Bedeutung, Erfassung und Veränderung interpersonaler Problemmuster in der Psychotherapieforschung : Eine Untersuchung mit dem Inventar zur Erfassung interpersonaler Probleme

Abstract

In this study evaluation of interpersonal problems and modification of interpersonal problems were examined in different areas of inpatient and outpatient psychotherapy. Interpersonal problems were assessed via the Inventory of Interpersonal Problems (IIP-D; Horowitz et al., 2000). In four empirical studies subtypes of interpersonal problems could be identified based on strategies for circumplex data evaluation (see Gurtman, 1994; Wright et al., 2009) and cluster analytic methods. In a first study interpersonal subtypes were identified within a diagnostic homogenous group of N=78 patients with primary diagnosis of generalized anxiety disorder. In a second study interpersonal subtypes identified in a diagnostic homogenous group of N=52 patients with generalized anxiety disorder differed with regard to reduction of global interpersonal distress after outpatient short-term treatment. In a third study it could be demonstrated that evaluation of interpersonal problems based on interpersonal subtypes leads to clinically relevant information also in a diagnostic heterogeneous sample of N=2809 patients treated in inpatient setting. Subtypes differed with regard to change of interpersonal problems dependent on the predominant type of interpersonal problems. Furthermore, interpersonal subtypes also differed with regard to general outcome. In a fourth study N=121 patients treated with analytic psychotherapy were examined. In this naturalistic study, for analytic long-term treatment large effects with regard to interpersonal problems could be found for all problem patterns. The respective interpersonal problem patterns identified with the IIP differ with regard to frequency of occurrence in clinical samples. Differences between these subtypes refer to quality and extent of interpersonal problems, interpersonal flexibility and modification of interpersonal problems. The results support earlier findings regarding the identification of interpersonal subtypes in diagnostic homogenous samples of patients with generalized anxiety disorder (Kasoff & Pincus, 2002) and social phobia (Kachin et al., 2001). Detection of interpersonal subtypes shows the limitations of classificatory diagnoses according to ICD (Dilling et al., 2008) or DSM (Sass et al., 2000), which do not account for patients interpersonal style. Based on the presented strategy, the full potential of the IIP for group level data evaluation can be achieved. As the presented results show, an evaluation based on interpersonal subtypes delivers a key for better understanding of inter-individual differences in outcome with regard to improvement of interpersonal distress as well as with regard to global mental distress. An appropriate consideration of patients interpersonal difficulties and interpersonal style in psychotherapy research leads to more meaningful and clinically relevant data.