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Interpersonal Problems among psychiatric outpatients and non-clinical samples
... It uses a 5-level Likert scale including eight subscales, that is, dominance, vindictiveness, coldness, social inhibition, non-assertiveness, overaccommodation, self-sacrifice, and intrusion. The Thai version of the IIP-32 demonstrates good reliability and validity (Wongpakaran, et al., 2012c). In this study, the IIP-32 showed a Cronbach's a of .81. ...
... The original 20-item scale contains an equal number of negatively and positively worded items, minimizing acquiescence bias. However, these reversed items may appear bewildering to respondents, and so, the opposite of a construct reverse score may differ basically from the construct and thus undermine construct validity (Zhang, Noor, & Savalei, 2016), especially in the patient sample (Wongpakaran et al., 2012c). A number of psychological measurements originally were developed in non-clinical samples such as students, and later applied to clinical samples, where a variety of modification may occur such as removing some items. ...
Objective:
The UCLA Loneliness Scale, containing 20 items, is one of the commonly used loneliness scales. Some shorter versions have been developed using factor analysis. The study aimed to shorten the UCLA Loneliness Scale using Rasch and factor analysis methods and test the psychometric properties of the new scale.
Methods:
The full sample of the study included 719 respondents, divided into three subsamples (205, 324, and 190 for samples 1-3, respectively). The original, 20-item Revised UCLA Loneliness Scale (R-ULS) was shortened using 205 students (sample 1); the shortened scale was then validated for construct and concurrent validity with 324 students (sample 2) and 190 clinical participants (sample 3). Confirmatory factor analysis and Rasch analysis were used for construct validity. Convergent, discriminant, and concurrent validity were assessed by exploring the correlation with other psychological measurements.
Results:
In sample 1, the R-ULS was shortened to a 6-item scale (RULS-6) that fits the Rasch model. The RULS-6 met the criteria of unidimensionality and local independence without differential item functioning due to age and sex, and good targeting the clinical sample. Person Separation Index (PSI) reflected that reliability from the Rasch perspective was acceptable. However, collapsing categories 2 (sometime) and 3 (rarely) may be required in a clinical sample. When tested in samples 2 and 3, the RULS-6 fits the Rasch measurement model. Convergent and discriminant validity were demonstrated with interpersonal problems and attachment scales. As expected, a positive correlation was found between RULS-6 and anxiety, depression subscale, interpersonal difficulties, and somatization subscales denoting concurrent validity. Cronbach's alpha of the RULS-6 was good (.83).
Conclusion:
Using Rasch analysis, the proposed RULS-6 constituted a 70% reduction of the number of original items, yet preserved the psychometric properties in independent samples of students and psychiatric outpatients.
... Within clinical settings, the prevalence rates of BPD range from 1.3% ( Xiao et al., 2006) to 7.1% ( Yang et al., 2000). In Southeast Asia, no research has yet examined the prevalence of BPD, with the exception of one study conducted in Thailand, which found that 13.0% of inpatients and outpatients met diagnostic criteria for BPD (Wongpakaran et al., 2012), and another study based in Singapore, which found that 16.3% of prison inmates with a current or past history of receiving mental health treatment met criteria for BPD (Abdin et al., 2011). ...
... The prevalence rate of BPD in the patient sample (36.0%) was found to be similar or higher compared to countries in East and Southeast Asia, which share cultural similarities and/or are geographically close to Singapore. For instance, rates of BPD in clinical settings in Asia have ranged from 1.3% to 53.1% in China ( Huang et al., 2012;Xiao et al., 2006) and to 13.0% in Thailand ( Wongpakaran et al., 2012). In this study, the rate of BPD in Singapore was higher than the one established in an earlier study involving a forensic psychiatric population (Abdin et al., 2011). ...
This study examined the construct validity of the McLean Screening Instrument for Borderline Personality Disorder (MSI-BPD) in a consecutive sample of adult psychiatric patients (n = 128) and a separate sample of undergraduate students (n = 289) in Singapore. Participants were administered the MSI-BPD and other measures assessing related symptoms of BPD. Patients were also administered a semistructured interview by interviewers blind to their MSI-BPD scores. Confirmatory factor analyses revealed a unique three-factor solution, consisting of affect dysregulation, self-disturbances, and behavioral and interpersonal dysregulation. In both samples, the MSI-BPD demonstrated good internal consistency and convergent validity. The measure also showed good discriminant validity and predictive accuracy (AUC = .82), with an optimal cut-off score of 7.5. Overall, the findings suggest that BPD is a valid and coherent clinical construct in Singapore, and point to the need to further clarify the presentation and etiology of BPD in this cultural context.
... Furthermore, depression is a heterogeneous disorder, and different subtypes may be associated with varying profiles of interpersonal distress. Chronic and acute forms of depression, for example, appear to give rise to distinct behaviours, with more significant social avoidance in acute depression(Ley et al., 2011), and major depressive disorder with higher scores in the non-assertive, socially inhibited and self-sacrificing IIP sub-scales(Wongpakaran et al., 2012). Patients with chronic depression reported higher difficulty differentiating and describing their emotions than episodically depressed patients(van Randenborgh et al., 2012). ...
Background: Recognized as a common and debilitating condition with a high recurrence rate, depression is considered a severe public health problem. The association between interpersonal problems and depressive disorders is well documented, but studies in non-clinical populations are scarce. The working hypotheses were that (Hp1) depressed women report more interpersonal problems than non-depressed ones, and (Hp2) depression is predicted by interpersonal problems. Methods: The present study analyzes the relationship between depression and interpersonal problems, assessed by the Inventory of Interpersonal Problems (IIP64), in a non-clinical Portuguese female population (n=240), aged 18 to 81. Two groups of participants were considered, based on the Beck Depression Inventory-short form (BDI-SF) cutoff points: G1 "non-depressed" (n=119, M=44.18, SD=12.34) and G2 "depressed" (n=121, M=41.14, DS=13.74). One-way ANOVA and binary logistic regression with forward selection were performed. Results: There was a significant difference in interpersonal problems between depressed and non-depressed women. Specifically, when women experienced depressive symptoms, they identified more interpersonal problems. The sub-scales IIP1 dominating/controlling, IIP7 Self-sacrifice and IIP4 Socially inhibited had the most significant impact on the likelihood of depression. Conclusions: This study emphasizes that clinical practice and universal and selective prevention strategies for depression should include analyses and interventions on factors such as inhibition, reduction of the social network, difficulty in emotional expression and low gratification experienced in interpersonal relationships.
... In the transition from adolescence to adulthood, university students often are required to adapt to new social roles, to deal with their own finances, and to strive for academic achievement [1]. Some may undergo a mental health hurdle such as stress, amotivation, interpersonal difficulty, or depression [2][3][4]. The mental health problems of university students have strikingly increased in the past decade [5,6], especially among medical students. ...
Suicidal ideation is a serious condition antecedent to suicidal attempts and is highly related not only to depression but also other psychosocial factors. This study aimed to examine the predictive effects of these potential factors for suicidal ideation among young adult university students. A cross-sectional survey was conducted on a sample of university students in Thailand. An online questionnaire employed the perceived stress scale-10 (PSS-10), the patient health questionnaire-8 (PHQ-8), the multidimensional scale of perceived social support (MSPSS), and a screening instrument for borderline personality disorder. An ordinal regression analysis was applied to determine the predictive effects of the independent variables. Of 336 students, the mean age was 20.26 ± 1.3 years, 80.4% of whom were female; 14.3% had suicidal ideation. The significant predictors of suicidal thoughts were perceived stress (AOR 1.11, 95% CI 1.01 to 1.22); depressive symptoms (AOR 1.16, 95% CI 1.05 to 1.22); borderline personality symptoms (AOR 1.19, 95% CI 1.01 to 1.40); and perceived social support (AOR 0.97, 95% CI 0.94 to 1.00). Not only did depressive symptoms contribute to suicidal ideation but they also constituted important variables. Therefore, they should be included in intervention plans to prevent suicidality among university students.
