Self-reported Interpersonal Problems Research Articles

Who Returns to work? Exploring the Role of Interpersonal Problems in Occupational Rehabilitation.

Current interventions designed to facilitate return to work (RTW) after long-term sick leave show weak effects, indicating the need for new approaches to the RTW process. The importance of social relationships in the workplace is widely recognized in existing RTW literature, but very little is known about the role of the interpersonal problems of the returning worker. Current research indicates that a subset of these - hostile-dominant interpersonal problems - give particular disadvantages in several life areas. This prospective cohort study aims to test whether higher levels of interpersonal problems predict lower likelihood of RTW when controlling for symptom levels (H1); and whether higher levels of hostile-dominant interpersonal problems specifically predict lower likelihood of RTW (H2). 189 patients on long-term sick leave completed a 3½-week transdiagnostic RTW program. Before treatment, self-reported interpersonal problems, chronic pain, insomnia, fatigue levels, anxiety and depression were collected. RTW data for the following year were collected from the Norwegian Labour and Welfare Administration. A multivariable binary logistic regression analysis found that (H2) hostile-dominant interpersonal problems significantly predicted RTW (OR = 0.44, [95% CI: 0.19, 0.98], p = .045), while a corresponding analysis (H1) found that general interpersonal problems did not. Hostile-dominant interpersonal problems negatively predict RTW after long-term sick leave, suggesting an overlooked factor in the field of occupational rehabilitation. The findings could open up new avenues for research and interventions entailed to individuals in the field of occupational rehabilitation.

My problem or yours? Interpersonal problems and marital quality

Research has consistently illustrated the impact of personality on marital quality. Given the inherent dyadic nature of relationships, recent investigations have integrated spouse-rated personality to account for both spouses' perspectives. Grounded in Contemporary Integrative Interpersonal Theory, we viewed personality through an interpersonal lens and conceptualized maladaptive interpersonal functioning as interpersonal problems. The present study examined the incremental validity of spouse-rated interpersonal problems beyond self-reported interpersonal problems to predict marital quality within an expanded actor-partner interdependence model (APIM). Within a community sample of heterosexual, married couples (N=110), we used expanded APIMs, integrating both self-report and spouse-rating, to test the incremental validity of spouse-perceived interpersonal problems over self-perceived interpersonal problems on marital quality through a model comparison approach. We tested for possible gender differences in effects. Spouse perception, notably spouse-rated partner effects, appears to be the most frequent predictor of marital quality, and self-perception had less impact. Given the implications marital quality has on health and well-being, intervention efforts capitalizing on acceptance of spouses' perspectives are likely to lead to greater improvements in quality and overall health.

Naturalistically observed interpersonal problems and diabetes management in older adolescents and young adults with type 1 diabetes

Objective This study investigated the links between naturalistically observed and self-reported interpersonal problems, diabetes management, and glucose levels in older adolescents and young adults with type 1 diabetes. Design Sixty-eight older adolescents and young adults (aged 17–20 years) participated in a cross-sectional study that consisted of three home visits and a daily diary segment. Main Outcome Measures Participants wore the Electronically Activated Recorder (EAR) for four days to capture interpersonal problems and wore a continuous glucose monitor for blood glucose levels. Researchers also collected HbA1c values, conducted an interview to assess diabetes management, and collected participant-reported severity of interpersonal problems. Results High EAR-observed interpersonal problems were associated with poor diabetes management. Multiple regression analyses revealed that high EAR-observed interpersonal problems continued to explain variance in poor diabetes management after including self-reported interpersonal problems and covariates. Conclusion These findings corroborate literature suggesting that negative interactions are associated with type 1 diabetes management. This study is the first to use the EAR to capture naturalistically observed interactions in this population and identify its utility beyond self-reports. These findings highlight the importance of considering naturalistically observed interactions when developing interventions to promote better diabetes management in older adolescents and young adults.

Effectiveness of Open-Ended Psychotherapy Under Clinically Representative Conditions.

