Alexithymia and interpersonal problems

BACKGROUND: Interpersonal relationships are substantially codetermined by nonverbal communication, e.g. facial affect. Given the deficits of nonverbal affect recognition and expression in alexithymia, we hypothesized that alexithymics had more interpersonal problems than nonalexithymic individuals, and that the various facets of the alexithymia construct are differentially related to interpersonal problems. METHOD: 149 subjects participating in an inpatient group psychotherapy program completed the Toronto Alexithymia Scale (TAS-20) and the Inventory of Interpersonal Problems (IIP-C) at the beginning of the treatment. The IIP-C was also administered to a subgroup at the end of the treatment. RESULTS: Based on the alexithymia scores, patients were classified as low- (TAS-20 score /=61). High-alexithymic patients had significantly more interpersonal problems than low alexithymics, particularly in the IIP-C scales indicating hostility and social avoidance. The TAS-20 subscale difficulty describing feelings showed the highest correlations with interpersonal problems (r between 0.23 and 0.55). At the end of the treatment, the high alexithymics still scored highest on the IIP-C, but the magnitude of change in interpersonal problems did not differ across the groups. CONCLUSIONS: Our findings suggest that the interpersonal style of alexithymic individuals is characterized by a cold and socially avoidant behavior, corresponding to the predominantly insecure attachment pattern found in alexithymia. Additionally, our results indicate that group psychotherapy is as helpful for alexithymic as for nonalexithymic subjects with respect to interpersonal problems. Finally, we propose that alexithymia involves a reduced capacity to use social interactions for affect regulation.     

Interpersonal profiles in major depressive disorder

Although patients with mood disorders report interpersonal difficulties in addition to depression or anxiety, few studies have examined interpersonal patterns in those patients. Here the authors' goals were to (a) identify the interpersonal pattern in patients with major depressive disorder (MDD), (b) determine interpersonal differences between subgroups of MDD patients, and (c) examine the interpersonal patterns of comorbid MDD patients. One- hundred forty-one MDD adults participated in an ongoing randomized clinical trial of treatments for depression. Interpersonal profiles revealed that MDD patients were significantly more distressed by interpersonal problems than normative samples. Furthermore, MDD patients with depressive personality disorder reported more interpersonal distress than MDD-only patients report and were more likely to have interpersonal problems related to dominance and control than submissiveness.     

Interpersonal psychotherapy for borderline personality disorder

This paper outlines an approach to the treatment of borderline personality disorder (BPD) based on principles of interpersonal psychotherapy. The rationale for using a modified version of interpersonal psychotherapy (IPT) is described-BPD is a disorder of attachment, depression is commonly associated with BPD and the primary symptoms of BPD such as rapid mood fluctuations, impulsivity and cognitive distortions are manifested within interpersonal relationships. A focus on interpersonal dysfunction between self and others may improve the quality of relationships for these patients and improve their capacity to manage the instability engendered by depressed mood. It is argued that the normal structure of IPT meets the basic requirements of any psychotherapy for BPD but that the current four foci of IPT are inadequate to address the complexity of the problems of the person with BPD. A case is made to extend the focal areas of IPT to increase the specificity of treatment tailoring it to the core pathology of the disorder. It is suggested that consideration of regulation of the self within interpersonal interactions becomes the primary focus for treatment. KEY PRACTITIONER MESSAGE: Borderline personality disorder is manifested through problems on interpersonal relationships. Interpersonal psychotherapy may be a useful treatment for BPD. Interpersonal psychotherapy uses a focus for treatment. A new focus of problems of self/other regulation is suggested. Further research is needed to determine if this approach is effective.     

大学生宽恕、人际关系满意感与主观幸福感的关系研究

目的:探讨大学生宽恕、人际关系满意感与主观幸福感之间的关系。方法:采用人际侵犯动机量表、主观幸福感量表和人际关系满意感量表对641名大学生进行测量。结果:大学生的宽恕、人际关系满意感和主观幸福感都显著正相关,宽恕对主观幸福感有直接影响,也通过人际关系满意感间接影响主观幸福感。结论:在宽恕对主观幸福感的影响中,人际关系满意感具有部分中介作用。     