... The effect of neuroticism on depression is complex, and multiple mediating variables have been investigated. These include catastrophic and anxiety-provoking appraisals [8], cognitive emotion regulation [9], social inhibition [6,10] and perceived stress [11]. Perceived stress, the feelings or thoughts that individuals experience following stressful life events, is independently linked and often precedes the occurrence of depression. ...
Equanimity is widely and commonly practiced, but few have investigated the concept in clinical research. While the mediation model of neuroticism, perceived stress and depression have been demonstrated, it remains unclear whether equanimity mediates the relationship of these variables in parallel, serial or moderated mediation models. This study aimed to investigate the role of equanimity among those models. Methods: In all, 644 general participants (74.2% female, mean age = 28.28 (SD = 10.6)) provided data on the 10-item Perceived Stress Scale (PSS), the Neuroticism Inventory (NI), depression subscale of the Core Symptom Index, and the equanimity subscale of the inner Strength-based Inventory. Mediation and moderation analyses with the 5000 bootstrapping method were applied. Results: Equanimity was shown to moderate the relationship between NI/PSS and depressive symptom. Statistical evaluation supported all parallel, serial and moderated mediation models. Equanimity as a moderator provided a higher amount of percent variance explained by depressive symptoms than parallel and serial mediation models. Conclusions: Results suggest that the effect of perceived stress and neuroticism on depression can be mitigated by increasing levels of equanimity. The results demonstrated one potential benefit from practicing equanimity; enabling its extension to mental health problems could constitute an interesting focus for future research.
... The IIP-32 demonstrated strong internal consistency (Cronbach's alpha = 0.84) and acceptable test-retest reliability (intraclass correlation coefficient = 0.74). The Thai version demonstrated excellent reliability and validity [61], and the scale performed well with this study's sample (Cronbach's alpha = 0.88). ...
Background
A number of factors have been demonstrated to be associated with Problematic Internet Use (PIU); otherwise known as Internet Addiction), which is mostly concerned with psychological problems such as loneliness. This study aimed to examine how and in what way loneliness influenced PIU.
Methods
A self-report measurement on loneliness, the Internet addiction test (IAT) and instruments on interpersonal problems were administered to 318 medical students (57% females); mean age totaled 20.88 years (SD = 1.8). We performed a mediation analysis to evaluate direct effects of loneliness on IAT, as well as indirect effects mediated by interpersonal problems. In addition, motivation for internet use was added to the mediation model and tested whether it acted as the second mediator (serial mediation model) or a moderator (moderated mediation model).
Results
After controlling for sex and age, socially inhibited problems exhibited full mediation whereas the remainder showed partial mediation effects, with the exception that intrusive and cold interpersonal problems indicated no mediating role. Negative motivation and motivation for being accepted had mediation effects for all types of interpersonal problems. Motivation for working was found to be a significant mediator and moderator of the most interpersonal problems. Intrusive and cold styles became a mediator only when some motivation variables were added to the model, implying that not only psychological problems should be included when analyzing PIU, but also other variables such motivation for internet use. The percent of variance explained, by IAT score, increased from 13% in the mediation model to 33% by the moderated mediation model, and 43% using the serial mediation model.
Conclusion
The study suggested the crucial role of loneliness and interpersonal problems on PIU, for which motivation for internet use explained how each interpersonal problem would be associated. This may provide some insight regarding the pathological characteristics of those using the internet as a coping strategy.
... The IIP-32 demonstrated strong internal consistency (Cronbach's alpha = 0.84) and acceptable test-retest reliability (intraclass correlation coefficient = 0.74). The Thai version demonstrated excellent reliability and validity [31]. The scale performed well with this study's sample (Cronbach's alpha = 0.88). ...
Background:
The Relationship Questionnaire (RQ) is a commonly used self-reporting questionnaire used to measure adult attachment styles. The RQ has two parts. RQ1, a single item where individuals have to indicate their preferred relationship style, and RQ2, where individuals can rate their relationship style in more detail using four different scales. Agreement is expected between the highest levels selected and the style chosen in RQ1. An advantage of the RQ is its brevity, whereas a disadvantage is that it constitutes a single item. A validation of RQ has not been clearly demonstrated, even though it has convergent validity in relation to other measurements in this area.
Methods:
168 patients completed the RQ, the short version of the Experience in Close Relationships (Revised) questionnaire (ECR-R), and scales of depression and interpersonal problems. Regression analysis was conducted to examine the congruity in regard to attachment theory.
Results:
ratings from 15.5% of the patients showed disagreement between RQ1 and RQ2. Each type of attachment measured by the RQ was predicted by the ECR-R scores, as hypothesized. In the predictive analysis of depression and interpersonal problems, both RQ dimensions and ECR-R scores were coherent.
Conclusions:
RQ is a valid self-reported measurement that can be applied clinically on the condition that the rater identifies an agreement between RQ1 and RQ2.
... In clinical settings, the prevalence rates of BPD range from 1.3 [20] to 7.1% [21]. In Southeast Asia, one study conducted in Thailand found that 13.0% of inpatients and outpatients met diagnostic criteria for BPD [22], whereas studies based in Singapore found that a prevalence rate of 16.3% in a prison setting [23] and 36% in a psychiatric setting [24•]. ...
Purpose of review:
This review discusses cultural trends, challenges, and approaches to assessment and treatment of personality traits and disorders. Specific focus include current developments in the Asian, Italian, Iranian, and Australian societies, as well as the process of acculturation, following moves between cultures with the impact on healthy and disordered personality function.
Recent findings:
Each culture with its specific history, dimensions, values, and practices influences and gears the individual and family or group in unique ways that affect personality functioning. Similarly, each culture provides means of protection and assimilation as well as norms for acceptance and denunciations of specific behaviors and personality traits. The diagnosis of personality disorders and their treatment need to take into consideration the individual in the context of the culture and society in which they live. Core personality problems, especially emotion dysregulation and interpersonal functioning are specifically influenced by cultural norms and context.
... Little research has been conducted on BPD in Southeastern Asia, but BPD has been diagnosed in clinical settings in Thailand, a collectivistic, feminine society characterized by moderately high power differential and avoidance of uncertainty [33]. Wongpakaran et al. [140] found that 13.0% of inpatients and outpatients met criteria for BPD. Furthermore, two female patients with BPD and comorbid depression were reported in a study on the treatment of depression with transcranial magnetic stimulation [141]. ...
Background: In recent years, there have been significant advancements in understanding the etiology,
assessment, and treatment of borderline personality disorder (BPD). However, the influence of culture has
not been carefully considered. The present review is an attempt to identify cultural factors that may
change the presentation, assessment, and response to treatment among adults and adolescents with BPD.
Discussion: We discuss the relevance of examining the BPD diagnosis across cultures, define culture, and
review studies on the prevalence of BPD across sociocultural groups. Conclusion: We provide a
comprehensive list of assessments developed to capture BPD and the cultural adaptations and validations
attempted thus far. We also summarize the evidence base for culturally sensitive treatments for BPD.
Finally, we present suggestions for future research and clinical implications for our findings.
