McEvoy
- Discipline of Psychology, Perth, Western Australia, Australia
- Centre for Clinical Interventions, North Metropolitan Health Service, Perth, Western Australia, Australia
- Curtin enAble Institute, Curtin University, Bentley, Western Australia, Australia
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Stadel M, Stulp G, Langener AM, Elmer T, van Duijn MAJ, Bringmann LF. Feedback About a Person's Social Context - Personal Networks and Daily Social Interactions. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2024; 51:476-489. [PMID: 37615808 PMCID: PMC11196300 DOI: 10.1007/s10488-023-01293-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/02/2023] [Indexed: 08/25/2023]
Abstract
The social context of a person, meaning their social relationships and daily social interactions, is an important factor for understanding their mental health. However, personalised feedback approaches to psychotherapy do not consider this factor sufficiently yet. Therefore, we developed an interactive feedback prototype focusing specifically on a person's social relationships as captured with personal social networks (PSN) and daily social interactions as captured with experience sampling methodology (ESM). We describe the development of the prototype as well as two evaluation studies: Semi-structured interviews with students (N = 23) and a focus group discussion with five psychotherapy patients. Participants from both studies considered the prototype useful. The students considered participation in our study, which included social context assessment via PSN and ESM as well as a feedback session, insightful. However, it remains unclear how much insight the feedback procedure generated for the students beyond the insights they already gained from the assessments. The focus group patients indicated that in a clinical context, (social context) feedback may be especially useful to generate insight for the clinician and facilitate collaboration between patient and clinician. Furthermore, it became clear that the current feedback prototype requires explanations by a researcher or trained clinician and cannot function as a stand-alone intervention. As such, we discuss our feedback prototype as a starting point for future research and clinical implementation.
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Affiliation(s)
- Marie Stadel
- Department of Sociology, University of Groningen, Groningen, The Netherlands.
- Department of Psychometrics and Statistics, University of Groningen, Groningen, The Netherlands.
| | - Gert Stulp
- Department of Sociology, University of Groningen, Groningen, The Netherlands
- Inter-University Center for Social Science Theory and Methodology, University of Groningen, Groningen, the Netherlands
| | - Anna M Langener
- Department of Sociology, University of Groningen, Groningen, The Netherlands
- Department of Psychometrics and Statistics, University of Groningen, Groningen, The Netherlands
- Groningen Institute for Evolutionary Life Sciences, University of Groningen, Groningen, The Netherlands
| | - Timon Elmer
- Department of Psychology, University of Zurich, Zurich, Switzerland
| | - Marijtje A J van Duijn
- Department of Sociology, University of Groningen, Groningen, The Netherlands
- Inter-University Center for Social Science Theory and Methodology, University of Groningen, Groningen, the Netherlands
| | - Laura F Bringmann
- Department of Psychometrics and Statistics, University of Groningen, Groningen, The Netherlands
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Vierl L, Wülfing P, Juen F, Hörz-Sagstetter S, Spitzer C, Benecke C. Unravelling inter-relations within and between psychodynamic constructs and psychopathology using network analysis. Personal Ment Health 2024. [PMID: 38886928 DOI: 10.1002/pmh.1628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 04/26/2024] [Accepted: 05/29/2024] [Indexed: 06/20/2024]
Abstract
Psychodynamic constructs and psychopathology are closely inter-related, but more detailed insight is needed. We investigated these complex inter-relations using network analysis. A Gaussian graphical model in a sample of N = 2232 psychotherapeutic inpatients was estimated. Self-administered questionnaires to assess interpersonal relations (Inventory of Interpersonal Problems-32), psychodynamic conflicts (Operationalized Psychodynamic Diagnosis-Conflict Questionnaire), personality functioning (Operationalized Psychodynamic Diagnosis-Structure Questionnaire-Short Form, Inventory of Personality Organization-Short Form), and psychopathology (Brief Symptom Inventory) were utilized. We investigated the network structure, identified the most inter-related psychodynamic constructs and the psychodynamic constructs with the strongest inter-relations to psychopathology, and explored the clustering of all included constructs. Active and passive conflict processing modes were negatively inter-related in most conflicts. Passive conflict processing modes were more strongly related to psychopathology than active ones in all conflicts, apart from the care versus autarky conflict. Identity diffusion shared the strongest inter-relations within psychodynamic constructs. The psychodynamic constructs that were most strongly related to psychopathology were impairments in self-perception and the passive self-worth conflict. Psychopathology and psychodynamic constructs formed distinct clusters. Our results emphasize the relevance of personality functioning within psychodynamic constructs and in relation to psychopathology.
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Affiliation(s)
- Larissa Vierl
- Akademie für Psychoanalyse und Psychotherapie München e.V., Munich, Germany
- Department of Psychology, University of Kassel, Kassel, Germany
| | - Philipp Wülfing
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Rostock, Rostock, Germany
| | - Florian Juen
- Akademie für Psychoanalyse und Psychotherapie München e.V., Munich, Germany
- Department of Psychology, University of the Bundeswehr, Munich, Germany
| | - Susanne Hörz-Sagstetter
- Akademie für Psychoanalyse und Psychotherapie München e.V., Munich, Germany
- Department of Clinical Psychology and Psychotherapy, Psychologische Hochschule Berlin, Berlin, Germany
| | - Carsten Spitzer
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Rostock, Rostock, Germany
| | - Cord Benecke
- Department of Psychology, University of Kassel, Kassel, Germany
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Mau M, Roessler KK, Andersen LN, Vang ML. Self-Perceived Interpersonal Problems Among Long-Term Unemployed Individuals, and Vocational Rehabilitation Programs (In)ability to Change Them. JOURNAL OF OCCUPATIONAL REHABILITATION 2024:10.1007/s10926-024-10188-w. [PMID: 38632114 DOI: 10.1007/s10926-024-10188-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/07/2024] [Indexed: 04/19/2024]
Abstract
OBJECTIVE Self-perceived interpersonal problems can challenge one's access to the work market, making it harder to attain and keep a job while adding to the distress of being outside of the labor market. METHODS In this study, we compared the self-perceived interpersonal problems among long-term unemployed individuals taking part in vocational rehabilitation programs (VRPs) (N = 220) with those of the general population. In addition, we examined whether their self-perceived interpersonal problems changed while taking part in the VRPs. RESULTS We found that participants report significantly higher levels of self-perceived interpersonal problems as measured by the Inventory of Interpersonal Problems (IIP), especially with regard to feeling cold/distanced, socially inhibited, vindictive/self-centered, and non-assertive. The participants did not report a significant decrease in self-perceived interpersonal problems after being part of VRPs for one year. CONCLUSION These results are relevant as they may inform interventions targeted this population aimed at increasing employability and/or individual well-being. Importantly, the findings may be viewed as a reflection of both social and individual processes. Long-term unemployed individuals' tendency to feel insufficiently engaged may reflect difficulty with keeping up with a job market in constant change.
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Affiliation(s)
- Martin Mau
- Department of Psychology, University of Southern Denmark, Odense, Denmark.
- Health, Social Work and Welfare Research, UCL University College, Odense, Denmark.
| | - Kirsten K Roessler
- Department of Psychology, University of Southern Denmark, Odense, Denmark
| | - Lotte N Andersen
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Maria L Vang
- Department of Psychology, University of Southern Denmark, Odense, Denmark
- Department of Occupational and Environmental Health, Odense University Hospital, Odense, Denmark
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Salameh-Dakwar R, Elran-Barak R, Zahra-Zeitoun Y, Soroka G, Froylich D, Assalia A, Latzer Y. Interpersonal Characteristics and Binge Eating among Patients Pursuing Bariatric Surgery. Healthcare (Basel) 2023; 11:2836. [PMID: 37957980 PMCID: PMC10647538 DOI: 10.3390/healthcare11212836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 10/17/2023] [Accepted: 10/20/2023] [Indexed: 11/15/2023] Open
Abstract
BACKGROUND Preoperative binge eating behavior has been associated with difficulties in weight loss maintenance among patients pursuing bariatric surgery. However, limited data exists on the relationship between interpersonal difficulties and binge eating. OBJECTIVES To identify interpersonal factors linked with binge eating among bariatric surgery candidates. SETTING One hundred and seventeen adult bariatric surgery candidates (BMI = 42.2 ± 5.2) from three different hospitals completed questionnaires on the day of their bariatric committee meeting for operation approval. METHODS Binge eating was assessed using the Questionnaire on Eating and Weight Patterns-5 (QEWP-5) as a dichotomous variable. Self-esteem was measured using the Rosenberg Self-Esteem Scale (RSES), and interpersonal characteristics were evaluated using the short version of the Inventory of Interpersonal Problems (IIP-32). Sociodemographic variables (age, gender, income, education) and BMI were considered as confounders. RESULTS Approximately 25% of bariatric surgery candidates reported experiencing binge eating episodes within the previous three months. Participants with binge eating exhibited significantly lower self-esteem and more interpersonal difficulties, particularly in the domains of aggressiveness and dependence, compared to those without binge eating. Logistic regression analysis revealed that aggressiveness was a significant predictor of binge eating in this sample. CONCLUSIONS This study is the first, to the best of our knowledge, to investigate the relationship between interpersonal difficulties and binge eating among bariatric surgery candidates. The findings highlight the significant contribution of aggressiveness to binge eating and emphasize the importance of clinicians assessing patients' interpersonal functioning, particularly with regard to aggressiveness, as a factor that may contribute to the maintenance and occurrence of binge eating behaviors.
