Interpersonal process in psychotherapy through the lens of the structural analysis of social behavior

As psychotherapy research focuses more and more on mechanisms of therapeutic change, increased attention has naturally been directed at therapy process. Over the past several decades, a variety of researchers have successfully applied Benjamin's 1974 Structural Analysis of Social Behavior (SASB) to the study of in-session psychotherapy events. This system for conceptualizing and analyzing interpersonal and intrapsychic processes has been shown to provide theoretically rigorous and empirically tractable instantiations of both helpful and hindering therapeutic exchanges. In this article the therapeutic alliance is conceived in terms of interpersonal processes as demarcated according to the SASB. This article also provides a review of SASB's wide-ranging applications to observing and studying the therapeutic relationship, therapy process, and client outcome. Also discussed are several data analytic and methodological considerations related to the SASB model and several new ancillary measures based on the SASB. Finally, the applied and clinical utility of the SASB system is discussed in light of a variety of contemporary empirical findings.     

Clinical features of tic-related obsessive-compulsive disorder: results from a large multicenter study

OBJECTIVE: To evaluate the clinical features of obsessive-compulsive disorder (OCD) patients with comorbid tic disorders (TD) in a large, multicenter, clinical sample.MethodA cross-sectional study was conducted that included 813 consecutive OCD outpatients from the Brazilian OCD Research Consortium and used several instruments of assessment, including the Yale-Brown Obsessive-Compulsive Scale, the Dimensional Yale-Brown Obsessive-Compulsive Scale, the Yale Global Tic Severity Scale (YGTSS), the USP Sensory Phenomena Scale, and the Structured Clinical Interview for DSM-IV Axis I Disorders. RESULTS: The sample mean current age was 34.9 years old (SE 0.54), and the mean age at obsessive-compulsive symptoms (OCS) onset was 12.8 years old (SE 0.27). Sensory phenomena were reported by 585 individuals (72% of the sample). The general lifetime prevalence of TD was 29.0% (n = 236), with 8.9% (n = 72) presenting Tourette syndrome, 17.3% (n = 141) chronic motor tic disorder, and 2.8% (n = 23) chronic vocal tic disorder. The mean tic severity score, according to the YGTSS, was 27.2 (SE 1.4) in the OCD + TD group. Compared to OCD patients without comorbid TD, those with TD (OCD + TD group, n = 236) were more likely to be males (49.2% vs. 38.5%, p < .005) and to present sensory phenomena and comorbidity with anxiety disorders in general: separation anxiety disorder, social phobia, specific phobia, generalized anxiety disorder, post-traumatic stress disorder, attention-deficit hyperactivity disorder, impulse control disorders in general, and skin picking. Also, the "aggressive," "sexual/religious," and "hoarding" symptom dimensions were more severe in the OCD + TD group.ConclusionTic-related OCD may constitute a particular subgroup of the disorder with specific phenotypical characteristics, but its neurobiological underpinnings remain to be fully disentangled.     

Early effects of emotion on word immediate repetition priming: Electrophysiological and source localization evidence

The processing of a stimulus benefits from the previous exposure of an identical stimulus, which is known as immediate repetition priming (IRP). Although several experimental manipulations modulate the size of this effect, the influence of affective information is still unclear. In order to explore the temporo–spatial characteristics of the interaction between emotion and IRP, event-related potentials (ERPs) to negative and neutral target words were measured during a lexical decision task in an IRP paradigm. Temporal and spatial versions of principal components analyses were used to detect and quantify those ERP components associated with IRP. A source localization procedure provided information on the neural origin of these components. Behavioural analyses showed that reaction times to repeated negative and neutral words differed from those to unrepeated negative and neutral words, respectively. However, the interaction between repetition and emotion was only marginally significant. In contrast, ERP analyses revealed specific IRP effects for negative words: Repeated negative words elicited reduced P120/enhanced N170 effects and weaker activation suppression in the left inferior frontal gyrus than did unrepeated negative words. These results suggest that a word’s negative content captures attention interfering with IRP mechanisms, possibly at an early semantic stage of processing.     

Adaptation of the MSCI for the measurement of cohesion in Spanish young soccer players

This work describes the Spanish adaptation and studies the psychometric properties of Yukelson, Weinberg, and Jackson's Multidimensional Sport Cohesion Instrument (MSCI) with a sample of 173 soccer players. The Spanish version is composed of 22 items grouped in four factors: quality of teamwork (performance aspects), attraction to the group, valued roles and quality of teamwork (interpersonal relationships), that accounted for 53.30% of the total variance. Reliability coefficients (Cronbach's Alphas) for the factors ranged from .84 (factor 1) to .56 (factor 4). Suggestions are made for future research on the validity of the scale, mainly in terms of convergence with other multidimensional measures of sport cohesion.     