... At the time of the original trial, MBT had not yet been indicated for ASPD and the trial was not designed with this diagnosis in mind. Nevertheless, our original design allows us to measure change in important psychological features directly related to characteristics of ASPD such as anger, hostility, impulsivity (as reflected in self-harm and suicide) and difficulty in relaxing interpersonal control related to loss of dignity, selfworth and self-respect [54]. Mood disorders, particularly anxiety and depression, are known to co-occur with ASPD [9,55,56] and to be frequent triggers for aggression [57,58]. ...
Background
Antisocial personality disorder (ASPD) is an under-researched mental disorder. Systematic reviews and policy documents identify ASPD as a priority area for further treatment research because of the scarcity of available evidence to guide clinicians and policymakers; no intervention has been established as the treatment of choice for this disorder. Mentalization-based treatment (MBT) is a psychotherapeutic treatment which specifically targets the ability to recognise and understand the mental states of oneself and others, an ability shown to be compromised in people with ASPD. The aim of the study discussed in this paper is to investigate whether MBT can be an effective treatment for alleviating symptoms of ASPD. Methods
This paper reports on a sub-sample of patients from a randomised controlled trial of individuals recruited for treatment of suicidality, self-harm, and borderline personality disorder. The study investigates whether outpatients with comorbid borderline personality disorder and ASPD receiving MBT were more likely to show improvements in symptoms related to aggression than those offered a structured protocol of similar intensity but excluding MBT components. ResultsThe study found benefits from MBT for ASPD-associated behaviours in patients with comorbid BPD and ASPD, including the reduction of anger, hostility, paranoia, and frequency of self-harm and suicide attempts, as well as the improvement of negative mood, general psychiatric symptoms, interpersonal problems, and social adjustment. ConclusionsMBT appears to be a potential treatment of consideration for ASPD in terms of relatively high level of acceptability and promising treatment effects. Trial registrationISRCTN ISRCTN27660668, Retrospectively registered 21 October 2008
... The Thai version of 32-item Inventory of Interpersonal Problems has demonstrated good reliability and validity levels. 70 The perceived stress scale This ten-item, 5-point Likert scale instrument records how frequently people feel stressed. 71 The Thai versions of perceived stress scale (PSS) have demonstrated good reliability and validity. ...
Purpose:
Despite the fact that pain is related to depression, few studies have been conducted to investigate the variables that mediate between the two conditions. In this study, the authors explored the following mediators: cognitive function, self-sacrificing interpersonal problems, and perception of stress, and the effects they had on pain symptoms among patients with depressive disorders.
Participants and methods:
An analysis was performed on the data of 346 participants with unipolar depressive disorders. The 17-item Hamilton Depression Rating Scale, Mini-Mental State Examination, the pain subscale of the health-related quality of life (SF-36), the self-sacrificing subscale of the Inventory of Interpersonal Problems, and the Perceived Stress Scale were used. Parallel multiple mediator and serial multiple mediator models were used. An alternative model regarding the effect of self-sacrificing on pain was also proposed.
Results:
Perceived stress, self-sacrificing interpersonal style, and cognitive function were found to significantly mediate the relationship between depression and pain, while controlling for demographic variables. The total effect of depression on pain was significant. This model, with an additional three mediators, accounted for 15% of the explained variance in pain compared to 9% without mediators. For the alternative model, after controlling for the mediators, a nonsignificant total direct effect level of self-sacrificing was found, suggesting that the effect of self-sacrificing on pain was based only on an indirect effect and that perceived stress was found to be the strongest mediator.
Conclusion:
Serial mediation may help us to see how depression and pain are linked and what the fundamental mediators are in the chain. No significant, indirect effect of self-sacrificing on pain was observed, if perceived stress was not part of the depression and/or cognitive function mediational chain. The results shown here have implications for future research, both in terms of testing the model and in clinical application.
Child sexual abuse (CSA) is a pervasive social problem that can have long-term effects on women's relationships because it makes them vulnerable to revictimization. Girls are more vulnerable than boys to be victims of CSA, and those abused by someone they trust are at higher risk of experiencing increased trauma and interpersonal problems. This quantitative research study investigated the association between CSA and interpersonal relationships. Participants completed anonymous surveys exploring these two variables. Results showed that among other vulnerabilities, women who reported sexual abuse within the family reported overall greater interpersonal problems compared with non-abused participants. Given the prevalence of intrafamilial and other types of CSA and its impact on interpersonal relationships, providing an environment where girls are safe from abuse is important. Research, education, policy, and educational programs can help prevent CSA and its consequences.
Purpose
Evidence has shown that the Five precepts significantly affect the relationship between attachment and resilience; however, little is known whether observing the Five Precepts would help reduce depressive symptoms among those who experience risks. The aim of this study was to examine the moderating role of the Five Precepts in the mediation model relationship among neuroticism, perceived stress, and depression.
Patients and methods
The study employed a cross-sectional survey design and data were collected from the end of 2019 to September 2022 in Thailand. In all, 644 general participants completed questionnaires on the Neuroticism Inventory (NI), the 10-item Perceived Stress Scale (PSS), Depression Subscale, and the Five-Precept Subscale of the Inner Strength-based Inventory (SBI-PP). Mediation and moderation analyses with 5000 bootstrapping methods were used.
Results
Among all, 74.2% were female, and the mean age totalled 28.28 years (SD = 10.6). SBI-PP was shown to have a moderation effect on the relationship between NI, PSS and depressive symptoms. The moderating effect between SBI-PP and PSS was significant, whereas SBI-PP and NI was not. The index of moderated mediation from the Five Precepts was significant (b = -0.019 (95%CI -0.029, -0.009)). The moderated mediation model increased the percent variance explaining depressive symptoms to 47.6%, compared with 32.6% from the mediation model alone.
Conclusion
Observing the Five Precepts offers evidence that it buffers the effect of perceived stress on depression. People with high levels of observing the Five Precepts are less likely to develop depressive symptoms. Implications as well as possible future research are discussed.
Background
Outcome measurement is important for monitoring patients’ progress. The study aimed to develop an outcome inventory (OI) for clinical use in routine practice in psychiatric services and to examine the psychometric properties of the newly developed OI.
Methods
48 items measuring anxiety, depression, interpersonal difficulties, and somatization were collected. Factor analysis was used to reduce the number of items. The final OI consisting of 21 items was then examined for psychometric properties among 1302 participants, 880 were nonclinical and 422 clinical patients. Tests included confirmatory factor analysis, internal consistency, test-retest reliability, convergent and discriminant validity, and diagnostic ability for major depression. Responsiveness was compared between baseline and 3-month follow-up.
Results
Confirmatory factor analysis revealed the OI-21 demonstrated the designated four components. Cronbach’s alpha was good to excellent for all subjects with good test-retest reliability, concurrent validity, convergent and discriminant validity. It demonstrated area under the ROC curve of 0.89 indicating good diagnostic performance. Sensitivity to change after 3 months was observed in both types of treatment. However, interpersonal difficulties were sensitive to change in those receiving additional psychotherapy.
Conclusion
OI-21 demonstrated its validity, reliability, and sensitivity to change. It constitutes a promising tool for outcome assessment in nonclinical populations and among psychiatric patients.
The purpose of this research was to develop a Japanese short version of the Inventory of Interpersonal Problems (IIP) and examine its reliability and validity. In Study 1, we developed a short version of the IIP using item response theory (IRT). The results indicated sufficient measurement accuracy for the short version compared to the original IIP and an existing short version (IIP-32). Specifically, the short version had better measurement accuracy for participants with higher levels of interpersonal problems. Similar to previous research, confirmatory factor analysis demonstrated the factor structure and circumplex structure. In Study 2, we examined the reliability and validity of the short version. The results revealed good internal consistency and test-retest reliability. Furthermore, the short version correlated with depression, state anxiety, eating disorder tendency, psychological symptoms, self-esteem, and personality. Finally, the application of the short version in counseling situations is discussed.