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Affiliation(s)
| | - Roni Elran-Barak
- School of Public Health, University of Haifa, Haifa 3498838, Israel
| | | | | | | | | | - Yael Latzer
- School of Public Health, University of Haifa, Haifa 3498838, Israel
- Rambam Medical Center, Haifa 3109601, Israel
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Shea MT, Krupnick JL, Sautter FJ, Mete M, Green BL, Norman SB, Finley SL, Eaton E. A randomized clinical trial comparing Interpersonal Psychotherapy with Prolonged Exposure for the treatment of PTSD in veterans. J Anxiety Disord 2023; 99:102770. [PMID: 37738685 DOI: 10.1016/j.janxdis.2023.102770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 07/25/2023] [Accepted: 09/03/2023] [Indexed: 09/24/2023]
Abstract
Trauma-focused therapies are recommended as first-line treatments for posttraumatic stress disorder (PTSD), but many veterans do not complete or sufficiently respond to these treatments. Interpersonal Therapy (IPT) is a non-trauma focused approach that directly addresses the interpersonal and social impairments associated with PTSD. This two-site randomized controlled equivalence trial compared IPT with Prolonged Exposure (PE) in improving PTSD symptoms and interpersonal functioning in 109 veterans with PTSD. Secondary outcomes included functioning and quality of life. We hypothesized that IPT would be statistically equivalent to PE in reducing PTSD symptoms, and superior to PE in improving interpersonal functioning and secondary outcomes of work and social adjustment and quality of life. PTSD symptom severity decreased significantly in both treatments from pre- to post-treatment. Although IPT improved as much as PE and treatments did not differ significantly, the 95 % confidence interval for the difference between the groups did not fall completely within the margin of equivalence. IPT was not superior to PE in improvement in interpersonal functioning or on secondary outcomes. Findings from multi-level linear mixed models using longitudinal data (posttreatment, three and six month follow up) for the primary outcomes of PTSD and interpersonal functioning were consistent with the post-treatment analyses. Although statistically inconclusive in terms of equivalence, the comparable reduction in PTSD symptoms slightly favoring IPT suggests that IPT is an acceptable alternative to gold-standard trauma-focused treatments for veterans with PTSD.
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Affiliation(s)
- M Tracie Shea
- Department of Veterans Affairs Providence Healthcare System, Providence, RI, United States of America; Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, United States of America.
| | - Janice L Krupnick
- Department of Psychiatry, Georgetown Medical School, Washington, DC, United States of America
| | - Frederic J Sautter
- Southeast Louisiana Veterans Health Care System, New Orleans, LA, United States of America; Tulane University Health Sciences Center, New Orleans, LA, United States of America
| | - Mihriye Mete
- MedStar Health Research Institute, Washington, DC, United States of America
| | - Bonnie L Green
- Department of Psychiatry, Georgetown Medical School, Washington, DC, United States of America
| | - Sonya B Norman
- National Center for PTSD, Executive Division, VA Medical Center, White River Junction, VT, United States of America; Department of Psychiatry, University of California San Diego School of Medicine, San Diego, CA, United States of America
| | - Shauna L Finley
- Brown Medicine Primary Care, Providence, RI, United States of America
| | - Erica Eaton
- Department of Veterans Affairs Providence Healthcare System, Providence, RI, United States of America; Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, United States of America
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7
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Noel OR, Segal DL, Granier KL. Personality, Interpersonal Problems, and Anxiety Among Older Adults. Psychol Rep 2023; 126:656-673. [PMID: 34961375 DOI: 10.1177/00332941211061697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
INTRODUCTION This study examined relationships between personality disorder (PD) features, Big Five personality traits, and interpersonal problems with anxiety. METHOD Older adults (N = 130) completed the Geriatric Anxiety Scale, Coolidge Axis Two Inventory, Big Five Inventory-2, and Circumplex Scales of Interpersonal Problems. Pearson correlation analyses were used to assess simple relationships between anxiety with PD features (CATI scales), Big Five personality domains (BFI-2 scales), and interpersonal problems (CSIP scales). Multiple linear regression analyses were performed to determine the extent to which the PD scales of the CATI, the personality scales of the BFI-2, and the scales of the CSIP explained variance in anxiety. RESULTS Anxiety was positively correlated with 13 of 14 PD scales, ranging from .23 (Narcissistic) to .61 (Depressive). Regarding Big Five personality traits, anxiety was negatively associated with Agreeableness (-.23), Conscientiousness (-.30), and Extraversion (-.31) but was positively associated with Negative Emotionality (.56). Regarding interpersonal problems, anxiety was positively related to all eight CSIP scales, ranging from Self-sacrificing (.30) to Distant/Cold (.62). Regression analyses indicated that PD features accounted for the most variance in anxiety symptoms (53%), followed by interpersonal problems (46%), and Big Five personality traits (33%). DISCUSSION Anxiety appears to be meaningfully associated with PD features, several aspects of Big Five personality traits, and interpersonal problems, suggesting that these variables may play important roles in the development and maintenance of anxiety, or vice versa. Our findings especially speak to the growing awareness of the deleterious impact of PD features on clinical syndromes in later life, as evidenced by strong comorbidities with anxiety.
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Affiliation(s)
- Olivia R Noel
- Department of Psychology, 14676University of Colorado at Colorado Springs, Colorado Springs, CO, USA
| | - Daniel L Segal
- Department of Psychology, 14676University of Colorado at Colorado Springs, Colorado Springs, CO, USA
| | - Katie L Granier
- Department of Psychology, 14676University of Colorado at Colorado Springs, Colorado Springs, CO, USA
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Goldstein E, King C, Crits-Christoph P, Connolly Gibbons MB. The association between trauma and interpersonal problems in a United States community mental health setting. J Clin Psychol 2023; 79:1192-1207. [PMID: 36459614 DOI: 10.1002/jclp.23467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 10/05/2022] [Accepted: 11/20/2022] [Indexed: 12/03/2022]
Abstract
OBJECTIVE Previous research has documented associations between trauma and interpersonal problems. We examined the impact of trauma on interpersonal problems among depressed patients seeking treatment in a community mental health setting. METHODS A total of 453 patients seeking treatment and screened for a comparative effectiveness study of therapies for depression were included. We conducted analyses relating the 32-item inventory of interpersonal problems (IIP-32) to trauma measures. RESULTS 99.1% of the sample experienced a traumatic event. There were significant associations between the total number of traumas, the number of sexually and physically assaultive traumas, and both gender and race. The number of sexually assaultive traumas was significantly related to the IIP-32 "too caring" subscale (simple r = 0.167, p < 0.001). Controlling for demographics and other IIP-32 subscales, the total number of traumas remained significantly related to the IIP-32 "too caring" domain (partial r = 0.163, p < 0.001). CONCLUSIONS Traumatic events are prevalent among community populations and these experiences are associated with certain interpersonal problems. Trauma and interpersonal problems are key issues for the treatment of patients in the community mental health setting.
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Affiliation(s)
- Elena Goldstein
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Catherine King
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Paul Crits-Christoph
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Mary Beth Connolly Gibbons
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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Barber KE, Zainal NH, Newman MG. Positive relations mediate the bidirectional connections between depression and anxiety symptoms. J Affect Disord 2023; 324:387-394. [PMID: 36584704 PMCID: PMC9893796 DOI: 10.1016/j.jad.2022.12.082] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 10/14/2022] [Accepted: 12/18/2022] [Indexed: 12/29/2022]
Abstract
INTRODUCTION Major depressive disorder (MDD) and generalized anxiety disorder (GAD) co-occur at high rates, often preceding and predicting one another over long durations. Interpersonal theories propose that relationships with others may contribute to the longitudinal connections between MDD and GAD. Therefore, the current study examined the mediational effect of positive relations with others in these connections over 18 years. METHODS Community-dwelling adults (n = 3294) participated in data collection at three time-points (Time 1 [T1], Time 2 [T2], and Time 3 [T3]) spaced about nine years apart. MDD and GAD symptoms were assessed using the Composite International Diagnostic Interview-Short Form. Positive relations was measured with the Psychological Well-Being Scale-Positive Relations with Others subscale. Structural equation mediation modeling was used for data analysis. RESULTS Results indicated that lower T2 positive relations significantly mediated the relationship between higher T1 MDD severity predicting more severe T3 GAD symptoms (d = 0.375) and explained 10.7% of the variance. T2 positive relations also had a significant mediational effect in the association between T1 GAD symptoms positively predicting T3 MDD severity (d = 0.360), accounting for 12.2% of the variance of this connection. These mediational effects were significant after adjusting for age, gender, education, and T1 symptoms (d = 0.277-0.677). CONCLUSIONS Supporting interpersonal theories, lack of positive relations with others mediated the bidirectional connections between MDD and GAD symptoms across 18 years. Future research should continue to explore the influence of positive relations on mental health and whether treatments that enhance interpersonal functioning could improve treatment for depression and anxiety.