ObjectiveThis study investigates the effectiveness of open-ended psychotherapy in a large, naturalistic, and diverse patient cohort using rigorous and multifaceted assessments.MethodPatients (N = 370) in open-ended psychotherapy completed an extensive set of self-report measures and diagnostic interviews, including long-term follow-up in order to assess stability of outcomes. About half of the patients qualified for a personality disorder at the onset of treatment. Treatments were open-ended, and on average therapists provided substantially larger treatment doses than common in the literature.ResultsA substantial majority recovered from their respective Axis I (58%) and/or Axis II (55%) disorders during treatment. Patients also experienced large positive changes in self-report measures of overall psychiatric symptoms and moderate positive changes in self-reported interpersonal problems, while very few (< 3%) demonstrated negative development. The patients maintained their diagnostic and self-assessed changes at a two-and-a-half-year follow-up. In contrast, self-reported occupational functioning showed minimal improvement throughout the treatment and follow-up phase.ConclusionA naturalistic patient cohort undergoing open-ended psychotherapy demonstrates substantial and stable improvements.

Between a rock and a hard place: Associations between Mentzos' "dilemma", self-reported interpersonal problems, and psychosocial functioning in individuals with non-affective psychoses.

Primary aim of this study was to determine the extent and type of self-reported interpersonal problems in patients with non-affective psychoses and their impact on psychosocial functioning. Furthermore, we aimed to explore potential links with the psychodynamic construct of Stavros Mentzos' "psychotic dilemma", which describes an insufferable inner tension caused by an individual's struggle of being torn between "self-oriented" and "object-oriented" tendencies. In a cross-sectional study among 129 patients with non-affective psychoses, measures of cognition, symptom load and social functioning as well as a tentative, psychodynamic assessment of Mentzos' "dilemma" were obtained during a clinical research visit. Self-report data on interpersonal problems were gathered using the Inventory of Interpersonal Problems (IIP-64D) and compared with a German representative standard sample. Second, IIP-64D scores were compared between groups with or without Mentzos' "dilemma". Hierarchical regression analyses were performed to test for the impact of interpersonal problems on psychosocial functioning, while controlling for cognitive deficits and psychopathology. Results showed that IIP-64D scores differed significantly from healthy controls, except for "self-centred" and "intrusive" interpersonal styles. Participants with a potential "psychotic dilemma" scored significantly higher on the subscales: "domineering", "self-centred", "cold", and "socially avoidant" than the group without a "psychotic dilemma". The total amount of interpersonal problems, and particularly high scores on the IIP-64D "socially avoidant" subscale, predicted psychosocial dysfunction, whereas a "cold" interpersonal style had an opposite effect. In conclusion, specific interpersonal problems may predict psychotherapeutic outcome measures like psychosocial functioning and are partly compatible with the psychodynamic construct of Stavros Mentzos' "psychotic dilemma".

Interpersonal problems across levels of the psychopathology hierarchy

We examined the relationship between psychopathology and interpersonal problems in a sample of 825 clinical and community participants. Sixteen psychiatric diagnoses and five transdiagnostic dimensions were examined in relation to self-reported interpersonal problems. The structural summary method was used with the Inventory of Interpersonal Problems Circumplex Scales to examine interpersonal problem profiles for each diagnosis and dimension. We built a structural model of mental disorders including factors corresponding to detachment (avoidant personality, social phobia, major depression), internalizing (dependent personality, borderline personality, panic disorder, posttraumatic stress, major depression), disinhibition (antisocial personality, drug dependence, alcohol dependence, borderline personality), dominance (histrionic personality, narcissistic personality, paranoid personality), and compulsivity (obsessive-compulsive personality). All dimensions showed good interpersonal prototypicality (e.g., detachment was defined by a socially avoidant/nonassertive interpersonal profile) except for internalizing, which was diffusely associated with elevated interpersonal distress. The findings for individual disorders were largely consistent with the dimension that each disorder loaded on, with the exception of the internalizing and dominance disorders, which were interpersonally heterogeneous. These results replicate previous findings and provide novel insights into social dysfunction in psychopathology by wedding the power of hierarchical (i.e., dimensional) modeling and interpersonal circumplex assessment.