Interpersonal problems are frequently the target of psychotherapeutic treatments for depression, but there is a scarcity of empirical evidence as to which, if any, particular type of interpersonal problems respond most favourably to these treatments. The scope of this thesis is to explore the relationship between interpersonal problems and outcomes in psychotherapy, in particular Dynamic Interpersonal Therapy (DIT). Specifically, its focus is the development of a new method of classifying the interpersonal focus of therapy, which could then be used as a predictor of treatment outcomes. Different types of interpersonal problems can be identified using a well-established measure, the Inventory of Interpersonal Problems (IIP), however, it cannot identify which problems actually become the specific target of treatment. DIT provides an ideal construct for this in the form of its key component: the interpersonal affective focus of treatment (IPAF). Chapter one reviews the development and use of the Inventory of Interpersonal Problems (IIP) in the context of interpersonal approaches to depression and explores how it might be most usefully employed as a basis for a new coding system for IPAFs. Chapter two is the first systematic review and meta-analysis of research into changes in interpersonal problems over the course of psychotherapeutic treatment of depression. Chapter three reports the development of the IPAF coding system. A theory-driven qualitative analysis of audio recordings of IPAFs obtained from pilot trials of DIT is presented, using the IIP as a predetermined analytic framework. In chapter four, the reliability and validity of this typology is further investigated. Chapter five is a study of the relationship between interpersonal problems (measured with both the IIP and the IPAF typology) and treatment outcomes in DIT. Lastly, chapter six provides a summary of findings and a discussion of limitations and directions for future research.
Background
In the era of high-speed internet, using the internet regardless of platform might be considered a part of everyone’s daily activities. A number of factors have been demonstrated to be associated with internet addiction, which is mostly concerned with psychological problems such as loneliness. This study aimed to examine how and in what way loneliness has influenced internet addiction. Specifically, we proposed and tested interpersonal problems and motivation for the internet as intervening variables of the relationship between loneliness and internet addiction.
Methods
Self-report measurement on loneliness, internet addiction test (IAT) and interpersonal problems consisting of domineering, vindictive, cold, socially inhibited, nonassertive, overly accommodating, self-sacrificing and intrusive, were administered to 318 medical students (57% females); mean age was 20.88 (SD, 1.8), to test whether interpersonal problems mediated the relationship between loneliness and internet addiction in the mediation model. In addition, motivation for internet use was added to the mediation model and tested whether it was the second mediator (serial mediation model) or a moderator (moderated mediation model).
Results
After controlling for sex and age, socially inhibited problems exhibited full mediation whereas the remainder had partial mediation effect, with the exception that intrusive and cold interpersonal problems had no mediating role. Negative motivation and motivation for being accepted had mediation effects for all styles of interpersonal problems. Motivation for working was found to be a significant mediator and moderator of the most interpersonal problems. Intrusive and cold styles became a mediator only when some motivation variables were added to the model, implying that not only psychological problems should be included when analysis internet addiction, but also other variables such motivation for internet use. The percent of variance explained, by IAT score, increased from 13% by the mediation model to 33% by the moderated mediation model, and 43% by the serial mediation model.
Conclusion
The study suggested the crucial role of loneliness and interpersonal problems on internet addiction, for which motivation for the internet use explained how each interpersonal problem would be associated. This may provide some insight regarding the pathological characteristics of those using the internet as a coping strategy. Intervention to help students experiencing loneliness to avoid excessive use of the internet is possible when their interpersonal problems and various types of motivation are identified.
Pathogenic beliefs (PBs) are a key construct within control-mastery theory, a dynamic cognitive-relational psychotherapy approach. It is common for these beliefs to trigger interpersonal problems. The present study explored the relationship between PBs and interpersonal problems. Sixty-eight patients with depressive disorder were assessed using a 54-item Pathogenic Belief Scale (PBS), and the Inventory of Interpersonal Problems (IIP-32). Eight sub scales of the IIP-32 were analysed, along with the interpersonal circumplex (IPC) dominance and love dimensions. The PBS was significantly associated with the IIP-32 total score (r = .608, p < .01). The PBS scores were significantly correlated with the dominance dimension (r = −.285, p < .05), but not the love dimension. PBs have a significant correlation with interpersonal problems. They correlated with the submissive or hostile quadrant of the IPC, which measures negative sense of self and disappointment in oneself in relating to others.
Introduction:
Internet addiction is common among medical students, and the prevalence is higher than the general population. Identifying and creating solutions for this problem is important. The aim of this study was to examine the prevalence and associated factors, particularly loneliness and interpersonal problems among Chiang Mai medical students.
Materials and methods:
Of 324 first to sixth year medical students, 56.8% comprised females with a mean age of 20.88 (SD 1.8). All completed questionnaires related to the objectives and activities of internet use, the Young Internet Addiction Test, the UCLA loneliness scale, and the Interpersonal Problems Inventory were employed to identify internet addiction.
Results:
In all, 36.7% of the subjects exhibited internet addiction, mostly at mild level. Amount of time used daily, loneliness and interpersonal problems were strong predictors (beta = 0.441, p < 0.05, beta = 0.219, p < 0.001 and beta = 0.203 p < 0.001, respectively), whereas age and sex were not. All objectives of using internet contributed to the variance of internet addiction score. For internet activities, only non-academic or studying contributed. The final model accounted for 42.8% of total variance of the internet addiction score.
Conclusion:
Even though most addiction was at a mild level, careful strategies should be applied to better understand the situation. Along with a screening for potential internet addiction among medical students, attention should be paid to identifying those who experience loneliness and interpersonal problems, because both are strong predictors that can be improved by a variety of appropriate intervention.
Somatization is a common symptom among the elderly, and even though personality disorders have been found to be associated with somatization, personality traits have not yet been explored with regard to this symptom. The aim of this study is to investigate the relationship between personality traits and somatization, and social inhibition.
As part of a cross-sectional study of a community sample, 126 elderly Thais aged 60 years or over completed self-reporting questionnaires related to somatization and personality traits. Somatization was elicited from the somatization subscale when using the Symptom Checklist SCL-90 instrument. Personality traits were drawn from the 16 Personality Factor Questionnaire and social inhibition was identified when using the inventory of interpersonal problems. In addition, path analysis was used to establish the influence of personality traits on somatization and social inhibition.
Of the 126 participants, 51% were male, 55% were married, and 25% were retired. The average number of years in education was 7.6 (standard deviation =5.2). "Emotional stability" and "dominance" were found to have a direct effect on somatization, as were age and number of years in education, but not sex. Also, 35% of the total variance could be explained by the model, with excellent fit statistics. Dominance was found to have an indirect effect, via vigilance, on social inhibition, which was also influenced by number of years in education and emotional stability. Social inhibition was not found to have any effect on somatization, although hypothetically it should.
"Emotional stability", "dominance", and "vigilance", as well as age and the number of years in education, were found to have an effect on somatization. Attention should be paid to these factors in the elderly with somatization.
Objective: Explore how therapist’s interpersonal and attachment styles have an impact upon both the therapeutic alliance formed and therapy outcomes.
Material and Method: One hundred twenty one outpatients attending for routine psychiatric services were monitored for symptom outcomes, comprising depression, anxiety, and interpersonal problems. Patients were also asked about the level of therapeutic alliance that had been formed, covering goals, tasks, and the bond developed, using the Working Alliance Inventory (WAI). At the same time, the participating therapists reported upon their interpersonal styles by categorizing them into domineering or submissive styles using the IIP-32 questionnaire and their attachment styles by categorizing them into secure or preoccupied styles using the ECR-R. To explore therapist factors such as interpersonal and attachment styles, as well as to establish the presence of gender matching, the working alliance was used as a dependent variable.