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Affiliation(s)
- Kathryn E Barber
- Marquette University, Department of Psychology, Milwaukee, WI, USA; The Pennsylvania State University, Department of Psychology, University Park, PA, USA.
| | - Nur Hani Zainal
- Harvard Medical School, Department of Health Care Policy, Boston, MA, USA
| | - Michelle G Newman
- The Pennsylvania State University, Department of Psychology, University Park, PA, USA
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Vierl L, Juen F, Benecke C, Hörz-Sagstetter S. Exploring the associations between psychodynamic constructs and psychopathology: A network approach. Personal Ment Health 2023; 17:40-54. [PMID: 35879050 DOI: 10.1002/pmh.1559] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 06/03/2022] [Accepted: 07/12/2022] [Indexed: 11/09/2022]
Abstract
Psychodynamic therapy effectively reduces symptomatology by focusing on underlying (unconscious) processes instead of symptoms. Nevertheless, the exact interrelationship between psychodynamic constructs and psychopathology remains unclear. This study uses network analysis to explore these associations. We computed a cross-sectional partial correlation network between psychodynamic constructs (i.e., personality functioning, interpersonal relations, and active and passive modes of intrapsychic conflicts according to the Operationalized Psychodynamic Diagnostics [OPD] system) and psychopathology (i.e., depression and somatization) in a naturalistic sample of 341 adults registering for psychodynamic outpatient therapy. We estimated node centrality, node predictability, and bridge symptoms and used community detection analysis. Bootstrap methods were applied to assess network stability. Psychodynamic constructs and psychopathology resulted in separate but connected clusters. Personality functioning emerged as the most influential node in the network and was bridging the clusters. The network was found to be highly stable, allowing reliable interpretations. The results offer important insights on how psychodynamic constructs relate to psychopathology, which can be used to inform treatment approaches. The findings suggest that personality functioning may be an important intervention target. However, future research is needed to include a broader range of diagnoses. In addition, longitudinal studies may clarify the direction of causality.
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Affiliation(s)
- Larissa Vierl
- Akademie für Psychoanalyse und Psychotherapie München e.V., Munich, Germany.,Department of Psychology, University of Kassel, Kassel, Germany
| | - Florian Juen
- Akademie für Psychoanalyse und Psychotherapie München e.V., Munich, Germany.,Department of Psychology, University of Innsbruck, Innsbruck, Austria
| | - Cord Benecke
- Department of Psychology, University of Kassel, Kassel, Germany
| | - Susanne Hörz-Sagstetter
- Akademie für Psychoanalyse und Psychotherapie München e.V., Munich, Germany.,Psychologische Hochschule Berlin, Berlin, Germany
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11
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Psychosocial factors associated with anxious depression. J Affect Disord 2023; 322:39-45. [PMID: 36375541 DOI: 10.1016/j.jad.2022.11.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 10/06/2022] [Accepted: 11/07/2022] [Indexed: 11/13/2022]
Abstract
BACKGROUND Anxious depression is a common subtype of major depressive disorder (MDD) associated with adverse outcomes and severely impaired social function. The aim of this study was to explore the relationships between child maltreatment, family functioning, social support, interpersonal problems, dysfunctional attitudes, and anxious depression. METHODS Data were collected from 809 MDD patients. The Hamilton Anxiety Scale (HAMA), Hamilton Depression Scale-17 (HAMD-17), Family Assessment Device (FAD), Childhood Trauma Questionnaire (CTQ), Social Support Rating Scale (SSRS), Interpersonal Relationship Integrative Diagnostic Scale (IRIDS), and Dysfunctional Attitudes Scale (DAS) were administered and recorded. Anxious depression was defined as an anxiety/somatization factor score ≥ 7 on the HAMD-17. Chi-squared tests, Mann-Whitney U tests, distance correlations, and structural equation models were used for data analysis. RESULTS Two-fifths of MDD patients had comorbid anxiety, and there were significant differences in child maltreatment, family functioning, social support, interpersonal problems, and dysfunctional attitudes between groups. Of these factors, interpersonal relationships were most related to anxiety in MDD patients, and dysfunctional attitudes mediated the relationship between interpersonal relationships and anxiety in MDD patients. LIMITATIONS This study used cross-sectional data with no further follow-up to assess patient outcomes. This study did not include information about pharmacological treatments. A larger sample size is needed to validate the results. CONCLUSIONS Psychosocial factors were significantly associated with anxious depression. Interpersonal relationships and dysfunctional attitudes have a direct effect on anxious depression, and interpersonal relationships also mediate the effects of anxious depression via dysfunctional attitudes.
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12
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Soodla HL, Akkermann K. Bottom-up transdiagnostic personality subtypes are associated with state psychopathology: A latent profile analysis. Front Psychol 2023; 14:1043394. [PMID: 36895730 PMCID: PMC9990091 DOI: 10.3389/fpsyg.2023.1043394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 01/23/2023] [Indexed: 02/23/2023] Open
Abstract
Introduction Personality-based profiling helps elucidate associations between psychopathology symptoms and address shortcomings of current nosologies. The objective of this study was to bracket the assumption of a priori diagnostic class borders and apply the profiling approach to a transdiagnostic sample. Profiles resembling high-functioning, undercontrolled, and overcontrolled phenotypes were expected to emerge. Methods We used latent profile analysis on data from a sample of women with mental disorders (n = 313) and healthy controls (n = 114). 3-5 profile solutions were compared based on impulsivity, perfectionism, anxiety, stress susceptibility, mistrust, detachment, irritability, and embitterment. The best-fitting solution was then related to measures of depression, state anxiety, disordered eating, and emotion regulation difficulties to establish clinical significance. Results A 5-profile solution proved best-fitting. Extracted profiles included a high-functioning, a well-adapted, an impulsive and interpersonally dysregulated, an anxious and perfectionistic, and an emotionally and behaviorally dysregulated class. Significant differences were found in all outcome state measures, with the emotionally and behaviorally dysregulated class exhibiting the most severe psychopathology. Discussion These results serve as preliminary evidence of the predictive nature and clinical utility of personality-based profiles. Selected personality traits should be considered in case formulation and treatment planning. Further research is warranted to replicate the profiles and assess classification stability and profiles' association with treatment outcome longitudinally.
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Affiliation(s)
- Helo Liis Soodla
- Institute of Psychology, University of Tartu, Tartu, Estonia.,Centre for Cognitive and Behavioural Therapy, Tartu, Estonia
| | - Kirsti Akkermann
- Institute of Psychology, University of Tartu, Tartu, Estonia.,Centre for Cognitive and Behavioural Therapy, Tartu, Estonia
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Monteleone AM, Globus I, Cascino G, Klomek AB, Latzer Y. Psychopathology predicts mental but not physical bariatric surgery outcome at 3-year follow-up: a network analysis study. Eat Weight Disord 2022; 27:3331-3340. [PMID: 36029369 PMCID: PMC9803758 DOI: 10.1007/s40519-022-01463-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 07/29/2022] [Indexed: 01/04/2023] Open
Abstract
PURPOSE This study aimed to explore the psychopathological variables that may predict bariatric surgery outcomes after 3 years. METHODS One hundred ninety-six candidates for bariatric surgery completed self-report questionnaires to assess eating attitudes, eating disorder (ED)-related psychopathology, affective symptoms, interpersonal and psycho-social functioning. One-hundred patients repeated this assessment 3 years after bariatric surgery. A network analysis was run including the pre-surgical measurements in the network. A composite score derived from the combination of the most central network nodes, as well as clinical and socio-demographical variables, was included in a multivariate regression analysis with weight loss, ED psychopathology and psycho-social functioning as outcomes. RESULTS Depression, stress, and shape concerns were the most central network nodes. The composite network score predicted higher ED psychopathology and worse psycho-social functioning at 3-year follow-up, but not weight loss. Higher age, restricting type of bariatric surgery and higher pre-operative BMI were further predictors of reduced weight loss and greater ED psychopathology. CONCLUSIONS Affective symptoms and shape concern play a central role in the psychopathology of candidates to bariatric surgery and predict post-surgery ED psychopathology and psycho-social functioning. These variables may allow to identify patients with higher pre-operative risk and in need of further psycho-social interventions. LEVEL OF EVIDENCE III, evidence obtained from well-designed cohort study.