Systems-centered training groups' process and outcome: a comparison with AGPA institute groups

In this quasi-experimental study we compared the process and outcome of six experiential Systems-Centered Training (SCT) groups to those of American Group Psychotherapy Association (AGPA) Institute groups from two prior studies (MacKenzie, Dies, Coche, Rutan, & Stone, 1987; Tschuschke & Greene, 2002). The SCT training compared well overall and the results provided preliminary, indirect support for the usefulness of "functional subgrouping" - SCT's conceptual and methodological bridge between the group-as-a-whole and the individual member. However, quasi-experimental design limitations make other interpretations equally plausible. Within-group change in the process variables for the SCT groups was also explored, as well as the relative contributions of these variables to post-training learning outcomes and anxious and depressive experience. The results partly corroborated prior studies, but also suggested that SCT may alter training group dynamics, learning, and emotional experience in ways consistent with SCT theory.     

Therapist empathy,homework compliance,and outcome in cognitive behavioral therapy for generalized anxiety disorder: partitioning within- and between-therapist effects

Although client-perceived therapist empathy relates to positive therapy outcomes, including in cognitive behavioral therapy (CBT), little is known about how empathy exerts its ameliorative effect. One possible way is by promoting clients’ subsequent homework compliance, a variable that also predicts positive outcomes in CBT. The present study sought to investigate simultaneously, in the context of 43 therapist–client dyads receiving 15 sessions of CBT for generalized anxiety disorder, (1) the association of early client-perceived therapist empathy (averaged over sessions 1, 3, 5) with mid-treatment client homework compliance (averaged over sessions 6, 8, 10); (2) the association of mid-treatment homework compliance on client posttreatment worry severity; and (3) the indirect effect of early perceived therapist empathy on posttreatment worry through mid-treatment homework compliance. Given that clients were nested within therapists, we examined both within- and between-therapist differences in clients’ ratings of therapist empathy and homework compliance, and tested both of these indices as predictors of the relevant dependent variables in a multilevel model. At the within-therapist level (i.e., differences between clients within a given therapist’s caseload), greater early empathy was associated with greater mid-treatment homework compliance. At the between-therapist level (i.e., differences between therapists across all of their cases), greater between-therapist homework compliance was related to lower posttreatment worry. Finally, homework compliance was not found to mediate the relationship between empathy and posttreatment outcome. The results underscore the importance of parsing client and therapist effects, and are discussed with regard to their training and research implications.     

Mental representations of attachment in day care providers

Mental representations of attachment of 31 day‐care providers were assessed using the Adult Attachment Interview (AAI), and compared with established observational measures of their behavior with the children under their care. Contrary to expectation, there was no significant association between the caregivers’ mental representations of attachment and their observed behavior. Teacher‐report ratings of aggressive behavior were obtained for 135 children who had been under the care of these providers. Ten of the 13 children who scored in the clinical range for aggressive behavior were known to have been under the care of a provider with a secure mental representation of attachment for an extended period of time (average 14 months), but the average age of first exposure to such a provider in this study was 16 months. For center‐based day‐care providers, standardized observational assessments of caregiving behavior appear to be unrelated to mental representations of attachment. Children who, during the second year of life, were cared for by providers with secure mental representations of attachment were not necessarily protected from abnormally aggressive behavioral outcome.     

Electrophysiological differences in the processing of affective information in words and pictures

It is generally assumed that affective picture viewing is related to higher levels of physiological arousal than is the reading of emotional words. However, this assertion is based mainly on studies in which the processing of either words or pictures has been investigated under heterogenic conditions. Positive, negative, relaxing, neutral, and background (stimulus fragments) words and pictures were presented to subjects in two experiments under equivalent experimental conditions. In Experiment 1, neutral words elicited an enhanced late positive component (LPC) that was associated with an increased difficulty in discriminating neutral from background stimuli. In Experiment 2, high-arousing pictures elicited an enhanced early negativity and LPC that were related to a facilitated processing for these stimuli. Thus, it seems that under some circumstances, the processing of affective information captures attention only with more biologically relevant stimuli. Also, these data might be better interpreted on the basis of those models that postulate a different access to affective information for words and pictures.