Self-reported interpersonal problems and impact messages as perceived by significant others are differentially associated with the process and outcome of depression therapy.

Interpersonal factors play a major role in causing and maintaining depression. This study sought to investigate how patients' self-perceived interpersonal problems and impact messages as perceived by significant others are interrelated, change over therapy, and differentially predict process and outcome in psychotherapy of depression. For the present study, we used data from 144 outpatients suffering from major depression that were treated within a psychotherapy study. Interpersonal variables were assessed pre- and posttherapy with the self-report Inventory of Interpersonal Problems-Circumplex Scale (IIP-32; Thomas, Brähler, & Strauss, 2011) and with the informant-based Impact Message Inventory (Caspar, Berger, Fingerle, & Werner, 2016). Patients' levels on the dimensions of Agency and Communion were calculated from both measures; their levels on Interpersonal Distress were measured with the IIP. Depressive and general symptomatology was assessed at pre-, post-, and at 3-month follow-up; patient-reported process measures were assessed during therapy. The Agency scores of IIP and IMI correlated moderately, but the Communion scores did not. IIP Communion was positively associated with the quality of the early therapeutic alliance and with the average level of cognitive-emotional processing during therapy. Whereas IIP Communion and IMI Agency increased over therapy, IIP Distress decreased. A pre-post-decrease in IIP Distress was positively associated with pre-postsymptomatic change over and above the other interpersonal variables, but pre-post-increase in IMI Agency was positively associated with symptomatic improvement from post- to 3-month follow-up. These findings suggest that significant others seem to provide important additional information about the patients' interpersonal style. (PsycINFO Database Record

Supplemental Material for Self-Reported Interpersonal Problems and Impact Messages as Perceived by Significant Others Are Differentially Associated With the Process and Outcome of Depression Therapy

Supplemental Material for Self-Reported Interpersonal Problems and Impact Messages as Perceived by Significant Others Are Differentially Associated With the Process and Outcome of Depression Therapy

Metacognitive Interpersonal Therapy for Personality Disorders: A Case Study Series

The study aimed to assess the effectiveness of metacognitive interpersonal therapy (MIT) as a psychological treatment for presentations consistent with non-borderline personality disorders (PD). We conducted a single-case series of three patients with personality disorders meeting inclusion criteria. Clients received 2 years of weekly individual MIT. Outcomes were assessed every 3 months for the first year at the end of treatment and at 3-months follow-up. Co-primary outcomes were reduction in the number of SCID-II PD criteria met and reduction in self-reported global distress (SCL-90-R GSI). Secondary outcomes were reduction in self-reported interpersonal problems (IIP-32), anxiety (STAI-Y), depression (BDI-II) and emotional dysregulation (DERS). Reliable Change Indices were calculated for all outcomes. All three patients completed treatment, achieving reliable change at the end of treatment for reduction in total number of personality disorder criteria and in overall symptoms. For secondary outcomes, two patients improved in emotion regulation, one in depression. There was no evidence of reliable change on self-reported anxiety or interpersonal problems. At 3-months post treatment improvements in overall symptoms and emotional regulation were observed for all patients. Plot analyses of the results showed a trend towards reduction for all outcomes. MIT is a new manualized treatment for non-borderline PD’s. We demonstrate preliminary evidence of acceptability and effectiveness in this understudied population. Future studies are required to establish the effectiveness of MIT in larger PD samples, including patients with lower socio-economic status.