Results: Multivariate analysis revealed that neither the gender of the therapist nor the gender of the patient, or the therapists’ styles, had an effect on the Working alliance or working outcomes. The multivariate test for WAI-goal (Wilks’ Lambda F (3, 134) = 4.24, p = 0.007), interpersonal style (Wilks’ Lambda F (3, 134) = 2.77, p = 0.044), attachment style (Wilks’ Lambda F (3, 134) = 2.76, p = 0.045) and IIP-Style*Attachment Style (Wilks’ Lambda F (3, 134) = 3.13, p = 0.028) produced statistically significant results, while working alliance-goal was the only predictor of the level of anxiety and depression in patients (p = 0.014 and p = 0.002, respectively). Submissive style was positively correlated to anxiety (p = 0.011) and interpersonal difficulties (p = 0.006), whilst surprisingly, a secure attachment style was found to have a positive correlation with anxiety and depression. However, when both styles were combined, the resulting style negatively predicted anxiety (p = 0.002).
Conclusion: Therapist factors were found to have no effect on working alliance, as reported by the patients; however, it was reported that when the therapists employed a secure or submissive attachment style, this played a role in helping to reduce symptoms. The working alliance-goal element was found to be a predictor of a reduction in levels of both anxiety and depression among patients.
Keywords: Interpersonal style, Attachment style, Therapeutic alliance, Psychotherapy outcome
A number of factors, such as demographics, cognitive function, personality and interpersonal relationship) play a role in late-life depression. This study investigates the influence of social inhibition on the inverse emotional stability (neuroticism) and depressive symptoms found in elderly Thai people.
In total, 123 elderly Thais aged 60 years of age or older were tested using the 64-item Inventory of Interpersonal Problems, Symptom Checklist-90, and the 16 Personality Factors Questionnaire. Hierarchical regression and path analyses were performed in order to identify the relationships among these variables.
The age of the participants ranged from 60 to 93 years old (mean = 71.7; SD = 6.2), and out of the group, 51.2% were male, 56.1% were married and 61.8% were on a low income. The average number of years spent in education among the participants was 7.6 (SD = 5.1). The variables found to be significantly associated with depression were age, intellect, social inhibition and possession of inverse emotional stability (neuroticism). Low levels of emotional stability were most strongly associated with depressive symptoms (standardized regression coefficients -0.29), but this effect was found to be reduced (mediated, to -0.26) by social inhibition. In total, 30% of the total variance could be explained by this model, and there was an excellent statistical fit.
The variables found to be significantly associated with depression were a younger age, as well as lower levels of intellectual skill, social inhibition and inversed emotional stability (neuroticism). It was found that a lack of emotional stability is, along with a younger age, the strongest predictor of depressive symptoms, but can be mediated by social inhibition.
Describes a new instrument, the Inventory of Interpersonal Problems (IIP), which measures distress arising from interpersonal sources. The IIP meets the need for an easily administered self-report inventory that describes the types of interpersonal problems that people experience and the level of distress associated with them before, during, and after psychotherapy. In Study 1, psychometric data are presented for 103 patients who were tested at the beginning and end of a waiting period before they began brief dynamic psychotherapy. On both occasions, a factor analysis yielded the same six subscales; these scales showed high internal consistency and high test–retest reliability. Study 2 demonstrated the instrument's sensitivity to clinical change. In this study, a subset of patients was tested before, during, and after 20 sessions of psychotherapy. Their improvement on the IIP agreed well with all other measures of their improvement, including those generated by the therapist and by an independent evaluator. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Integrates previous theory and research addressing interpersonal complementarity, a construct that is central to refined and extended research and clinical applications of interpersonal theory. The 1982 Interpersonal Circle is presented, which the present author constructed as a comprehensive taxonomy of the domain of 2-dimensional interpersonal behavior. The 1982 Circle integrates and expands the content of 4 major adult interpersonal measures (the Interpersonal Check List, the Interpersonal Adjective Scales, the Interpersonal Behavioral Inventory, and the Impact Message Inventory) to provide a circle taxonomy consisting of 16 segments 128 subclasses, 2 levels, and 350 bipolar items. Previous conceptions of interpersonal complementarity are reviewed and, using the 1982 Circle as a theoretical and operational guide, 11 propositions of complementarity as they apply in personality, psychopathology, and psychotherapy are derived. (108 ref)
Depression is remarkably persistent and recurrent. Why? Although several predictors of depression chronicity have been identified, a conceptual framework regarding mechanisms whereby depression chronicity occurs is lacking. The goal of this article is to explain depression chronicity, at least in part, with reference to processes, mostly interpersonal in nature, that serve to extend and reestablish depression. Several such processes are described, and available empirical evidence regarding each is reviewed. Clinical and research implications of the present conceptualization are elucidated. To the degree that these processes receive continued empirical support as mechanisms whereby depression persists, they represent leverage points to combat the vexing problem of depression chronicity.
In recent years, personality psychologists have shown interest once again in operationalizing and testing interpersonal conceptualizations of personality. Both applied and basic personality research have converged upon T. F. Leary's (1957, Interpersonal diagnosis of personality, New York: Ronald) circumplex model of interpersonal behavior. Results of these studies conflict. In this paper, we examined the reliability and validity of the Interpersonal Check List (R. Laforge & R. Suczek, 1955, Journal of Personality, 24, 94–112), the instrument most often used to operationalize the Leary model. Results showed the following: (1) only octant scales have acceptable internal consistencies, as assessed by Cronbach's α; (2) ICL variables approach a cirulant ordering when variance due to acquiescence response set is removed, but significant measurement gaps are evident in the Hostile-Submissive and Friendly-Dominant quadrants; and (3) ICL sixteenths do not form Guttman Scales, bringing into question the radex structure of the Leary (1957) model.
http://psychiatry.or.th/JOURNAL/56-1/06-Tinakon.pdf
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.
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).
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.
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.
This study aimed to investigate the psychometric properties of the Thai version of the Experiences of Close Relationships-Revised (Thai ECR-R) questionnaire.
400 students from a university in northern Thailand were randomly selected to complete the Thai ECR-R, the extraversion scale for 16 personality factors, the self-esteem scale and the trait anxiety scale. A retest of the Thai ECR-R was conducted at four-week intervals. Exploratory and confirmatory factor analyses were performed to test the validity of the construct.
The Thai ECR-R showed good internal consistency and satisfactory test-retest reliability. The avoidance and anxiety subscales demonstrated a convergent validity with the extraversion, self-esteem and trait anxiety scales. An exploratory analysis yielded a two-factor structure. Confirmatory factor analysis also provided general support for the hypothesised two-factor model, although there was a slight lack-of-fit.
The overall psychometric properties of the Thai ECR-R were acceptable. In order to render it more congruent with Thai culture, a revision of some items was considered. Further research on other age groups should be conducted in future.