Intrapersonal conflict in goals and values of patients with unipolar depression

BACKGROUND: Although increased conflicts between attitudes and beliefs about certain goals or values are often discussed as important factors in depression, there are only few empirical studies investigating these relations among patients with depressive disorders. METHODS: In the present study, we used the Intrapersonal Conflict Test to assess cognitive inconsistencies in goals or values. A total of 53 inpatients with unipolar depression and 24 nondepressed controls (inpatients of an internal and a surgery ward) participated in the study. In addition to the Intrapersonal Conflict Test, patients completed the Beck Depression Inventory, the Dysfunctional Attitude Scale, the Inventory of Interpersonal Problems as well as the Problem Solving Inventory. RESULTS: Compared with controls, patients with depressive disorders showed significantly higher scores for global inconsistencies, inconsistencies within different goals/values, as well as between goals/values and their perceived realization. Significant correlations were found between conflict measures and the Inventory of Interpersonal Problems, as well as the Problem Solving Inventory. Path analyses show that group differences in intrapersonal conflicts were partially mediated by interpersonal problems but not by depressive symptoms or cognitive vulnerability factors. CONCLUSIONS: Given the cross-sectional design of the study, the findings of this exploratory study do not allow for conclusions regarding the role of intrapersonal conflicts in the development and course of depression. Nevertheless, the high levels of intrapersonal conflicts observed in the study suggest that inconsistencies in goals or values should be considered in the psychological treatment of depression.     

Interpersonal contribution to outcome: the relation of interpersonal distress and symptomatic improvement as a result of psychotherapy

The study utilized a 32‐item brief measure of interpersonal problems (IIP) to examine interpersonal distress in relation to symptomology and treatment outcome as assessed by the Outcome Questionnaire‐45 (OQ‐45). The study included a community sample of 210 individuals receiving psychotherapy at a mental health training facility. A number of significant correlations were found between interpersonal distresses with symptomology. The highest correlations were found between levels of general interpersonal distress and symptoms relating to psychiatric and social distress at the onset of therapy; in general the IIP did not differentiate between symptomology types. The study failed to replicate previous research indicating a relation between facets of interpersonal problems with treatment outcome. Copyright © 2010 John Wiley & Sons, Ltd. Key Practitioner Message: ? Evidence is provided for the use of a brief measure of interpersonal problems (IIP‐32) as a valid alternative to lengthier versions in a clinical setting. ? Interpersonal problems are associated with various facets of clinical symptomology but do little to differentiate between symptomology types. ? Reported rates of general interpersonal distress at the onset of therapy differ among clients that do and do not make clinically significant changes in areas of overall symptomology and interpersonal difficulties.     

A systems approach to investigating interpersonal strife

Investigated the relationships between computer-simulated, in-vitro interactional personality behavior and various indices of interpersonal relationships using data collected from 31 families. Interpersonal strife scores for each of 31 family triads developed via mathematical simulation using a systems approach correlated significantly with 6 of the 10 personal relationship variables. Stepwise regression analysis showed that strife for this sample was allied most closely with rigid, unstable interpersonal interactions. It was concluded that (1) mathematical simulation of interpersonal behavior shows validity for group behavior as well as dyadic behavior; and (2) the systems approach offers a unique, in-vitro way of studying and diagnosing interpersonal difficulties.     

大学生依恋现状及其与自尊、人际关系的研究

目的研究大学生的依恋现状及其与自尊、人际关系的关系。方法使用亲密关系经历量表、自尊量表、人际关系综合诊断量表对236名大学生进行调查。结果①大学生依恋类型由多到少依次为恐惧型、迷恋型、安全型、冷漠型。不同性别、年级、是否独生子女的大学生的依恋没有显著差异,不同生源地的大学生在依恋回避维度上有显著差异(t=-2.151,P<0.05);②不同依恋类型的大学生在自尊水平(F=5.841,P<0.01)和人际关系(F=11.337,P<0.01)上存在显著差异;③回归分析表明,依恋焦虑、自尊能够联合解释人际关系的34.1%;④自尊在依恋对人际关系的影响中充当中介变量。结论大学生总体依恋质量不高,依恋焦虑、自尊对人际关系有预测作用,在依恋焦虑对人际关系的影响中,70.4%是由自尊造成的。     

Interpersonal problems: self-therapist agreement and therapist consensus

This study investigated patient-therapist agreement and therapist consensus of patients' interpersonal problems. The sample comprised 199 patients, who answered a questionnaire addressing interpersonal problems. At the same time, each patient was rated by two therapists on an observer version of the same questionnaire. The participants came from 10 different treatment units within the Norwegian Network of Personality-Focused Treatment Programs. Interpersonal problems were measured by a short version of the Inventory of Interpersonal Problems-Circumplex (IIP-C). The results of both patient-therapist agreements and therapist consensus of patients' interpersonal problems was low to moderate. The therapists perceived the patients to have somewhat higher levels of interpersonal problems than the patients reported, although the profile similarity between self-reports and observer reports was high. Some gender differences were revealed, but in terms of self-therapist agreement, no interaction with the therapists' length of clinical experience or acquaintance with the patient was found.     