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Affiliation(s)
| | - Inbal Globus
- School of Public Health, University of Haifa, Haifa, Israel
- Maccabi Healthcare Services, Tel-Aviv, Israel
| | - Giammarco Cascino
- Department of Medicine, Surgery and Dentistry 'Scuola Medica Salernitana', Section of Neurosciences, University of Salerno, Salerno, Italy
| | | | - Yael Latzer
- Eating Disorders Institution, Psychiatric Division, Rambam Medical Center, Haifa, Israel
- Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
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Tomczyk J, Nezlek JB, Krejtz I. Gratitude Can Help Women At-Risk for Depression Accept Their Depressive Symptoms, Which Leads to Improved Mental Health. Front Psychol 2022; 13:878819. [PMID: 35465539 PMCID: PMC9022718 DOI: 10.3389/fpsyg.2022.878819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 03/21/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction Gratitude is commonly known as a positive emotion, but it can also be understood as a disposition—one’s inherent quality that includes being grateful for the positive aspects of one’s life and appreciating altruistic gifts. A growing body of research suggests that having a disposition of gratitude is positively related to wellbeing and psychological adjustment. The present study examined the extent to which acceptance of illness—a measure of adjustment to a distressing condition—mediated relationships between dispositional gratitude and wellbeing among women who had elevated levels of depressive symptoms. Methods Participants were 131 women who, based on scores on the Center for Epidemiological Studies Depression scale, were at-risk for experiencing clinical depression. Thirty-five of these participants had been diagnosed as depressed at some point in their lives and 96 had not. Participants completed measures of dispositional gratitude, wellbeing, anxiety, and acceptance of illness. Results Dispositional gratitude was positively correlated with wellbeing and was negatively correlated with depression and anxiety. Dispositional gratitude was also positively correlated with acceptance of illness. Mediational analyses found that acceptance of illness mediated relationships between dispositional gratitude and wellbeing, between dispositional gratitude and anxiety, and between dispositional gratitude and depression. Moreover, such mediation varied as a function of whether women had ever been diagnosed as depressed. Acceptance of illness was related more strongly to wellbeing for women who had been diagnosed as depressed at some time in their lives than it was for women who had never been diagnosed as depressed. Conclusion Women with elevated depressive symptoms who were more grateful (compared to those who were less grateful) were more accepting of their condition, which was related to increased wellbeing and decreased feelings of depression and anxiety.
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Affiliation(s)
- Joanna Tomczyk
- Institute of Psychology, SWPS University of Social Sciences and Humanities, Warsaw, Poland
| | - John B Nezlek
- Institute of Psychology, SWPS University of Social Sciences and Humanities, Warsaw, Poland.,Center for Climate Change and Social Transformation, SWPS University of Social Sciences and Humanities, Warsaw, Poland.,College of William and Mary, Williamsburg, VA, United States
| | - Izabela Krejtz
- Institute of Psychology, SWPS University of Social Sciences and Humanities, Warsaw, Poland
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15
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Coleman M, Jones EJ, Hoiles KJ, McEvoy PM. The association between carer self-compassion, expressed emotion, quality of life, and paediatric eating disorder symptoms. Eat Behav 2022; 45:101628. [PMID: 35490441 DOI: 10.1016/j.eatbeh.2022.101628] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 03/15/2022] [Accepted: 03/23/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVE The aim of this study was to investigate carer variables on paediatric eating disorders. We examined whether carer self-compassion, the tendency to treat oneself with kindness during distress and disappointments, was associated with lower carer expressed emotion, and, in turn, whether lower carer expressed emotion would be associated with both higher carer quality of life and lower eating disorder symptoms in young people. Further, we examined whether higher carer quality of life was associated with lower adolescent eating disorder symptoms. METHOD Data were extracted from the Helping out Paediatric Eating Disorders (HOPE) project database. Participants included children and adolescents diagnosed with a DSM5 eating disorder and their primary carer (N of dyads = 359). Primary carers completed the Self-Compassion Scale-Short Form (SCS-SF), Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q-SF), and the Family Questionnaire-Expressed Emotion (FQ-EE). Children and adolescents completed an adapted version of the Eating Disorder Examination (EDE). RESULTS As hypothesised, structural equation modelling (SEM) revealed a direct relationship between higher carer self-compassion and lower expressed emotion, and between lower expressed emotion and both higher carer quality of life and lower eating disorder symptoms. However, contrary to our hypothesis, carer quality of life was not significantly associated with paediatric eating disorder symptoms. Expressed emotion carried significant indirect effects between carer self-compassion and (a) paediatric eating disorder symptoms and (b) carer quality of life. DISCUSSION The results highlight the importance of further research to determine whether targeting carer self-compassion is helpful in the treatment of eating disorders in young people.
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Affiliation(s)
| | - Emily J Jones
- Eating Disorders Program, Child and Adolescent Mental Health Service, Perth, Australia.
| | - Kimberley J Hoiles
- Eating Disorders Program, Child and Adolescent Mental Health Service, Perth, Australia
| | - Peter M McEvoy
- School of Psychology, Curtin University, Perth, Australia; Centre for Clinical Interventions, Perth, Australia
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16
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Can Rehabilitation in Nature Improve Self-Perceived Interpersonal Problems? A Matched-Control Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063622. [PMID: 35329308 PMCID: PMC8949583 DOI: 10.3390/ijerph19063622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 03/02/2022] [Accepted: 03/17/2022] [Indexed: 11/21/2022]
Abstract
Self-perceived interpersonal problems are of central concern for researchers and individuals; they are at the basis of psychopathology and cause for subjective distress. In this study, we examine whether a group-based rehabilitation program in nature may reduce self-perceived interpersonal problems in a heterogeneous group of men declining participation in traditional rehabilitation offers. The intervention consisted of weekly meetings in nature, taking place over the course of nine weeks. Through a matched-control study including 114 participants in the intervention group and 39 in a treatment as usual group participating in traditional rehabilitation offers, we found that there was no statistically significant development in self-perceived interpersonal problems in the nature-based rehabilitation offer. Though promising with regards to a number of mental challenges, including relational challenges, nature-based group-rehabilitation may require a more elaborate and thoroughgoing intervention, including e.g., a therapist and more time to be an effective intervention against interpersonal problems. We conclude that perhaps due to the fundamental aspect of self-perceived interpersonal problems, exposure to nature, and being in a group of men in a similar situation for the duration that this intervention lasted, may not be enough to address such underlying perceptions of self.
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17
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Kozina RM, Lear MK, Stacy S, Kern S, Ripley A, Clapp J. Moderating effects of brooding on the link between functional impairment and interpersonal needs in survivors of serious trauma. J Clin Psychol 2022; 78:1839-1850. [PMID: 35150129 DOI: 10.1002/jclp.23327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 12/12/2021] [Accepted: 01/22/2022] [Indexed: 11/07/2022]
Abstract
OBJECTIVES Trauma and resulting functional limitations demonstrate associations with perceived burdensomeness and thwarted belongingness, factors contributing to elevated risk for suicidal ideation. However, survivors display differential risk in response to impairment, highlighting the need for research on exacerbating factors. The current study examined the impact of brooding on the association of functional impairment with burdensomeness and belongingness among trauma-exposed undergraduates (N = 262). METHOD Trauma was assessed via clinical interview with questionnaires for study variables. Regression models examined the unique and interactive effects of physical impairment, emotional impairment, and brooding on burdensomeness and thwarted belongingness. RESULTS An interaction of brooding and impairment due to emotional difficulties was observed for burdensomeness with impairment linked to elevated burdensomeness at high (β = -0.46; p < 0.001), but not low (β = -0.07; p = 0.476) brooding. Impairment due to emotional difficulties (β = -0.38; p < 0.001) and brooding (β = 0.25; p < 0.001) were associated with belongingness. CONCLUSIONS Findings identify brooding as a potential target for assessment and intervention in trauma-exposed individuals.
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Affiliation(s)
- Ryan M Kozina
- Department of Psychology, University of Wyoming, Laramie, Wyoming, USA
| | - M Kati Lear
- Department of Psychology, University of Wyoming, Laramie, Wyoming, USA
| | - Stephanie Stacy
- Department of Psychology, University of Wyoming, Laramie, Wyoming, USA
| | - Shira Kern
- Department of Psychology, University of Wyoming, Laramie, Wyoming, USA
| | - Adam Ripley
- Department of Psychology, University of Wyoming, Laramie, Wyoming, USA
| | - Joshua Clapp
- Department of Psychology, University of Wyoming, Laramie, Wyoming, USA
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18
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Rappaport LM, Di Nardo N, Brotman MA, Pine DS, Leibenluft E, Roberson-Nay R, Hettema JM. Pediatric anxiety associated with altered facial emotion recognition. J Anxiety Disord 2021; 82:102432. [PMID: 34146888 PMCID: PMC8364876 DOI: 10.1016/j.janxdis.2021.102432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 05/01/2021] [Accepted: 06/04/2021] [Indexed: 10/21/2022]
Abstract
Multiple psychiatric disorders are associated with difficulties in facial emotion recognition. However, generalized anxiety disorder may be associated with more accurate recognition of others' emotional expressions, particularly expressions of happiness and fear, which index safety and threat. Children aged 9-14 from a community sample (N = 601) completed a facial emotion labeling task. Children's symptoms of depressive and anxiety syndromes were assessed by self- and parent-report. Elevated symptoms of generalized anxiety disorder were associated with more accurate facial emotion recognition (β = 0.16, p = 0.007), specifically recognition of happiness (β = 0.17, p = 0.002) and fear (β = 0.15, p = 0.006). Elevated depressive symptoms were associated with less accurate facial emotion recognition (β = -0.12, p = 0.018), specifically happiness (β = -0.15, p = 0.002). Elevated symptoms of separation anxiety disorder were also associated with less accurate facial emotion recognition (β = -0.16, p = 0.003), specifically happiness (β = -0.15, p = 0.006) and fear (β = -0.15, p = 0.005), which highlights the importance of distinguishing between anxiety syndromes. Results held when adjusting for child age and sex. Evidence that symptoms of generalized anxiety disorder are associated with more accurate recognition of happiness and fear is consistent with theories of heightened social vigilance and support a transdiagnostic role of facial emotion recognition that may inform the psychosocial development of youth with anxiety and depressive symptoms.