Tested the hypotheses that (a) normal Ss respond differentially to the behavior of depressed patients, (b) this differential response is due to the fact that the target individuals are depressed, and not that they are patients, and (c) this pattern can be related to the symptomatology of depression. Each of 45 normal female undergraduates conversed on the telephone with either a depressed patient ( n = 15), a nondepressed patient ( n = 15), or a normal control ( n = 15). It was found that following the phone conversation, Ss who had spoken to depressed patients were themselves significantly more depressed, anxious, hostile, and rejecting. Measures of activity, approval responses, hope statements, and genuineness did not distinguish between S groups or between target groups, but important differences were found in the Ss' perception of the patients. It was proposed that environmental response may play an important role in the maintenance of depressed behavior. Furthermore, special skills may be required of the depressed person to cope with the environment his behavior creates. (21 ref)
We constructed a set of circumplex scales for the Inventory of Interpersonal Problems (IIP; Horowitz, Rosenberg, Baer, Ureno, & Villasenor, 1988). Initial scale construction used all 127 items from this instrument in two samples of university undergraduates (n = 197; n = 273). Cross-sample stability of item locations plotted against the first two principal components was high. A final set of eight 8-item circumplex scales was derived from the combined sample (n = 470) and cross-validated in a third university sample (n = 974). Finally, we examined the structural convergence of the IIP circumplex scales with an established measure of interpersonal dispositions, the Revised Interpersonal Adjective Scales (IAS-R; Wiggins, Trapnell, & Phillips, 1988). Although both circumplex instruments were derived independently, they shared a common Circular space. Implications of these results are discussed with reference to current research methods for the study of interpersonal behavior.
We describe a new method for aggregating psychodynamic formulations of independent clinicians. 15 patients (10 female and 5 male, aged 23-41) were interviewed before they began brief dynamic psychotherapy. Different panels of 8 formulators (drawn from a pool of 72 psychodynamic clinicians with 10-38 years of clinical experience) observed each videotaped interview and wrote individual formulations. The text of each formulation was divided into thought-units, and thought-units that occurred 3 or more times were combined into a final consensual formulation. (One case was formulated twice to demonstrate the replicability of the method). Other clinical raters then read each consensual formulation and judged, for a list of interpersonal problems, whether each problem was apt to be distressing for that patient. The raters were very successful in predicting which problems were later discussed in treatment. Predictions were best for formulations with a high proportion of interpersonal content.
The authors examined the level and structure of the Inventory of Interpersonal Problems-Circumplex version (IIP-C; L. M. Horowitz, L. E. Alden, J. S. Wiggins, & A. L. Pincus, 2000) before and after 20 sessions of acute-phase cognitive therapy for depression (N = 118), as well as associations with the Schedule for Nonadaptive and Adaptive Personality (L. A. Clark, 1993b) and the Social Adjustment Scale--Self-Report version (M. M. Weissman & S. Bothwell, 1976). Interpersonal problems had a 3-factor structure (Interpersonal Distress, Love, and Dominance), with the latter 2 factors approximating a circumplex, both before and after therapy. Interpersonal Distress decreased and social adjustment increased with therapy, but the Love and Dominance dimensions were relatively stable, similar to personality constructs. Social adjustment related negatively to Interpersonal Distress but not to Love or Dominance. Personality pathology related broadly to Interpersonal Distress and discriminantly to Love and Dominance. These findings support the reliability and validity of the IIP-C and are discussed in the context of personality theory and measurement.
In this study, we examined the relationship between treatment outcome and variables from the Inventory of Interpersonal Problems Circumplex scales (IIP-C; Horowitz, Alden, Wiggins, & Pincus, 2000) in the Pennsylvania Psychological Association's Practice Research Network (PRN; Borkovec, Echemendia, Ragusea, & Ruiz, 2001). The PRN was a naturalistic observation treatment outcome study conducted with clinicians who were providing outpatient therapy. Assessment instruments, including the Compass Assessment System (Howard, Brill, Lueger, O'Mahoney, & Grissom, 1993; Sperry, Brill, Howard, & Grissom, 1996) and the IIP-C, were used to assess outcome at the 7th session (N=73) and at termination (N=42). Significant associations were identified between seventh-session outcome and most of the IIP variables. Only IIP elevation and amplitude were related to termination outcome. Elevation, amplitude, and hostile submissive problems were related to treatment length. Ad hoc analyses indicated that the IIP elevation fully mediated the relationships between interpersonal problems and seventh-session outcome but not the relationship between amplitude and outcome. We discuss the results in relation to the external validity of the IIP.
This study examined (a) the role of avoidance coping in prospectively generating both chronic and acute life stressors and (b) the stress-generating role of avoidance coping as a prospective link to future depressive symptoms. Participants were 1,211 late-middle-aged individuals (500 women and 711 men) assessed 3 times over a 10-year period. As predicted, baseline avoidance coping was prospectively associated with both more chronic and more acute life stressors 4 years later. Furthermore, as predicted, these intervening life stressors linked baseline avoidance coping and depressive symptoms 10 years later, controlling for the influence of initial depressive symptoms. These findings broaden knowledge about the stress-generation process and elucidate a key mechanism through which avoidance coping is linked to depressive symptoms.
In this article, the authors study the factorial structure of 2 versions (64 items and 32 items) of the Dutch translation of the Inventory of Interpersonal Problems (IIP; L. M. Horowitz, L. E. Alden, J. S. Wiggins, & A. L. Pincus, 2000) in both a clinical sample (n = 382) and a student sample (n = 287). First, the authors test whether both inventories are constituted by correlated uni-dimensional subscales, and they conclude that this is true only for the short version. Second, the authors study whether the correlations between the subscales follow a circumplex pattern. This proves to be true for both versions. Coefficients alpha and correlations between the IIP-64 and IIP-32 subscales are discussed.
To understand a construct means to set it within an appropriate "nomological net" of lawful relations. For measures of interpersonal constructs, the interpersonal circumplex provides a nomological system of great potential for validating constructs and their measures. Three multidimensional measures-of dependency, empathy, and narcissism-were subjected to an interpersonal analysis, and construct parameters and similarities were estimated by using formulas derived from the circumplex model. The results offered a distinctly interpersonal perspective on the construct validity of the respective measures. Expanded uses for the interpersonal circumplex are discussed.
Examination of the literature indicated a need for explicit guidelines for evaluating circumplexity in bipolar personality data. The present authors call attention to certain properties of circulant correlation matrices that permit straightforward and computationally simple evaluations of circumplexity in a given set of data. Computational procedures are described for estimating a matrix of population correlation coefficients, of which obtained correlation coefficients are presumed to be samples, and for testing the goodness of fit of the 2 matrices. Simple computational formulas for determining the latent roots and vectors of circulant correlation matrices are used to distinguish among the several types of principal components that underlie such matrices. Properties of such correlation matrices, and of their underlying multivariate structures, are illustrated with reference to empirical data from the personality literature. (50 ref) (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Compared S. J. Blatt's (see record
1976-12367-001) constructs of dependency and self-criticism with A. T. Beck–s (1983) constructs of sociotropy and autonomy in the development and maintenance of depression. 197 undergraduate women completed a battery of instruments, including the Depressive Experience Questionnaire and the Beck Depression Inventory. Dependency and sociotropy displayed considerable overall convergence and were associated with similar interpersonal features. Some differences emerged between self-criticism and autonomy. In particular, self-criticism emerged as interpersonally complex, incorporating distrust, social avoidance, and concern with others' reactions. However, similarities between the 2 constructs outweighed the differences. Self-criticism and autonomy reflected as much interpersonal content as dependency and sociotropy. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
The Short Interpersonal Reactions Inventory [SIRI (Grossarth-Maticek, Eysenck, Vetter & Schmidt, Topics in Health, 1988)] is a questionnaire designed to measure personality traits predisposing to disease, notably ischaemic heart disease and cancer. It has been criticized by several authors in terms of design, scoring and validity. In a sample of 762 Australian twins taking part in a genetic study of asthma, we have examined the psychometric properties of the SIRI, and its relationship with the Eysenck Personality Questionnaire. Asthma was not significantly associated with any of the items or subscales of the SIRI. Scores on the seven subscales as defined by the SIRI authors (Types 1–3, 4 + and 4−, 5–6) were heavily skewed or truncated in six cases. Disturbingly, the two alternative forms of the Type 4 subscale were poorly intercorrelated (r = 0.17). A factor analysis using polychoric correlations partially replicated these subscales, but with important differences, similar to those found by other authors (Ranchor, Sanderman & Bouma, Personality and Individual Differences, 14, 483–484 1992). Scores on the SIRI and EPQR/S personality types were found to correlate broadly, as predicted by Eysenck (Perceptual and Motor skills, 71, 216–218, 1990). Attempts to assign each subject to a single major type were unsuccessful, whether by maximum subscale score, or membership of the upper quartile of a subscale distribution. Finally, we found that the questionnaire could be shortened from 70 to 25 items with little loss of internal reliability. We conclude that the SIRI has a number of shortcomings as currently formulated, but that it may serve as the basis for shorter instruments with superior internal and construct validity.