P02-427 - Alexithymia and interpersonal functioning:an extension of empirical research by using a dimensional approach for interpersonal style and the structured interview for alexithymia

IntroductionThe concept of alexithymia refers to problems in experiencing and regulating affects; clinical study as well as empirical research suggests that alexithymia is related to cold and socially inhibited interpersonal functioning. However, empirical studies frequently use only self report questionnaires.Objectives/aimsThis study investigates the relation between alexithymia and self-reported interpersonal problems. By using an interview measure of alexithymia next to a questionnaire, we want to avoid artificially high correlations due to shared method variance and thus get a clearer picture of the link between alexithymia and interpersonal style. We hypothesize that alexithymia will be related to a cold, but not to a dominant or submissive interpersonal style.MethodThe Toronto Structured Interview for Alexithymia (TSIA) was administered by a trained researcher to 74 psychiatric inpatients, who also filled out the Toronto Alexithymia Scale (TAS-20) and the Inventory of Interpersonal Problems (IIP-64). Dimensional affiliation and dominance scores of the IIP-64 were computed and Pearson correlations between TSIA, TAS-20 and IIP-64 dimensional scores were calculated.ResultsAs hypothesized, we observed no significant correlation between TSIA, TAS-20 and the dominance dimension of the IIP-64 and a significant correlation between the affiliation dimension and TSIA and TAS-20.ConclusionsOur results support previous research and confirm that alexithymia is related to a cold interpersonal style. Since our findings converge for both measurements of alexithymia, the link between alexithymia and interpersonal style can not be explained by shared method variance. The measurement of only self-reported interpersonal problems is a limitation of this study.

Interpersonal problems among 988 Norwegian psychiatric outpatients. A study of pretreatment self-reports

Objective No studies, to our knowledge, have examined what specific kinds of interpersonal problems characterize a general psychiatric outpatient population. Do they differ from the normal population in any specific way, apart from the expected “more of everything”? The aim of this study was to map and categorize a large psychiatric outpatient sample with regard to self-reported interpersonal problems. Method First-admission psychiatric patients completed the 64-item version of the Inventory of Interpersonal Problems (Horowitz et al, Inventory of Interpersonal Problems Manual. San Antonio, TX: The Psychological Corporation 2000) before treatment. Scores were compared with Norwegian reference data. Profile characteristics of 8 subgroups (octant groups), corresponding to 8 different forms of predominant interpersonal problem, were calculated according to the structural summary method (Gurtman and Balakrishnan, Circular measurement redux: the analysis and interpretation of interpersonal circle profiles. Clin Psychol Sci Pract. 1998;5[3]:344-360). Results The clinical sample had considerably more interpersonal problems than the normal reference sample. Among the 8 octant groups with different predominant interpersonal problems, the 3 most prevalent in the sample, characterized by a low degree of assertiveness (low agency), were also the most distressed with regard to interpersonal problems. Conclusions Psychiatric outpatients seem to have the most severe interpersonal problems along the agency dimension; that is, they have problems being assertive. Patients within different octant groups of the 64-item version of the Inventory of Interpersonal Problems system, corresponding to different kinds of specific, predominant interpersonal problems, have characteristic ways of relating to others, which ought to be identified and addressed in therapy.

Validity of the Inventory of Interpersonal Problems (IIP–64) for Predicting Assertiveness in Role-Play Situations

The Inventory of Interpersonal Problems (IIP–64; Horowitz, Alden, Wiggins, & Pincus, 2000) is a self-report measure of maladaptive relationship behavior. Ninety-five adult female participants completed the IIP-64 and then interacted with a same-sex confederate in three diagnostic role plays, designed to evoke assertive responses. After each role play, both the participant and the confederate judged how assertive the participant had been, using two subscales from the Interpersonal Adjective Scales (IAS; Wiggins, 1995). The participants' general self-images, assessed with the IIP-64, were quite congruent with how they judged their own assertiveness in the role plays. But when role-play assertiveness was judged by the confederate, the match with the participants' general self-images was considerably lower. Our results indicate that self-reported interpersonal problems do not converge well with external judgments of interpersonal behavior.