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Affiliation(s)
- Lance M. Rappaport
- Department of Psychology, University of Windsor, Windsor, Ontario, Canada; Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Nicole Di Nardo
- Department of Psychology, University of Windsor, Windsor, Ontario, Canada
| | - Melissa A. Brotman
- Emotion and Development Branch, National Institute of Mental Health, Bethesda, Maryland, USA
| | - Daniel S. Pine
- Emotion and Development Branch, National Institute of Mental Health, Bethesda, Maryland, USA
| | - Ellen Leibenluft
- Emotion and Development Branch, National Institute of Mental Health, Bethesda, Maryland, USA
| | - Roxann Roberson-Nay
- Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, Virginia, USA
| | - John M. Hettema
- Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, Virginia, USA; Department of Psychiatry, Texas A&M Health Sciences Center, Bryan, Texas, USA
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Rationale, design, and methods of a two-site randomized controlled trial: Comparative effectiveness of two treatments for posttraumatic stress disorder in veterans. Contemp Clin Trials 2021; 105:106408. [PMID: 33872802 DOI: 10.1016/j.cct.2021.106408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 04/09/2021] [Accepted: 04/14/2021] [Indexed: 11/23/2022]
Abstract
PTSD is associated with serious problems in interpersonal functioning, including higher rates of marital conflict and divorce, disrupted relationships with family and friends, estrangement from others and social isolation. Cognitive behavioral and trauma focused treatments are effective for treating PTSD symptoms, but a substantial proportion of individuals, particularly veterans, with PTSD, do not engage, complete, or fully respond to these treatments, and the effects of these treatments on interpersonal functioning are unknown. There is a critical need for alternative treatments with established efficacy, and for treatments that directly address problems in relationship functioning. Interpersonal Psychotherapy for PTSD (IPT-PTSD) is a promising candidate for such a treatment. This paper describes the rationale, design, and methods of the first randomized controlled equivalence trial comparing IPT-PTSD with a first-line gold standard treatment for PTSD (Prolonged Exposure; PE) in the treatment of PTSD in veterans. Both treatments include up to 12 weekly individual sessions. Assessments were conducted at baseline, following sessions four and eight, end of treatment, and 3 and 6 months post-treatment. Primary hypotheses are that IPT-PTSD will be statistically equivalent to PE in reducing the severity of PTSD symptoms, and superior to PE in improving interpersonal functioning. Secondary hypotheses propose that IPT will be superior to PE in improving overall social adjustment and quality of life, and in reducing suicidal ideation. Findings from this study have the potential to improve treatment options for veterans struggling with PTSD and interpersonal problems.
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20
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Gómez Penedo JM, Schwartz B, Deisenhofer AK, Rubel J, Babl AM, Lutz W. Interpersonal clarification effects in Cognitive-Behavioral Therapy for depression and how they are moderated by the therapeutic alliance. J Affect Disord 2021; 279:662-670. [PMID: 33190117 DOI: 10.1016/j.jad.2020.10.043] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 09/10/2020] [Accepted: 10/25/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND Although a wide body of research links depression to interpersonal deficits, Cognitive-Behavioral Therapy (CBT), considered the gold standard in the treatment of this condition, has not been developed to specifically address interpersonal difficulties. However, cognitive changes on a relational level occurring during CBT might play an important role in the treatment of depression. Interpersonal clarification refers to the process of better understanding the nature of one's interpersonal patterns during therapy. The aim of this study is to analyze the effects of interpersonal clarification in CBT and how they are moderated by the therapeutic alliance. METHODS A sample of 621 patients diagnosed with depression were treated with CBT by 126 therapists in a university outpatient clinic. Patients completed measures of interpersonal problems and depression severity at baseline, measures of symptomatic evolution before each session and process measures (assessing interpersonal clarification and alliance) after each session. Multilevel models separating between-patient (BP) and within-patient (WP) effects of interpersonal clarification, and including BP and WP alliance effects as covariates and moderators of the interpersonal clarification effects were conducted. RESULTS Analyses showed both significant BP and WP effects interpersonal clarification, even when adjusting for alliance effects. Furthermore, significant interactive effects were found between outcome of WP interpersonal clarification with both BP alliance and WP alliance. LIMITATIONS Interpersonal clarification was measured with one single-item and adherence to CBT was not explicitly measured. CONCLUSIONS The results present preliminary evidence for considering interpersonal clarification a meaningful change process in CBT for depression, especially in the context of a stronger therapeutic alliance.
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Affiliation(s)
- Juan Martín Gómez Penedo
- Clinical Psychology and Psychotherapy, Department of Psychology, University of Trier; Department of Psychology, Universidad de Buenos Aires (CONICET).
| | - Brian Schwartz
- Clinical Psychology and Psychotherapy, Department of Psychology, University of Trier
| | | | - Julian Rubel
- Department of Psychology, Justus-Liebig University Giessen
| | - Anna M Babl
- Clinical Psychology and Psychotherapy Department, University of Bern
| | - Wolfgang Lutz
- Clinical Psychology and Psychotherapy, Department of Psychology, University of Trier
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21
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Bliton CF, Pincus AL. Construction and Validation of the Interpersonal Influence Tactics Circumplex (IIT-C) Scales. Assessment 2019; 27:688-705. [PMID: 31342776 DOI: 10.1177/1073191119864661] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Assessment of interpersonal dispositions (e.g., traits, problems) commonly employs self- and informant-report measures that conform to the two-dimensional interpersonal circumplex (IPC) model. Here, we adopted the IPC and interpersonal theory as a framework for mapping the universe of content of interpersonal influence. Although there are existing measures of influence tactics used in influence research, this literature is divided among disciplines with varying construct definitions and no unifying theory. Here, we define interpersonal influence as the conscious maneuvering of one's behavior to engender desired responses from others in interpersonal situations. The current article details the construction and validation of the Interpersonal Influence Tactics Circumplex (IIT-C) Scales in two samples (Ns = 862, 608). The 64-item IIT-C assesses a comprehensive taxonomy of interpersonal influence tactics conforming to the structure of the IPC. Circumplex structure of the IIT-C was confirmed and replicated. Using the structural summary method for circumplex data, associations with other IPC measures, existing measures of influence, normal personality traits, and pathological personality traits supported the validity of IIT-C scores. The IIT-C assesses a theoretically based and empirically derived set of interpersonal influence tactics and provides a common language for integrating distinct streams of influence research by conforming to the IPC.
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22
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Kalaycı BM, Nalbant K, Akdemir D, Akgül S, Kanbur N. Social functioning and its association with accompanying psychiatric symptoms in adolescents with anorexia nervosa. PSYCHIAT CLIN PSYCH 2019. [DOI: 10.1080/24750573.2019.1595867] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Affiliation(s)
- Bilge Merve Kalaycı
- Department of Child and Adolescent Psychiatry, Yildirim Beyazıt University, Yenimahalle Trainig and Research Hospital, Ankara, Turkey
| | - Kevser Nalbant
- Medical Faculty, Department of Child and Adolescent Psychiatry, Hacettepe University, Ankara, Turkey
| | - Devrim Akdemir
- Medical Faculty, Department of Child and Adolescent Psychiatry, Hacettepe University, Ankara, Turkey
| | - Sinem Akgül
- Medical Faculty, Division of Adolescent Medicine, Department of Pediatrics, Hacettepe University, Ankara, Turkey
| | - Nuray Kanbur
- Medical Faculty, Division of Adolescent Medicine, Department of Pediatrics, Hacettepe University, Ankara, Turkey
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Depression predicts interpersonal problems partially through the attitude towards social touch. J Affect Disord 2019; 246:234-240. [PMID: 30584957 DOI: 10.1016/j.jad.2018.12.054] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Revised: 11/13/2018] [Accepted: 12/16/2018] [Indexed: 12/21/2022]
Abstract
INTRODUCTION Depression is associated with difficulties in interpersonal relationships, of which communication is an integral part. Communication can not only be effected by verbal means, but also non-verbally by touch. Against this background, the aim of the present study was to investigate the relationship between depression, interpersonal problems and the attitude towards social touch. METHODS 147 individuals (115 females; 21-71 years old) seeking treatment in a clinic for outpatient psychotherapy took part in the survey. Three questionnaires evaluating the level of depression (Beck Depression Questionnaire), the degree of interpersonal problems (Inventory of Interpersonal Problems) and the attitude towards social touch (Social Touch Questionnaire, were administered. RESULTS Highly depressed individuals had a more negative attitude towards social touch than non-to lowly depressed individuals. Highly depressed individuals particularly reported to dislike physical touch by not well-known people, but not by close ones. Highly depressed individuals also reported more interpersonal problems, with the level of depression predicting the degree of interpersonal problems. This relationship was partially mediated by the attitude towards social touch in general and, to a greater extent, by the dislike of physical touch by people not well-known in particular. DISCUSSION Given the role of social touch in the relationship between depression and interpersonal problems, the attitude towards touch may be taken into consideration in the therapy of depressed patients. We assume that a more positive attitude towards social touch can influence the ability to create and maintain interpersonal relationships.