The Inventory of Interpersonal Problems (IIP) is a self-report instrument, designed to measure interpersonal distress. The properties of the Swedish IIP-version were studied in three different samples: non-psychiatric subjects, psychiatric out-patients, and psychiatric in-patients. The Swedish data were compared with Horowitz' normative American IIP-data. The patterns of correlation between the Swedish IIP and personality characteristics as assessed by personality inventory, self-report measures of alexithymia, and interview-based psychodynamic interviews were investigated. The results indicate that the Swedish IIP version possesses acceptable internal consistency, and construct validity in terms of its circumplex properties, and that it manifests meaningful patterns of correspondence with the self-report and interview-based instruments, developed within other theoretical frameworks, for assessing personality characteristics. For example, the pattern of correlations between the IIP and the alexithymia measures suggests alexithymia to be associated with problems of intimacy avoidance.
Patients with avoidant personality disorder (AVPD) display varied responses to behavioral treatment. This study examined the extent to which differences in patients' problematic interpersonal behavior influenced treatment response. Outpatients (N=76) meeting diagnostic criteria for AVPD completed the Inventory of Interpersonal Problems Circumplex Scales (IIP-C), a self-report measure that provides information on eight categories of interpersonal problems. As would be expected, all these patients reported problems with social avoidance and nonassertiveness. However, those patients who also had interpersonal problems related to distrustful and angry behavior benefited from the graduated exposure procedure but not from skills training. Patients with AVPD who experienced interpersonal problems related to being coerced and controlled by others, in addition to avoidance and nonassertiveness, benefited from both procedures. Skills training focused on the development of intimate relationships was of particular benefit to these patients. These results suggest that patients with AVPD differ in terms of their interpersonal problem “profiles” and that these differences influence response to behavioral intervention.
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.
We studied the reliability and validity of two versions (64 items and 32 items) of the Spanish translation of the Inventory of Interpersonal Problems (IIP-64 and IIP-32) and their usefulness as screening instruments for personality disorders in a sample of 190 outpatients and 66 healthy subjects. Patients were assessed using the IIP-64 and IIP-32, the Structured Clinical Interview for DSM-IV Axis II Personality Disorder diagnoses, and the Global Assessment of Functioning. The internal consistency and test-retest reliability were satisfactory. As theoretically predicted, factor analysis produced eight factors, and multidimensional scaling indicated the two dimensions of affiliation and dominance. Finally, a cutoff point of 87 for the IIP-64 showed 87% sensitivity and 85% specificity, whereas a cutoff point of 44 for the IIP-32 showed 82% sensitivity and 75% specificity. The Spanish versions of the IIP-32 and the IIP-64 are valid instruments for assessing interpersonal problems and for screening personality disorders in clinical practice.
Theoretical models and empirical evidence suggest that brooding, the maladaptive sub-component of depressive rumination, is associated with a sub-set of depressogenic interpersonal difficulties characterised by submissive interpersonal behaviours and rejection sensitivity. This study tested whether these cognitive and interpersonal vulnerability factors independently predicted future depression and investigated their interdependence in predicting depression. A heterogeneous adult sample completed self-report measures assessing depressive symptoms, brooding, reflection, rejection sensitivity and maladaptive interpersonal behaviours, at baseline and six months later. When examined separately, brooding and an interpersonal component reflecting submissive, (overly-accommodating, non-assertive, and self-sacrificing) interpersonal behaviours each prospectively predicted increased depressive symptoms six months later, after controlling for baseline depressive symptoms and gender. When examined together, the submissive interpersonal style but not brooding predicted depression, indicating that this maladaptive interpersonal style may mediate the effect of brooding on future depression. Thus, the effects of brooding on depression may in part depend on its association with an interpersonal style characterised by submissiveness.
The aim of the present study was to assess the relationship between change in interpersonal difficulties with change in chronic pain, health status and psychological state in 257 irritable bowel syndrome (IBS) patients in a randomized control trial comparing psychotherapy, antidepressant and usual care. We assessed at three time points interpersonal problems (IIP-32), abdominal pain and bowel symptoms, psychological distress (SCL-90), and health status (SF-36). Analysis included repeated measures (ANOVA) to assess change over time and multiple regressions to identify whether change in IIP was associated with outcome after controlling for psychological status. The main findings were: (1) difficulties with social inhibition and dependency were associated with longer disease duration; (2) change in mean IIP-32 over 15 months was significantly correlated with changes in pain, but these relationships were mediated by change in psychological distress; (3) change in IIP-32 was an independent predictor of improved health status at 15 months only in the psychotherapy group. These results indicate that improvement in interpersonal problems in IBS patients appear to be primarily associated with reduced psychological distress but, in addition, the association with improved health status following psychotherapy suggests that specific help with interpersonal problems may play a role in improving health status of patients with chronic painful IBS.
Kubler and Stotland (1964) have argued, 'emotional disturbance, even the most severe, cannot be understood unless the field in which it develops and exists is examined. The manifestations of the difficulty in the disturbed individual have meaning depending on aspects of the field. The significant aspects of the field are usually interpersonal'. Yet the study of depression has focused on the individual and his behavior out of his interactional context. To a large degree, the depressed person's monotonously reiterated complaints and self accusations, and his provocative and often annoying behavior have distracted investigators from considerations of his environment and the role it may play in the maintenance of his behavior. The possibility that the characteristic pattern of depressed behavior might be interwoven and concatenated with a corresponding pattern in the response of others has seldom been explored. This paper addresses itself to that possibility.
A new 4-group model of attachment styles in adulthood is proposed. Four prototypic attachment patterns are defined using combinations of a person's self-image (positive or negative) and image of others (positive or negative). In Study 1, an interview was developed to yield continuous and categorical ratings of the 4 attachment styles. Intercorrelations of the attachment ratings were consistent with the proposed model. Attachment ratings were validated by self-report measures of self-concept and interpersonal functioning. Each style was associated with a distinct profile of interpersonal problems, according to both self- and friend-reports. In Study 2, attachment styles within the family of origin and with peers were assessed independently. Results of Study 1 were replicated. The proposed model was shown to be applicable to representations of family relations; Ss' attachment styles with peers were correlated with family attachment ratings.
Cognitive therapy is based on the premise that cognition, the process of acquiring knowledge and forming beliefs, is a primary determinant of mood and behavior. After reviewing the basic theories of cognitive therapy, the authors discuss its application to the treatment of depression. They theorize that cognitive therapy can improve depressive mood and behavior by focusing on the depressed patient's cognitive disorder. This disorder includes impaired learning and memory function and a systematic negative bias in thinking. The authors note the encouraging results of preliminary outcome studies of this new treatment of depression; such results, they conclude, warrant further development and testing of cognitive therapy.
