In this study, we addressed the heterogeneity in interpersonal problems across patients with generalized anxiety disorder (GAD). We assessed interpersonal problems by the Inventory of Interpersonal Problems (IIP-C; Horowitz, Alden, Wiggins, & Pincus, 2000) in a sample of 78 GAD patients. We used IIP-C profiles describing interpersonal characteristics of the total GAD sample as well as clustered GAD interpersonal subtypes. Although the overall sample was located in the friendly submissive quadrant of the circumplex model, this was true only for the Exploitable cluster, which includes more than 50% of the patients. Importantly, clusters of GAD patients with other locations reporting predominantly Cold, Nonassertive, or Intrusive interpersonal problems were also identified. The 4 clusters did not differ in terms of gender, comorbid disorders, or the severity of depression or anxiety. Thus, the assessment of interpersonal problems provides additional diagnostic information covering the heterogeneity of GAD patients. This information could be used for differential indication and individual case formulation in GAD.
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"), generalized anxiety disorder (Przeworski et al., 2011; Salzer et al., 2008), posttraumatic stress disorder (Thomas et al., 2014), and eating pathology (Ambwani & Hopwood, 2009; Hopwood, Clarke, & Perez, 2007). Interpersonal pathoplasticity has also been used to predict variability in response to psychotherapy within a disorder (Cain et al., 2010). "
[Show abstract][Hide abstract] ABSTRACT: The context-free diagnoses outlined by the Diagnostic and Statistical Manual of Mental Disorders might not provide enough information to represent the heterogeneity observed in depressed patients. Interpersonal factors have been linked to depression in a mutually influencing pathoplastic relationship where certain problems, like submissiveness, are related to symptom chronicity. This study evaluated interpersonal
pathoplasticity in a range of depressive presentations. We examined archival data collected from 407 participants who met criteria for major depressive disorder (MDD), dysthymic disorder (DD), or subthreshold depression (sD). Latent profile analysis (LPA) identified 5 interpersonal subtypes (vindictive, intrusive, socially avoidant, exploitable, and cold). Apart from gender, the subtypes did not differ significantly on
demographic characteristics, psychiatric comorbidity, or self-report depression severity. Socially avoidant participants were more likely to meet criteria for a clinical depression diagnosis (MDD or DD), whereas vindictive participants were more likely to have sD. Our results indicate that interpersonal problems could account for heterogeneity observed in depression.
Journal of Personality Assessment 03/2015; DOI:10.1080/00223891.2015.1011330 · 1.84 Impact Factor
"On the level of overall interpersonal distress, we hypothesize higher scores among patients with GAD as compared with all other clinical groups. Furthermore, we expect GAD patients to exhibit especially pronounced problems with nonassertive, exploitable , overly nurturant, and/or intrusive behavior (Borkovec et al., 2004; Salzer et al., 2008). "
[Show abstract][Hide abstract] ABSTRACT: We examined the diagnostic specificity of interpersonal problems (IP) in generalized anxiety disorder (GAD). We expected generally higher interpersonal distress, and specifically higher levels of nonassertive, exploitable, overly nurturant, and intrusive behavior in n = 58 patients with Diagnostic and Statistical Manual of Mental Disorders, 4th Edition GAD compared with patients with post-traumatic stress disorder (n = 46), other anxiety disorders (n = 47), and unipolar depressive disorders (n = 47). IP were assessed with the Inventory of Interpersonal Problems. Specificity in the sense of heightened interpersonal distress for GAD was not supported in any of the aforementioned scales, neither for pure nor for comorbid GAD. This finding persisted after accounting for the degree of depressiveness (Beck Depression Inventory). GAD patients are rather not characterized by more self-ascribed IPs although they may worry more about interpersonal issues in general.
The Journal of nervous and mental disease 11/2010; 198(11):846-51. DOI:10.1097/NMD.0b013e3181f98063 · 1.69 Impact Factor
"Differences in interpersonal diagnosis will affect the manner in which patients express their distress and will influence the type of interpersonal situation they feel is needed to regulate their self, affect, and relationships (Pincus et al., 2010). Kachin et al. (2001), Salzer et al. (2008), and Wright, Pincus, Conroy, & Elliot (2009) have described procedures to determine the presence of a pathoplastic relationship using the IIP–C. If patients with a particular disorder are not defined by a uniform interpersonal profile on the IIP–C, nor are they defined by a complete lack of systematic interpersonal expression, then it is necessary to examine whether a pathoplastic relationship exists. "
[Show abstract][Hide abstract] ABSTRACT: Interpersonal assessment may provide a clinically useful way to identify subtypes of social phobia. In this study, we examined evidence for interpersonal subtypes in a sample of 77 socially phobic outpatients. A cluster analysis based on the dimensions of dominance and love on the Inventory of Interpersonal Problems-Circumplex Scales (Alden, Wiggins, & Pincus, 1990) found 2 interpersonal subtypes of socially phobic patients. These subtypes did not differ on pretreatment global symptom severity as measured by the Brief Symptom Inventory (Derogatis, 1993) or diagnostic comorbidity but did exhibit differential responses to outpatient psychotherapy. Overall, friendly-submissive social phobia patients had significantly lower scores on measures of social anxiety and significantly higher scores on measures of well-being and satisfaction at posttreatment than cold-submissive social phobia patients. We discuss the results in terms of interpersonal theory and the clinical relevance of assessment of interpersonal functioning prior to beginning psychotherapy with socially phobic patients.