Finding a voice: a journey towards being assertive

This is a case study of two depressed women who were able to benefit from a 16-week course of Interpersonal Psychotherapy. This well-established brief psychotherapy has become increasingly available throughout the UK. The focus of this biopsychosocial approach that is on change within the patients interpersonal world means a more active goal-focused approach that addresses symptomatic and emotional concerns using the individuals narrative. In both cases, there was a significant reported change in their depression, initial presenting problems, understanding of their difficulties and interpersonal functioning.     

What interpersonal problems are related to different therapeutic techniques early in treatment?

The current study seeks to explore the relationship between patient‐reported interpersonal problems and therapist interventions in early psychodynamic psychotherapy for 71 outpatients. Pretreatment ratings on the Inventory of Interpersonal Problems Circumplex Scales (IIP‐C) total and subscale scores were examined in relation to early treatment process. Independent clinicians reliably rated therapist use of psychodynamic–interpersonal (PI) and cognitive–behavioural (CB) interventions using the Comparative Psychotherapy Process Scale (CPPS) over two early treatment sessions (third and ninth). Intraclass correlation (ICC) values were in the excellent range for CPPS‐PI and CPPS‐CB scale scores (CPPS‐PI = 0.86; CPPS‐CB = 0.78). A significant positive correlation was found between interpersonal problems and global PI therapist technique. A significant positive correlation was also found between interpersonal problems and specific PI interventions, most significantly experience and expression of feelings in session. In specific interpersonal problem subscales, most significant was that Cold/Distant and Socially Inhibited octants positively related to global PI and to specific PI techniques, including exploration of uncomfortable feelings. Multiple regression analyses revealed most significantly that CPPS Intervention 7 (discussion of patient‐therapist relationship; positive) and CPPS Intervention 11 (therapist explanation of rationale behind treatment; negative) explained 15.6% of variance in interpersonal problem score. These findings demonstrate that the use of psychodynamic techniques tend to occur alongside patient‐reported interpersonal problems early in psychotherapy treatment. Clinical implications are discussed for this area of research, and future directions are explored.     

医学研究生人际信任及社交回避与苦恼现状调查分析

目的调查医学研究生人际信任及社交回避与苦恼现状,为加强和改进医学研究生的心理健康教育工作提供理论依据。方法采用人际信任量表(ITS)和社交回避与苦恼量表(SADS)对291名医学研究生进行调查。结果①医学研究生人际信任度的平均得分为(75.73±8.10),高于理论平均值75;②社交回避及苦恼的平均得分为(74.43±13.73),低于理论平均值84;③不同性别、不同出生地及不同年级的医学生SADS得分比较均无显著差异(t=0.503,0.765,-0.780;P>0.05);④不同性别、不同出生地ITS得分比较均无显著差异(t=1.314,-0.590;P>0.05);⑤不同年级ITS得分存在差异(t=-0.464,P<0.05)。结论医学研究生心理健康状况总体较好,但一年级人际信任状况较差,学校应有针对性地开展心理干预。     

Interpersonal problems and impacts: Further evidence for the role of interpersonal functioning in treatment outcome in major depressive disorder

Introduction

Empirical research has converged to support the concurrent association between social difficulties and psychiatric symptoms; yet, longitudinal associations between interpersonal problems and treatment outcome require clarification. The current investigation evaluated the influence of interpersonal problems assessed prior to treatment on interpersonal impacts assessed during treatment as well as on treatment outcome in outpatients with major depressive disorder (MDD).

Method

125 participants with a primary diagnosis of MDD were randomized to receive cognitive behavioural therapy or interpersonal therapy. Participants completed the Beck Depression Inventory-II, Hamilton Depression Rating Scale, and Inventory of Interpersonal Problems Circumplex before and after treatment. Therapists completed the Impact Message Inventory during and after treatment.