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Lindberg K, Nevonen L, Gustafsson SA, Nyman-Carlsson E, Norring C. Validation of the Inventory of Interpersonal Problems (IIP-64): a comparison of Swedish female outpatients with anorexia nervosa or bulimia nervosa and controls. Nord J Psychiatry 2018; 72:347-353. [PMID: 29703121 DOI: 10.1080/08039488.2018.1465589] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
AIM The aim of the study was to explore the psychometric properties of the Inventory of Interpersonal Problems (IIP-64) and to compare levels of interpersonal distress in Swedish female outpatients with anorexia nervosa or bulimia nervosa with age- and gender-matched controls. METHODS Totally, 401 participants were included; anorexia nervosa (n = 74), bulimia nervosa (n = 85) and controls (n = 242). All participants completed the IIP-64. The eating disorder (ED) patients also filled out the Eating Disorder Inventory-2/3 (EDI). RESULTS Internal consistency of IIP-64 was acceptable to high. Principal component analyses with varimax rotation of the IIP-64 subscales confirmed the circumplex structure with two underlying orthogonal dimensions; affiliation and dominance. Significant correlations between EDI-3 composite scales ineffectiveness and interpersonal problems and IIP-64 were found. ED patients reported higher levels of interpersonal distress than controls on all but one subscale (intrusive/needy). CONCLUSIONS IIP-64 can be considered to have acceptable to good reliability and validity in a Swedish ED sample. IIP-64 can be a useful complement in assessment of interpersonal problems in ED.
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Affiliation(s)
- Karolin Lindberg
- a Department of Clinical Neuroscience, Centre for Psychiatry Research , Karolinska Institutet , Stockholm , Sweden.,b R&D Unit, Stockholm Centre for Eating Disorders, Stockholm County Council , Stockholm , Sweden
| | - Lauri Nevonen
- a Department of Clinical Neuroscience, Centre for Psychiatry Research , Karolinska Institutet , Stockholm , Sweden.,c Praktikertjänst Psychiatry AB , Stockholm , Sweden.,d School of Medical Sciences , Örebro University , Örebro , Sweden
| | - Sanna Aila Gustafsson
- a Department of Clinical Neuroscience, Centre for Psychiatry Research , Karolinska Institutet , Stockholm , Sweden.,d School of Medical Sciences , Örebro University , Örebro , Sweden
| | - Erika Nyman-Carlsson
- c Praktikertjänst Psychiatry AB , Stockholm , Sweden.,d School of Medical Sciences , Örebro University , Örebro , Sweden
| | - Claes Norring
- a Department of Clinical Neuroscience, Centre for Psychiatry Research , Karolinska Institutet , Stockholm , Sweden.,b R&D Unit, Stockholm Centre for Eating Disorders, Stockholm County Council , Stockholm , Sweden
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25
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Bailey C, Abate A, Sharp C, Venta A. Psychometric evaluation of the Inventory of Interpersonal Problems 32. Bull Menninger Clin 2018; 82:93-113. [DOI: 10.1521/bumc.2018.82.2.93] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The Inventory of Interpersonal Problems 32 (IIP-32; Horowitz, Aiden, Wiggins, & Pincus, 2000) is a brief, 32-item, self-report questionnaire used to screen for interpersonal problems. While studies of the IIP-32's psychometric properties have been conducted in other nations, and studies have examined the psychometric properties of the IIP-32's circumplex structure, no studies have examined the factor-analytic structure in the United States since the original standardization sample. The aim of this study was to examine the psychometric properties of the IIP-32 in American college women for the first time and explore its structural validity as a circumplex measure and its concurrent validity with measures of attachment. The current study found that internal consistency estimates and interscale correlations were generally high and confirmed the proposed circumplex structure. In addition, concurrent validity was evidenced by confirming theorized relations between attachment and the IIP-32 subscales. However, IIP-32 subscales were limited with regard to divergent validity.
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Affiliation(s)
- Cassandra Bailey
- Department of Psychology, Sam Houston State University, Huntsville, Texas
| | - Anna Abate
- Department of Psychology, Sam Houston State University, Huntsville, Texas
| | - Carla Sharp
- Department of Psychology, The University of Houston, Houston, Texas
| | - Amanda Venta
- Department of Psychology, Sam Houston State University, Huntsville, Texas
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26
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MacNamara A, Jackson TB, Fitzgerald JM, Hajcak G, Phan KL. Working Memory Load and Negative Picture Processing: Neural and Behavioral Associations With Panic, Social Anxiety, and Positive Affect. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2018; 4:151-159. [PMID: 29805056 DOI: 10.1016/j.bpsc.2018.04.005] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Revised: 04/02/2018] [Accepted: 04/12/2018] [Indexed: 01/03/2023]
Abstract
BACKGROUND Internalizing disorders such as anxiety may be characterized by an imbalance between bottom-up (stimulus-driven) and top-down (goal-directed) attention. The late positive potential (LPP) can be used to assess these processes when task-irrelevant negative and neutral pictures are presented within a working memory paradigm. Prior work using this paradigm has found that working memory load reduces the picture-elicited LPP across participants; however, anxious individuals showed a reduced effect of working memory load on the LPP, suggesting increased distractibility. METHODS The current study assessed transdiagnostic associations between specific symptom dimensions of anxiety, the LPP, and behavior in a clinically representative, heterogeneous group of 76 treatment-seeking patients with internalizing disorders, who performed a working memory task interspersed with negative and neutral pictures. RESULTS As expected, negative pictures enhanced the LPP, and working memory load reduced the LPP. Participants with higher social anxiety showed increased LPPs to negative stimuli during early and late portions of picture presentation. Panic symptoms were associated with reduced LPPs to negative pictures compared with neutral pictures as well as a reduced effect of working memory load on the LPP during the late time window. Reduced positive affect was associated with greater behavioral interference from negative pictures. CONCLUSIONS Hypervigilance for negative stimuli was uniquely explained by social anxiety symptoms, whereas panic symptoms were associated with the opposing effect-blunted processing/avoidance of these stimuli. Panic symptoms were uniquely associated with reduced top-down control. Results reveal distinct associations between neural reactivity and anxiety symptom dimensions that transcend traditional diagnostic boundaries.
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Affiliation(s)
- Annmarie MacNamara
- Department of Psychological and Brain Sciences, Texas A&M University, College Station, Texas.
| | - T Bryan Jackson
- Department of Psychological and Brain Sciences, Texas A&M University, College Station, Texas
| | | | - Greg Hajcak
- Department of Psychology, Florida State University, Tallahassee, Florida
| | - K Luan Phan
- Department of Psychiatry, University of Illinois at Chicago, Chicago, Illinois; Department of Psychology, University of Illinois at Chicago, Chicago, Illinois; Department of Anatomy and Cell Biology, and Graduate Program in Neuroscience, University of Illinois at Chicago, Chicago, Illinois
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Lo Coco G, Mannino G, Salerno L, Oieni V, Di Fratello C, Profita G, Gullo S. The Italian Version of the Inventory of Interpersonal Problems (IIP-32): Psychometric Properties and Factor Structure in Clinical and Non-clinical Groups. Front Psychol 2018; 9:341. [PMID: 29615945 PMCID: PMC5868495 DOI: 10.3389/fpsyg.2018.00341] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Accepted: 02/28/2018] [Indexed: 11/13/2022] Open
Abstract
All versions of the Inventory of Interpersonal Problems (IIP) are broadly used to measure people's interpersonal functioning. The aims of the current study are: (a) to examine the psychometric properties and factor structure of the Italian version of the Inventory of Interpersonal Problems—short version (IIP-32); and (b) to evaluate its associations with core symptoms of different eating disorders. One thousand two hundred and twenty three participants (n = 623 non-clinical and n = 600 clinical participants with eating disorders and obesity) filled out the Inventory of Interpersonal Problems—short version (IIP-32) along with measures of self-esteem (Rosenberg Self-Esteem Scale, RSES), psychological functioning (Outcome Questionnaire, OQ-45), and eating disorders (Eating Disorder Inventory, EDI-3). The present study examined the eight-factor structure of the IIP-32 with Confirmatory Factor Analysis (CFA) and Exploratory Structural Equation Modeling (ESEM). ESEM was also used to test the measurement invariance of the IIP-32 across clinical and non-clinical groups. It was found that CFA had unsatisfactory model fit, whereas the corresponding ESEM solution provided a better fit to the observed data. However, six target factor loadings tend to be modest, and ten items showed cross-loadings higher than 0.30. The configural and metric invariance as well as the scalar and partial strict invariance of the IIP-32 were supported across clinical and non-clinical groups. The internal consistency of the IIP-32 was acceptable and the construct validity was confirmed by significant correlations between IIP-32, RSES, and OQ-45. Furthermore, overall interpersonal difficulties were consistently associated with core eating disorder symptoms, whereas interpersonal styles that reflect the inability to form close relationships, social awkwardness, the inability to be assertive, and a tendency to self-sacrificing were positively associated with general psychological maladjustment. Although further validation of the Italian version of the IIP-32 is needed to support these findings, the results on its cross-cultural validity are promising.