The Inventory of Interpersonal Problems (IIP) has been used to identify dysfunctional patterns in interpersonal interactions. Interpersonal problems can be organized in two dimensions, and the two-dimensional space can be divided into eight equal sectors (octants). Subscales of the IIP describe each of these octants. The instrument has been used to identify (a) interpersonal problems that are discussed most often in a brief dynamic psychotherapy and (b) problems that are treated most easily. The results show that problems in the "exploitable" octant improve most frequently, whereas problems in the "dominating," "vindictive," and "cold" octants do not improve as readily. Attachment styles in adulthood were examined (following a model proposed by Bowlby), and different attachment styles were found to correspond to different types of interpersonal problems. Finally, these variables were related to the ability to describe other people clearly. The article also discusses implications for brief dynamic psychotherapy.
A variety of behaviours have been identified as submissive (Buss & Craik, 1986). These are believed to be associated with vulnerability to psychopathology. This paper explores the construct and measurement of submissive behaviours and their association with psychopathology.
Two self-report scales were designed to measure the frequencies of (a) typical submissive behaviours (SBS) and (b) passive/withdrawal and affiliative strategies focused on conflict de-escalation (CDS). The association of these scales with psychopathology was explored in a series of questionnaire studies.
Study 1 assessed the SBS using a student sample (N = 332) and a mixed clinical group (N = 136). Of these, 177 students and 66 patients also completed the SCL-90-R. In Studies 2 and 3, the CDS and its association with depressive symptoms were assessed using a student sample (N = 154) and a depressed patient group (N = 60).
The SBS and CDS appeared reliable. There was a positive relationship between the SBS and the SCL-90-R, including interpersonal sensitivity and unexpressed hostility. The passive/withdrawal subscale of the CDS was associated with depressive symptoms. Evidence was obtained for sex differences with the affiliative subscale.
Some forms of submissive behaviour, especially those associated with passive/withdrawal and inhibition, are associated with a wide range of psychological problems.
There are limitations of inter-class correlation (usually, the Pearson's product-moment correlation) in evaluating reliability of an instrument. An intra-class correlation approach would be appropriate to examine the test-retest reliability of an instrument.
To introduce an intra-class correlation approach to examine the test-retest reliability of an instrument.
The method of constructing an intra-class correlation coefficient was presented.
The instrument with visual analog scales to measure the perceived competence to practice breast self-examination and perceived barriers to breast self-examination was tested. The intra-class correlation coefficient was 0.640.
The intra-class correlation is an alternative to test the reliability of an instrument and it is more sensitive to the detection of systematic error.
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.
We used a comprehensive longitudinal data set from Germany to examine trajectories of symptom distress depending on interpersonal problems at study intake measured via the Inventory of Interpersonal Problems-64 (IIP-64; Horowitz, Strau, & Kordy, 1994). Participants (N=622) underwent mid- or long-term outpatient psychotherapy (either psychodynamically oriented psychotherapy, cognitive behavioral therapy, or analytic psychotherapy). Data comprises up to 5 assessments during a 2-year period and was analyzed via hierarchical linear modeling. In the analytic psychotherapy subgroup, initial symptom level was higher in submissive patients. Initial interpersonal problems were not predictive of the rate of symptom change during therapy. Only in psychodynamic treatments, low affiliation positively affected treatment outcome. Interpersonal problems at intake were not related to the number of utilized sessions and utilization rate across treatment subgroups. We discuss the findings and outline future research topics.
This article examined the associations between occupational stress and interpersonal problems in physicians.
A nationwide representative sample of Norwegian physicians received the 64-item version of the Inventory of Interpersonal Problems (IIP-64) (N=862, response rate=70%) and six instruments measuring occupational stress. Comparison of means, correlation and reliability statistics and multiple regression analyses were applied.
The IIP-64 total score had a significant impact on job satisfaction, perceived unrealistic expectancies, communication with colleagues and nurses and on stress from interaction with patients. Being overly subassertive was related to low job satisfaction. Being overly expressive was linked to the experience of unrealistic expectancies from others and lack of positive feedback, whereas overly competitive physicians tended to have poorer relationships with both colleagues and nurses.
Addressing interpersonal problems in medical school and postgraduate training may be a valuable measure to prevent job stress and promote quality of care.
The aim of the study was to generate hypotheses for examining gender differences in variables with predictive value for the utilization of psychotherapy in patients with personality disorders (PDs).
Personality traits, affect experience and regulation, the quality of object relations and interpersonal problems within the process of psychotherapy planning were assessed in 140 psychiatric outpatients.
Besides the structured clinical interviews for DSM-IV I+II, variables were assessed with the Shedler-Westen assessment procedure (SWAP-200), the affect regulation and experience Q sort (AREQ), the quality of object-relations scale (QORS), and the Inventory of Interpersonal Problems (IIP). Correlation and group difference statistics, regression and canonical correlation analysis were performed.
Predictors concerning the utilization or non-utilization of psychotherapy were a schizoid PD rating a self-report of subassertive behaviour related to interpersonal problems in women, and a narcissistic PD rating in men. Canonical correlations between predictors and quality of object relations or interpersonal problems were found in women, while in men there was merely a tendency for predictor and affect regulation to be related.
The results suggest that for men it is more important to interpret the dominating affect, while for women, understanding the pathological object relation pattern is useful for successful therapy planning.
The Inventory of Interpersonal Problems (IIP–64; Horowitz, Alden, Wiggins, & Pincus, 200018.
Horowitz , L. M. ,
Alden , L. E. ,
Wiggins , J. S. and
Pincus , A. L. 2000. Inventory of Interpersonal Problems: Manual, San Antonio, TX: The Psychological Corporation. View all references) 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, 199548.
Wiggins , J. S. 1995. Interpersonal Adjective Scales: Professional Manual, Odessa, FL: Psychological Assessment Resources. View all references). 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.
The combination of antidepressants and brief psychotherapies has been proven more efficacious in treating major depression and is particularly recommended in patients with concomitant personality disorders. We compare the effects of 2 combined therapies, fluoxetine and interpersonal therapy (IPT) or fluoxetine and cognitive therapy (CT), on major depression in patients with borderline personality disorder (BPD).
Thirty-five consecutive outpatients with a diagnosis of BPD and a major depressive episode (not bipolar and not psychotic) were enrolled. They were randomly assigned to 1 of the 2 combined treatments and treated for 24 weeks. Assessment included a semistructured interview, Clinical Global Impression (CGI) scale, Hamilton Depression Rating Scale (HDRS), Hamilton Anxiety Rating Scale (HARS), Beck Depression Inventory-II (BDI-II), Social and Occupational Functioning Assessment Scale (SOFAS), Satisfaction Profile (SAT-P) for quality of life (QOL), and Inventory of Interpersonal Problems (IIP-64). Statistical analysis was performed using the univariate General Linear Model to calculate the effects of duration and type of treatment.
No significant differences between treatments were found at CGI, HDRS, BDI-II, and SOFAS score. Combined treatment with CT had greater effects on HARS score and on psychological functioning factor of SAT-P. Combined treatment with IPT was more effective on social functioning factor of SAT-P and on domains domineering or controlling and intrusive or needy of IIP-64.
Both combined therapies are efficacious in treating major depression in patients with BPD. Differences between CT and IPT concern specific features of subjective QOL and interpersonal problems. These findings lack reliable comparisons and need to be replicated.
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Personality Factor Questionnaire (16 PF): Champaign, IL: Institute for
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