Interpersonal Subtypes Within Generalized Anxiety Disorder

Department of Psychosomatic Medicine and Psychotherapy, Georg-August-University Goettingen, Germany.
Journal of Personality Assessment (Impact Factor: 1.84). 06/2008; 90(3):292-9. DOI: 10.1080/00223890701885076
Source: PubMed


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, 200023.

Horowitz , L. M. ,
Alden , L. E. ,
Wiggins , J. S. and
Pincus , A. L. 2000. Inventory of interpersonal problems manual, San Antonio, TX: Psychological Cooperation. View all references) 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.


Available from: Aaron Pincus
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    • "The scale consists of 10 items to be answered using a 6-point Likert scale (1 " applies completely " to 6 " does not apply at all " ). 4. Interpersonal problems and Attachment: The German version of the Inventory of Interpersonal Problems (IIP-D) measures self-rated difficulties with other people. Sixty-four items are subsumed under eight scales (eight items each related to the interpersonal circumplex): overly domineering, vindictive, cold, socially avoidant, nonassertive, exploitable, nurturant, and intrusive[20,33,34]. In order to reduce the number of variables, only the two major dimensions of the interpersonal circle were analysed[35]. "
    [Show abstract] [Hide abstract] ABSTRACT: Objectives: Little is known about patient characteristics as predictors for outcome in manualized short term psychodynamic psychotherapy (PDT). No study has addressed which patient variables predict outcome of PDT for social anxiety disorder. Research design and methods: In the largest multicenter trial on psychotherapy of social anxiety (SA) to date comparing cognitive therapy, PDT and wait list condition N = 230 patients were assigned to receive PDT, of which N = 166 completed treatment. Treatment outcome was assessed based on diverse parameters such as endstate functioning, remission, response, and drop-out. The relationship between patient characteristics (demographic variables, mental co-morbidity, personality, interpersonal problems) and outcome was analysed using logistic and linear regressions. Results: Pre-treatment SA predicted up to 39 percent of variance of outcome. Only few additional baseline characteristics predicted better treatment outcome (namely, lower comorbidity and interpersonal problems) with a limited proportion of incremental variance (5.5 to 10 percent), while, e.g., shame, self-esteem or harm avoidance did not. Conclusions: We argue that the central importance of pre-treatment symptom severity for predicting outcomes should advocate alternative treatment strategies (e.g. longer treatments, combination of psychotherapy and medication) in those who are most disturbed. Given the relatively small amount of variance explained by the other patient characteristics, process variables and patient-therapist interaction should additionally be taken into account in future research. Trial registration:
    Full-text · Article · Jan 2016 · PLoS ONE
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    • "For example, Slaney, Pincus, Uliaszek and Wang (2006) found high interpersonal profile elevation in individuals with maladaptive perfectionism. Salzer et al. (2008) found interpersonal rigidity in patients with generalized anxiety. Later, Couto, Vandenberghe, and Brito (2012) related hostility with interpersonal stress. "
    [Show abstract] [Hide abstract] ABSTRACT: Interpersonal interactions as social processes reflect and influence individuals' mental health. The aim of the study was to verify how marital interactions relate to mental health, and to investigate evidence for the validity of the Checklist for Interpersonal Transactions II (CLOIT-II). Participants were 169 couples from the southeast of the Brazilian state of Goiás, aged between 18 and 55 years (M = 21; SD = 5.48). They responded to a General Health Questionnaire (GHQ) and the CLOIT-II. Participants with low mental health problem scores in the GHQ (asymptomatic participants) tended to occupy interpersonal positions in the range between Deference/Trust and Affective warmth/Friendliness. In the group with high scores (symptomatic participants), interactions were defined by Coldness/Hostility. Mental health problems were positively correlated with mistrust, coldness and hostility and negatively correlated with positions of Affiliation. These results, in addition to supporting the validity of the CLOIT-II, indicate that the study of interpersonal relationships is relevant for the understanding of mental health.
    Full-text · Article · Dec 2015
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    • "Address correspondence to Sarah Simon, Department of Psychology, Long Island University–Brooklyn Campus, 1 University Plaza, Brooklyn, NY 11201; Email: Pincus, 2001), 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.
    Full-text · Article · Mar 2015 · Journal of Personality Assessment
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