Results

Interpersonal distress improved over the course of treatment; all other interpersonal changes were non-significant when distress was taken into account. Pre-treatment rigidity and agentic problems predicted less reduction in depressive symptoms, whereas agentic and communal impacts upon therapists during treatment predicted greater symptom change. Overall interpersonal distress was only indirectly associated with treatment response later in treatment, through its association with agentic style. Results did not differ across therapy type, and were replicated across self-report and interviewer-rated measures of depression severity.

Limitations

Limitations include the brief duration of treatment, lack of medication arm, and potentially restricted generalizability of patients in a randomized control trial to those in routine practice.

Conclusions

Interpersonal style demonstrated a trait-like stability over treatment, and appears to fluctuate due to co-occurring distress. Yet, specific interpersonal styles were negative prognostic indicators, even within therapy specifically targeting interpersonal functioning.     

Persistence of friendly and submissive interpersonal styles among those with binge‐eating disorder: Comparisons with matched controls and outcomes after group therapy

Interpersonal problems play a prominent role in the development of binge‐eating disorder (BED), so reducing their intensity may be a key focus of many psychological interventions. In recent years, several interpersonal treatments for BED were developed, which posit that binge eating arises to manage relational problems. However, few studies have evaluated the prototypical interpersonal problems, and no studies evaluated the longitudinal changes in interpersonal functioning after treatment within this population. We investigated the severity and prototypicality of interpersonal problems of 101 overweight women with BED from pre‐group psychodynamic–interpersonal psychotherapy (GPIP) to 12 months post‐GPIP. At baseline, we compared patients' interpersonal problems with two groups of matched controls (46 overweight and 49 normal weight women without a diagnosis of BED) and examined circular correlations between relational problems, depressive symptoms, and binge‐eating frequency. Results showed that participants with BED had significantly higher levels of interpersonal problems compared with the matched control samples, with predominantly nonassertive and exploitable styles. Depressive symptoms were related to the presence of friendly–submissive interpersonal problems only among those with BED. Although the intensity of nonassertive interpersonal problems of patients with BED decreased post‐group treatment, their profiles remained prototypically nonassertive and exploitable across all time points. Women with BED experience higher levels of interpersonal difficulties exemplified by an exploitable/nonassertive style that significantly improve but continue to prevail even after treatment. Clinicians might modify interventions to focus on increasing interpersonal skills and decreasing interpersonal dysfunctions among those with BED.     

家庭生活经历与大学生人际信任的关系

目的:探讨大学生人际信任水平与家庭生活经历之间的关系。方法:运用信任量表(Trust Scale)及自编基本情况调查表和满意度评分表,对366名大学生进行调查。结果:与父母一直生活在一起的学生信任量表得分显著高于不与父母生活在一起的学生(t=3.37,P=0.001),6岁以下就与父母分离、分离3年以上的表现尤为明显;无家庭搬迁经历的学生可预测性量表得分显著低于有家庭搬迁经历的学生(t=-2.46,P=0.015);父母受教育程度和城乡差异对人际信任影响不显著(F=1.07,1.01;P0.05);对父母人际关系现状满意度与信任量表总分之间相关显著(r=0.18,P0.05),对父亲人际关系现状的满意度与可依靠性(r=0.18,P0.05)和可信赖性(r=0.18,P0.05)之间也存在显著相关;亲子分离和对母亲人际关系现状满意度能预测人际信任的17.5%的变异量;亲子分离和家庭搬迁经历能预测可预测性的19.5%的变异量;亲子分离和对父亲人际关系现状满意度能预测可依靠的16.2%的变异量和可信赖性的15.4%的变异量。结论:亲子分离、父母人际关系等家庭生活经历对大学生人际信任有重要影响。     

大学生人际倦怠的初步研究

目的 编制大学生人际倦怠量表.方法 对500名大学生施测编制的大学生人际倦怠量表,对其中的180名大学生同时施测幸福感指数量表.结果 验证性因素分析表明,人际倦怠量表包括情绪耗竭、人格解体、成就感降低3个维度;人际倦怠量表及其各维度的α系数为0.7104～0.8217;人际倦怠及其各维度与总体情感指数和生活满意度呈显著...     