A controlled trial of paroxetine for chronic PTSD, dissociation, and interpersonal problems in mostly minority adults

This study evaluated the efficacy of paroxetine for symptoms and associated features of chronic posttraumatic stress disorder (PTSD), interpersonal problems, and dissociative symptoms in an urban population of mostly minority adults. Adult outpatients with a primary DSM-IV diagnosis of chronic PTSD received 1 week of single-blind placebo (N = 70). Those not rated as significantly improved were then randomly assigned to placebo (N = 27) or paroxetine (N = 25) for 10 weeks, with a flexible dosage design (maximum 60 mg by week 7). Significantly more patients treated with paroxetine were rated as responders (14/21, 66.7%) on the Clinical Global Impression-Improvement Scale (CGI-I) compared to patients treated with placebo (6/22, 27.3%). Mixed effects models showed greater reductions on the Clinician-Administered PTSD Scale (CAPS) total score (primary plus associated features of PTSD) in the paroxetine versus placebo groups. Paroxetine was also superior to placebo on reduction of dissociative symptoms [Dissociative Experiences Scale (DES) score] and reduction in self-reported interpersonal problems [Inventory of Interpersonal Problems (IIP) score]. In a 12-week maintenance phase, paroxetine response continued to improve, but placebo response did not. Paroxetine was well tolerated and superior to placebo in ameliorating the symptoms of chronic PTSD, associated features of PTSD, dissociative symptoms, and interpersonal problems in the first trial conducted primarily in minority adults.

Test of an interpersonal model of hypochondriasis.

The aim of this study was to test the interpersonal model of hypochondriasis proposed by Stuart and Noyes. According to this model, hypochondriasis is associated with insecure attachment that in adults gives rise to abnormal care-seeking behavior. Such behavior is associated with interpersonal difficulties and strained patient-physician relationships. One hundred sixty-two patients attending a general medicine clinic were interviewed and asked to complete self-report measures. Instruments included the Whiteley Index of Hypochondriasis, Somatic Symptom Inventory, Relationship Scales Questionnaire, Inventory of Interpersonal Problems, NEO Five-Factor Index, and measures of physician-patient interaction. The Structured Diagnostic Interview for DSM-III-R Hypochondriasis was also administered. Hypochondriacal and somatic symptoms were positively correlated with all of the insecure attachment styles, especially the fearful style. These same symptoms were positively correlated with self-reported interpersonal problems and negatively correlated with patient ratings of satisfaction with, and reassurance from, medical care. Hypochondriacal and somatic symptoms were also positively correlated with neuroticism. The findings indicate that hypochondriacal patients are insecurely attached and have interpersonal problems that extend to and include the patient-physician relationship. These data support the proposed interpersonal model of hypochondriasis.

The interpersonal consequences of inflated self-esteem in an inpatient psychiatric youth sample.

This study tested R. F. Baumeister, L. Smart, and J. M. Boden's (1996) theory of inflated self-esteem with an inpatient psychiatric youth sample. Participants were assessed on their self-reported self-esteem, self-reported interpersonal problems, and peer rejection (measured by evaluations from 3 or 4 peers). Consistent with the hypotheses, those with low self-esteem reported the most interpersonal problems, followed consecutively by the moderate self-esteem group and then the high self-esteem group, who reported the fewest interpersonal problems. Also in line with the hypotheses, those with low and high self-esteem were rejected by their peers when compared with the moderate self-esteem group. Thus, the high self-esteem group was rejected by their peers but did not themselves report interpersonal problems. These findings provide further support for Baumeister et al.'s theory and generalize the theory to a clinical setting.

Trust, distrust, and interpersonal problems: a circumplex analysis.

This study examined the self-reported interpersonal problems of individuals characteristically high or low in interpersonal trust. The interpersonal circumplex served as a guiding framework for assessing and interpreting these problems. As expected, extreme distrust was generally related to a symmetrical pattern of distress, with a peak at the hostile-dominant octant. Extreme high trust, on the other hand, was not associated with gullibility or with related interpersonal difficulties, supporting arguments that trust is essentially distinct from gullibility and exploitability. The Interpersonal Trust Scale and the Mach IV scale, the study's principal measures of trust, tap varieties of trust differing in their blends of dominance and hostility, leading to different problem patterns for extreme scorers