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Affiliation(s)
- Gianluca Lo Coco
- Department of Psychology and Educational Sciences, University of Palermo, Palermo, Italy
| | | | - Laura Salerno
- Department of Psychology and Educational Sciences, University of Palermo, Palermo, Italy
| | - Veronica Oieni
- Department of Psychology and Educational Sciences, University of Palermo, Palermo, Italy
| | - Carla Di Fratello
- Department of Psychology and Educational Sciences, University of Palermo, Palermo, Italy
| | - Gabriele Profita
- Department of Psychology and Educational Sciences, University of Palermo, Palermo, Italy
| | - Salvatore Gullo
- Faculty of Psychology, University Niccolò Cusano, Rome, Italy
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Kanter JW, Manbeck KE, Kuczynski AM, Maitland DW, Villas-Bôas A, Reyes Ortega MA. A comprehensive review of research on Functional Analytic Psychotherapy. Clin Psychol Rev 2017; 58:141-156. [DOI: 10.1016/j.cpr.2017.09.010] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Revised: 09/20/2017] [Accepted: 09/23/2017] [Indexed: 10/18/2022]
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Shevlin M, Hyland P, Karatzias T, Fyvie C, Roberts N, Bisson JI, Brewin CR, Cloitre M. Alternative models of disorders of traumatic stress based on the new ICD-11 proposals. Acta Psychiatr Scand 2017; 135:419-428. [PMID: 28134442 DOI: 10.1111/acps.12695] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/20/2016] [Indexed: 01/19/2023]
Abstract
OBJECTIVE Although there is emerging evidence for the factorial validity of the distinction between post-traumatic stress disorder (PTSD) and complex PTSD (CPTSD) proposed in ICD-11, such evidence has been predominantly based on using selected items from individual scales that describe these factors. We have attempted to address this gap in the literature by testing a range of alternative models of disorders of traumatic stress using a broader range of symptoms and standardized measures. METHOD Participants in this cross-sectional study were a sample of individuals who were referred for psychological therapy to a National Health Service (NHS) trauma centre in Scotland (N = 195). Participants were recruited over a period of 18 months and completed measures of stressful life events, DSM-5 PTSD, emotion dysregulation, self-esteem and interpersonal difficulties. RESULTS Overall, results indicate that a structural model incorporating six first-order factors (re-experiencing, avoidance of traumatic reminders, sense of threat, affective dysregulation, negative self-concept and disturbances in relationships) and two second-order factors (PTSD and disturbances in self-organization [DSO]) was the best fitting. The model presented with good concurrent validity. Childhood trauma was found to be more strongly associated with DSO than with PTSD. CONCLUSION Our results are in support of the ICD-11 proposals for PTSD and CPTSD.
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Affiliation(s)
- M Shevlin
- School of Psychology, Ulster University, Derry, UK
| | - P Hyland
- School of Business, National College of Ireland, Dublin, Ireland
| | - T Karatzias
- School of Health & Social Care, Edinburgh Napier University, Edinburgh, UK.,Rivers Centre for Traumatic Stress, NHS Lothian, Edinburgh, UK
| | - C Fyvie
- Rivers Centre for Traumatic Stress, NHS Lothian, Edinburgh, UK
| | - N Roberts
- Psychology and Counselling Directorate, Cardiff and Vale University Health Board, Cardiff, UK
| | - J I Bisson
- School of Medicine, Cardiff University, Cardiff, UK
| | - C R Brewin
- Clinical, Education & Health Psychology, University College London, London, UK
| | - M Cloitre
- School of Medicine, New York University, New York, NY, USA.,National Center for PTSD, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA
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Rutten EAP, Bachrach N, van Balkom AJLM, Braeken J, Ouwens MA, Bekker MHJ. Anxiety, depression and autonomy-connectedness: The mediating role of alexithymia and assertiveness. Psychol Psychother 2016; 89:385-401. [PMID: 26499179 DOI: 10.1111/papt.12083] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2014] [Revised: 09/08/2015] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Autonomy-connectedness (self-awareness, sensitivity to others, and capacity for managing new situations) reflects the capacity for self-governance, including in social relationships. Evidence showed that autonomy-connectedness is related to anxiety and depression. Little is known about the underlying mechanisms. We hypothesized that alexithymia and assertiveness would mediate the relationships between autonomy-connectedness and anxiety and depression. METHOD Relationships among the variables were investigated in 100 patients with a mean age of 42.2 suffering from anxiety and/or depression using a cross-sectional design. RESULTS The relationship between self-awareness and both anxiety and depression was mediated by alexithymia. For anxiety, there was also a direct effect of sensitivity to others that was not explained by either alexithymia or assertiveness. Assertiveness did not have any mediational effect. CONCLUSIONS The results indicate that particularly alexithymia explains the association of autonomy-connectedness with anxiety and depression. PRACTITIONER POINTS The study confirmed the relevance of autonomy-connectedness in anxiety and depression. In treating symptoms of anxiety, it is advisable to give attention to normalizing the patient's sensitivity to others. Treatment of patients with symptoms of anxiety and depression should include assessment of emotional awareness and, in the case of impaired emotional awareness, should be tailored as to promote increased awareness.
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Affiliation(s)
- Elisabeth A P Rutten
- Department of Medical and Clinical Psychology, Tilburg University, The Netherlands.
| | - Nathan Bachrach
- Vincent van Gogh Mental Health Care, Helmond, The Netherlands
| | - Anton J L M van Balkom
- Department of Psychiatry, Institute for Research in Extramural Medicine, VU-University Medical Centre and GGZinGeest Amsterdam, The Netherlands
| | - Johan Braeken
- Faculty of Educational Sciences, Centre for Educational Measurement (CEMO), University of Oslo, Norway
| | | | - Marrie H J Bekker
- Department of Medical and Clinical Psychology, Tilburg University, The Netherlands
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Huprich SK, Lengu K, Evich C. Interpersonal Problems and Their Relationship to Depression, Self-Esteem, and Malignant Self-Regard. J Pers Disord 2016; 30:742-761. [PMID: 26623538 DOI: 10.1521/pedi_2015_29_227] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
DSM-5 Section III recommends that level of personality functioning be assessed. This requires an assessment of self and other representations. Malignant self-regard (MSR) is a way of assessing the level of functioning of those with a masochistic, self-defeating, depressive, or vulnerably narcissistic personality. In Study 1, 840 undergraduates were assessed for MSR, depressive symptoms, self-esteem, anaclitic and introjective depression, and interpersonal problems. MSR, self-esteem, depressive symptoms, and anaclitic and introjective depression were correlated with multiple dimensions of interpersonal problems, and MSR predicted the most variance in interpersonal scales measuring social inhibition, nonassertion, over-accommodation, and excessive self-sacrifice. MSR, anaclitic, and introjective depression predicted unique variance in six of the eight domains of interpersonal problems assessed. In Study 2, 68 undergraduates were provided positive or negative feedback. Consistent with theory, MSR predicted unique variance in state anxiety but not state anger. Results support the validity of the MSR construct.
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Affiliation(s)
- Steven K Huprich
- Department of Psychology, Wichita State University, Wichita, Kansas
| | - Ketrin Lengu
- Department of Psychology, Eastern Michigan University, Ypsilanti, Michigan
| | - Carly Evich
- Department of Psychology, Eastern Michigan University, Ypsilanti, Michigan
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Dowgwillo EA, Pincus AL. Differentiating Dark Triad Traits Within and Across Interpersonal Circumplex Surfaces. Assessment 2016; 24:24-44. [DOI: 10.1177/1073191116643161] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Recent discussions surrounding the Dark Triad (narcissism, psychopathy, and Machiavellianism) have centered on areas of distinctiveness and overlap. Given that interpersonal dysfunction is a core feature of Dark Triad traits, the current study uses self-report data from 562 undergraduate students to examine the interpersonal characteristics associated with narcissism, psychopathy, and Machiavellianism on four interpersonal circumplex (IPC) surfaces. The distinctiveness of these characteristics was examined using a novel bootstrapping methodology for computing confidence intervals around circumplex structural summary method parameters. Results suggest that Dark Triad traits exhibit distinct structural summary method parameters with narcissism characterized by high dominance, psychopathy characterized by a blend of high dominance and low affiliation, and Machiavellianism characterized by low affiliation on the problems, values, and efficacies IPC surfaces. Additionally, there was some heterogeneity in findings for different measures of psychopathy. Gender differences in structural summary parameters were examined, finding similar parameter values despite mean-level differences in Dark Triad traits. Finally, interpersonal information was integrated across different IPC surfaces to create profiles associated with each Dark Triad trait and to provide a more in-depth portrait of associated interpersonal dynamics.
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Stomaching uncertainty: Relationships among intolerance of uncertainty, eating disorder pathology, and comorbid emotional symptoms. J Anxiety Disord 2016; 41:88-95. [PMID: 27019977 DOI: 10.1016/j.janxdis.2016.03.008] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Revised: 02/23/2016] [Accepted: 03/17/2016] [Indexed: 11/22/2022]
Abstract
Intolerance of uncertainty (IU) is proposed to be a transdiagnostic vulnerability factor for various emotional disorders. There is robust evidence for the role of IU in anxiety and depressive disorders, but a paucity of evidence in eating disorders (ED). This study evaluated the factorial validity, internal consistency, and convergent validity of the Intolerance of Uncertainty Scale-Short Form (IUS-12; Carleton, Norton, & Asmundson, 2007), and examined whether IU is associated with ED pathology and comorbid emotional symptoms, in a clinical sample with EDs (N=134). A unitary factor solution provided the best fit. The IUS-12 showed excellent internal consistency, and good convergent validity. IU had an indirect effect on dietary restraint, purging, and emotional symptoms via overvaluation of eating, weight, and shape. The indirect effect was not significant for bingeing. Findings provide partial support for the notion that IU is a vulnerability factor for ED pathology and support the notion that IU is a transdiagnostic vulnerability factor for emotional symptoms. Limitations, research implications, and future directions for research are discussed.