Interpersonal dysfunction in depressed women: impairments independent of depressive symptoms

BACKGROUND: The study explored the generality of interpersonal impairments in depressed women and examined the extent of their independence of current depressive episodes or symptoms. METHODS: 812 community women who were formerly depressed, currently depressed, or never depressed were compared on a variety of indices of interpersonal behavior and beliefs. Information was also obtained from their spouses, adolescent children, and raters. Current depressive mood and sociodemographic factors that might affect social functioning were controlled. RESULTS: Consistent with the hypotheses that interpersonal difficulties are not just consequences of depressive symptoms, formerly but not currently depressed women were significantly more impaired than never-depressed women on nearly all measures. They were less likely to be stably married, had poorer marital satisfaction, reported more spouse coercion and physical injury, had more problematic relationships with their child, friends, and extended family, reported more stressful life events with interpersonal and conflict content, and were more insecure in their beliefs about other people. Their spouses and boyfriends also reported more problems, and were themselves more likely to have diagnosable disorders. However, the groups did not differ in their children's perceptions of maternal warmth or hostility. LIMITATIONS: The cross-sectional design precluded conclusions about the causal direction of the relationship between interpersonal impairment and depressive disorder. Since clinical depression is more often than not followed by subthreshold symptoms that are not captured by standard diagnostic instruments, such symptoms are not easily discernable from preceding or co-existing interpersonal problems. Only women were studied. CONCLUSIONS: Interpersonal impairment is a stable feature of depression, a significant challenge to treatment, and may reflect underlying vulnerability to the onset, and recurrence, of depressive experiences.     

Attachment and interpersonal distress: examining the relationship between attachment styles and interpersonal problems in a clinical population

The present study examined the relationship between self‐perceived attachment styles and interpersonal problems. Specifically, we utilized a clinical sample from an outpatient university‐based community clinic who completed the Experiences in Close Relationships Scale‐Revised, the Relationship Questionnaire and Inventory of Interpersonal Problems Circumplex Scales (IIP‐64) as part of a psychological assessment process. The results showed a significant positive correlation between the IIP‐64 total score and both attachment anxiety and attachment avoidance. Findings revealed significant negative relationships between a secure attachment and the dominant, vindictive, cold, socially inhibited and non‐assertive subscales of the IIP‐64. Findings also revealed a significant positive relationship between a fearful attachment and the dominant, vindictive, cold, socially inhibited and non‐assertive subscales of the IIP‐64. Finally, results showed a significant relationship between a dismissive attachment and the dominant subscale of the IIP‐64. Copyright © 2008 John Wiley & Sons, Ltd.     

Interpersonal problems as predictors of alliance,symptomatic improvement and premature termination in treatment of depression

Background

Previous studies reported inconsistent findings regarding the association of interpersonal problems with therapy outcome. The current study investigates if interpersonal problems predict process and outcome of three different treatments for depression.

Methods

The data originate from a randomized clinical trial comparing supportive–expressive psychotherapy, antidepressant medication and pill-placebo for treatment of depression. Interpersonal problems were used as predictors of alliance, symptomatic improvement and premature termination of treatment.

Results

Interpersonal problems related to communion predicted better alliances, but slower symptomatic improvement. Low agency predicted slower symptomatic improvement in supportive–expressive psychotherapy, but not in the medication or placebo condition. Lower interpersonal distress was associated with an increased likelihood to terminate treatment prematurely.

Limitations

The sample size did not allow the detection of small effects within the treatment groups.

Conclusions

Interpersonal problems are influential for the treatment of depression, but parts of their effects depend on the type of treatment.     

The relationship between interpersonal problems and the helping alliance

Using data from a large longitudinal naturalistic study on course and outcome of psychotherapy, the present paper investigates the amount of interpersonal problems in an outpatient sample (N = 714) and the extent to which a patient's interpersonal problems determine the quality of the helping alliance. The results show that at the beginning of psychotherapy, subjects reported significant interpersonal distress on 2.43 of the eight IIP scales. Interpersonal problems were most prevalent in the octants "introverted," "submissive," "exploitable," and "overly nurturant." Furthermore, interpersonal problems were related to the helping alliance in different ways: "Too hostile" patients reported relatively poor initial helping alliance whereas "too friendly" patients rated more favorably the relationship to the therapist. However, interpersonal problems at intake did not predict the therapeutic alliance one-and-a-half years later. The results indicate that a poor initial helping alliance might be reversed during the course of treatment. Implications for future research and psychotherapeutic practice are discussed.