Assessing Anaclitic and Introjective Characteristics Using the SWAP‐200 Q‐Sort: Concurrent Validity with the Inventory of Interpersonal Problems Circumplex Scales

Miller, Racheli; Hilsenroth, Mark J.

doi:10.1002/cpp.2057

Cited by 4 publications

(4 citation statements)

References 43 publications

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“…Self-critical depressed individuals are more fearful avoidant; they function moderately well but still struggle to internalize their success and thereby reduce their harsh self-criticalness. Evidence for convergent and discriminant validity was supported, showing expected relationships with expert anaclitic and introjective prototypes and various functioning indices, including clinical, social, occupational, global, interpersonal functioning (Rost et al, 2018), and with interpersonal problems (Miller & Hilsenroth, 2017). In summary, needy depression and self-critical depression were associated with lower levels of psychopathology and fewer problems in terms of occupational, social, and relational functioning.…”

Section: Methodsmentioning

confidence: 94%

Personality and outcome in individuals with treatment-resistant depression—Exploring differential treatment effects in the Tavistock Adult Depression Study (TADS).

Rost¹,

Luyten²,

Fearon³

et al. 2019

Journal of Consulting and Clinical Psychology

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Objective: Although research over the past decades has investigated the impact of the personality dimensions of dependency and self-criticism on treatment outcome, little is known of how these personality features influence responsiveness to treatment in patients with severe, chronic forms of depression. Method: The present study uses data from the Tavistock Adult Depression Study (TADS), a randomized controlled trial investigating the effectiveness of long-term psychoanalytic psychotherapy (LTPP) compared with treatment as usual (TAU) for individuals diagnosed with treatment-resistant depression. Patients were rated with the Anaclitic Introjective Depression Assessment Q-sort, which distinguishes between two more maladaptive (Submissive and Dismissive) and two less maladaptive (Needy and Self-Critical) subdimensions of dependent or anaclitic and self-critical or introjective depression. Multilevel modeling was used to compare individuals' growth curves of depression severity as measured by the Hamilton Rating Scale for Depression over the 18months treatment period and two-year follow-up. Rates of clinically significant change were also determined. Results: As expected, depressed patients with more maladaptive dependent and self-critical features did not benefit from LTPP or TAU. Patients with less maladaptive self-critical features benefitted from both LTPP and TAU, while those with less maladaptive dependent features showed considerable gains from LTPP but not from TAU, with medium to large effect sizes. Conclusions: Findings of this study are consistent with existing research suggesting the need to modify and tailor treatments in accordance to individuals' pretreatment personality features. Given the time and cost-intensive nature of longer-term treatment, this may be particularly important in patients with treatment-resistant depression.

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Section: Methodsmentioning

confidence: 94%

Personality and outcome in individuals with treatment-resistant depression—Exploring differential treatment effects in the Tavistock Adult Depression Study (TADS).

Rost¹,

Luyten²,

Fearon³

et al. 2019

Journal of Consulting and Clinical Psychology

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“…Patients high on perfectionism may perceive their progress in both decreasing their perfectionistic beliefs and their symptoms, as less drastic, than an outside rater would. One new independent clinical rating system that has a scales consistent with perfectionism would be the Anaclitic and Introjective Depression Assessment (AIDA; Rost, Fon- agy, & Luyten, unpublished material), which has been recently supported in a series of construct validity analyses (Miller & Hilsenroth, 2016). An additional limitation is that the two measures of perfectionism used in these studies (The DAS and DEQ) were not developed to measure perfectionism, but rather dysfunctional attitudes.…”

Section: Limitationsmentioning

confidence: 99%

Perfectionism and therapeutic alliance: a review of the clinical research

Miller

Hilsenroth

Hewitt

2017

ResPsy

Self Cite

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In this review, we synthesize findings regarding the relationship between perfectionism and therapeutic alliance, most of which come from analyses by Blatt and colleagues. Results suggest what follows. First, patients’ initial level of perfectionism negatively affects patients’ bond with therapists and perception of therapists’ Rogerian attributes (empathy, congruence, and regard) early in treatment and engagement in therapy later in treatment. Second, therapists’ contribution to alliance is not seemingly affected by patients’ initial perfectionism level. Third, individual patients of therapists who are perceived on average by their patients to be higher on Rogerian attributes experience greater decreases in perfectionism and symptoms. Fourth, more positive perceptions of therapists’ Rogerian attributes early in treatment lead to greater symptom decrease for patients with moderate perfectionism. Fifth, greater early patient engagement in therapy is related to greater decrease in perfectionism, but a strong relationship with the therapist may be necessary for an accompanied greater decrease in symptoms. The relationship between pre-treatment perfectionism and alliance is partially explained by higher levels of hostility and lower levels of positive affect. Sixth, the relationship between pre-treatment perfectionism and outcome is almost entirely explained by level of patient contribution to alliance and satisfaction with social network, highlighting the importance of focusing on social functioning for patients with high perfectionism (both in and outside of the session). Limitations include that most of the findings are from analyses of one large data set and a range of measurement issues. Future research should utilize different measures, perspectives, and populations and examine specific session process.

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“…Aside from the original AIDA study (Rost et al, 2018), two studies have been conducted thus far using the AIDA. Miller and Hilsenroth (2017) assessed the concurrent validity of the AIDA with the Interpersonal Problems Circumplex scales (IIP-64). Findings from this study suggest that Dismissive features are related to difficulties involving high dominance and low affiliation in relationship, while Self-Critical features are not associated with any interpersonal problems.…”

Section: Measuring Anaclitic and Introjective Personality Featuresmentioning

confidence: 99%

Changes in anaclitic and introjective personality features in psychoanalysis: A clinician-report study.

Porcerelli

Jowers

Cogan

2021

Psychoanalytic Psychology

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This study aimed to assess changes in anaclitic and introjective personality features for individuals with depression and anxiety in a naturalistic study of psychoanalysis. Participants included 48 patients in psychoanalysis who were being treated by analysts from the American Psychoanalytic Association. Analysts completed the Shedler-Westen Assessment for each patient at the beginning and end of analysis. The SWAP-200 Anaclitic-Introjective Depression Assessment (AIDA) was used to determine anaclitic and introjective subtypes. Change in anaclitic and introjective features after 12 months or more of psychoanalysis was assessed using multivariate analysis of variance (MANOVA). Levels of introjective Self-Critical ratings significantly decreased at termination of psychoanalysis, while Global Assessment of Functioning (GAF) ratings significantly increased. Introjective Dismissive and Anaclitic Submissive displayed a trend toward significance, with Dismissive scores increasing. Anaclitic Needy did not show a statistically significant change from beginning to end of psychoanalysis. Findings are placed within the context of the extant literature, and implications for psychoanalysis are discussed.

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Assessing Anaclitic and Introjective Characteristics Using the SWAP‐200 Q‐Sort: Concurrent Validity with the Inventory of Interpersonal Problems Circumplex Scales

Cited by 4 publications

References 43 publications

Personality and outcome in individuals with treatment-resistant depression—Exploring differential treatment effects in the Tavistock Adult Depression Study (TADS).

Personality and outcome in individuals with treatment-resistant depression—Exploring differential treatment effects in the Tavistock Adult Depression Study (TADS).

Perfectionism and therapeutic alliance: a review of the clinical research

Changes in anaclitic and introjective personality features in psychoanalysis: A clinician-report study.

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