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Bouman WP, Davey A, Meyer C, Witcomb GL, Arcelus J. Predictors of psychological well-being among treatment seeking transgender individuals. SEXUAL AND RELATIONSHIP THERAPY 2016. [DOI: 10.1080/14681994.2016.1184754] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Erickson TM, Newman MG, Siebert EC, Carlile JA, Scarsella GM, Abelson JL. Does Worrying Mean Caring Too Much? Interpersonal Prototypicality of Dimensional Worry Controlling for Social Anxiety and Depressive Symptoms. Behav Ther 2016; 47:14-28. [PMID: 26763494 DOI: 10.1016/j.beth.2015.08.003] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2014] [Revised: 08/21/2015] [Accepted: 08/23/2015] [Indexed: 01/21/2023]
Abstract
Worry, social anxiety, and depressive symptoms are dimensions that have each been linked to heterogeneous problems in interpersonal functioning. However, the relationships between these symptoms and interpersonal difficulties remain unclear given that most studies have examined diagnostic categories, not accounted for symptoms' shared variability due to general distress, and investigated only interpersonal problems (neglecting interpersonal traits, interpersonal goals, social behavior in daily life, and reports of significant others). To address these issues, students (Study 1; N=282) endorsed symptoms and interpersonal circumplex measures of traits and problems, as well as event-contingent social behaviors during one week of naturalistic daily interactions (N=184; 7,036 records). Additionally, depressed and anxious patients (N=47) reported symptoms and interpersonal goals in a dyadic relationship, and significant others rated patients' interpersonal goals and impact (Study 2). We derived hypotheses about prototypical interpersonal features from theories about the functions of particular symptoms and social behaviors. As expected, worry was uniquely associated with prototypically affiliative tendencies across all self-report measures in both samples, but predicted impacting significant others in unaffiliative ways. As also hypothesized, social anxiety was uniquely and prototypically associated with low dominance across measures, and general distress was associated with cold-submissive tendencies. Findings for depressive symptoms provided less consistent evidence for unique prototypical interpersonal features. Overall, results suggest the importance of multimethod assessment and accounting for general distress in interpersonal models of worry, social anxiety, and depressive symptoms.
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Zimmermann J, Wright AGC. Beyond Description in Interpersonal Construct Validation: Methodological Advances in the Circumplex Structural Summary Approach. Assessment 2015; 24:3-23. [PMID: 26685192 DOI: 10.1177/1073191115621795] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The interpersonal circumplex is a well-established structural model that organizes interpersonal functioning within the two-dimensional space marked by dominance and affiliation. The structural summary method (SSM) was developed to evaluate the interpersonal nature of other constructs and measures outside the interpersonal circumplex. To date, this method has been primarily descriptive, providing no way to draw inferences when comparing SSM parameters across constructs or groups. We describe a newly developed resampling-based method for deriving confidence intervals, which allows for SSM parameter comparisons. In a series of five studies, we evaluated the accuracy of the approach across a wide range of possible sample sizes and parameter values, and demonstrated its utility for posing theoretical questions on the interpersonal nature of relevant constructs (e.g., personality disorders) using real-world data. As a result, the SSM is strengthened for its intended purpose of construct evaluation and theory building.
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Davey A, Bouman WP, Meyer C, Arcelus J. Interpersonal Functioning Among Treatment-Seeking Trans Individuals. J Clin Psychol 2015; 71:1173-85. [DOI: 10.1002/jclp.22209] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Amanda Davey
- LUCRED, School of Sport Exercise and Health Sciences; Loughborough University; Loughborough United Kingdom
| | | | - Caroline Meyer
- LUCRED, School of Sport Exercise and Health Sciences; Loughborough University; Loughborough United Kingdom
| | - Jon Arcelus
- Division of Psychiatry and Applied Psychology, Faculty of Medicine & Health Sciences, University of Nottingham; Nottingham United Kingdom
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Raykos BC, McEvoy PM, Erceg-Hurn D, Byrne SM, Fursland A, Nathan P. Therapeutic alliance in Enhanced Cognitive Behavioural Therapy for bulimia nervosa: Probably necessary but definitely insufficient. Behav Res Ther 2014; 57:65-71. [DOI: 10.1016/j.brat.2014.04.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2013] [Revised: 04/09/2014] [Accepted: 04/16/2014] [Indexed: 01/13/2023]
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McEvoy PM, Burgess MM, Nathan P. The relationship between interpersonal problems, therapeutic alliance, and outcomes following group and individual cognitive behaviour therapy. J Affect Disord 2014; 157:25-32. [PMID: 24581824 DOI: 10.1016/j.jad.2013.12.038] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2013] [Revised: 12/19/2013] [Accepted: 12/19/2013] [Indexed: 10/25/2022]
Abstract
BACKGROUND Cognitive behavioural therapy (CBT) is efficacious, but there remains individual variability in outcomes. Patient's interpersonal problems may affect treatment outcomes, either directly or through a relationship mediated by helping alliance. Interpersonal problems may affect alliance and outcomes differentially in individual and group (CBGT) treatments. The main aim of this study was to investigate the relationship between interpersonal problems, alliance, dropout and outcomes for a clinical sample receiving either individual or group CBT for anxiety or depression in a community clinic. METHODS Patients receiving individual CBT (N=84) or CBGT (N=115) completed measures of interpersonal problems, alliance, and disorder specific symptoms at the commencement and completion of CBT. RESULTS In CBGT higher pre-treatment interpersonal problems were associated with increased risk of dropout and poorer outcomes. This relationship was not mediated by alliance. In individual CBT those who reported higher alliance were more likely to complete treatment, although alliance was not associated with symptom change, and interpersonal problems were not related to attrition or outcome. LIMITATIONS Allocation to group and individual therapy was non-random, so selection bias may have influenced these results. Some analyses were only powered to detect large effects. Helping alliance ratings were high, so range restriction may have obscured the relationship between helping alliance, attrition and outcomes. CONCLUSIONS Pre-treatment interpersonal problems increase risk of dropout and predict poorer outcomes in CBGT, but not in individual CBT, and this relationship is not mediated by helping alliance. Stronger alliance is associated with treatment completion in individual, but not group CBT.
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Affiliation(s)
- Peter M McEvoy
- Centre for Clinical Interventions, 223 James Street, Perth, Western Australia 6003, Australia; School of Psychology and Speech Pathology, Curtin University, Perth, Australia.
| | - Melissa M Burgess
- Centre for Clinical Interventions, 223 James Street, Perth, Western Australia 6003, Australia; School of Psychology and Speech Pathology, Curtin University, Perth, Australia
| | - Paula Nathan
- Centre for Clinical Interventions, 223 James Street, Perth, Western Australia 6003, Australia
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McEvoy PM, Burgess MM, Nathan P. The relationship between interpersonal problems, negative cognitions, and outcomes from cognitive behavioral group therapy for depression. J Affect Disord 2013; 150:266-75. [PMID: 23668899 DOI: 10.1016/j.jad.2013.04.005] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2012] [Revised: 04/04/2013] [Accepted: 04/04/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND Interpersonal functioning is a key determinant of psychological well-being, and interpersonal problems (IPs) are common among individuals with psychiatric disorders. However, IPs are rarely formally assessed in clinical practice or within cognitive behavior therapy research trials as predictors of treatment attrition and outcome. The main aim of this study was to investigate the relationship between IPs, depressogenic cognitions, and treatment outcome in a large clinical sample receiving cognitive behavioral group therapy (CBGT) for depression in a community clinic. METHODS Patients (N=144) referred for treatment completed measures of IPs, negative cognitions, depression symptoms, and quality of life (QoL) before and at the completion of a 12-week manualized CBGT protocol. RESULTS Two IPs at pre-treatment, 'finding it hard to be supportive of others' and 'not being open about problems,' were associated with higher attrition. Pre-treatment IPs also predicted higher post-treatment depression symptoms (but not QoL) after controlling for pre-treatment symptoms, negative cognitions, demographics, and comorbidity. In particular, 'difficulty being assertive' and a 'tendency to subjugate one's needs' were associated with higher post-treatment depression symptoms. Changes in IPs did not predict post-treatment depression symptoms or QoL when controlling for changes in negative cognitions, pre-treatment symptoms, demographics, and comorbidity. In contrast, changes in negative cognitions predicted both post-treatment depression and QoL, even after controlling for changes in IPs and the other covariates. LIMITATIONS Correlational design, potential attrition bias, generalizability to other disorders and treatments needs to be evaluated. CONCLUSIONS Pre-treatment IPs may increase risk of dropout and predict poorer outcomes, but changes in negative cognitions during treatment were most strongly associated with improvement in symptoms and QoL during CBGT.
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