Relation of therapeutic alliance and perfectionism to outcome in brief outpatient treatment of depression.

Abstract

New analyses examining the relations among perfectionism, perceived relationship quality, and the therapeutic alliance demonstrated that (a) the patient contribution to the alliance and the perceived quality of the therapeutic relationship were independent predictors of outcome, (b) perfectionistic patients showed smaller increases in the Patient Alliance factor over the course of treatment, and (c) the negative relation between perfectionism and outcome was explained (mediated) by perfectionistic patients' failure to develop stronger therapeutic alliances.

Perfectionism and depressive symptoms 3 years later: negative social interactions, avoidant coping, and perceived social support as mediators

“…Second, in considering daily stress, we focused on negative social interactions, a construct that is conceptually and empirica lly sim ilar to but distingu ishab le from hassles [26]. The negative effect of perfectionism on therapeutic outcome was mediated by perfectionists' inability to contribute to the therapeuti c alliance [27] and thei r d issatisfact ion with social relations [28].…”

Validity of DAS perfectionism and need for approval in relation to the five-factor model of personality

“…For example, because self-criticism/autonomy and dependency/sociotropy are related to different interpersonal styles, Blatt et al (1998;see also Zuroff et al, 2000) residualized or ''purified'' the DAS perfectionism and need for approval factors by removing their shared variance to facilitate the evaluation of the differential relationships of these variables to therapeutic gain. Although pure perfectionism and pure need for approval both correlated strongly (r ¼ 0:80) with their respective original subscales (Zuroff et al, 2000), it is important to examine the similarities and differences between the pure and original DAS factors in relation to the FFM. Purifying the factors might serve to enhance the negative interpersonal content of DAS perfectionism and the positive interpersonal content of DAS need for approval.…”

La psychothérapie interpersonnelle : bien au-delà de ses premières applications

“…D'autres données de l'étude du NIMH (TDCRP) ont démontré l'importance du perfectionnisme, un trait de personnalité, qui représente également un facteur de vulnérabilité à la dépression. Les patients plus perfectionnistes semblent avoir des difficultés à établir une bonne alliance thérapeutique au cours du traitement (Zuroff et al, 2000) ; le « perfectionnisme » semble affecter les capacités relationnelles, car il est associé à un réseau social plus limité, fait qui prédit un moins bon résultat thérapeutique (Shahar et al, 2003). Comme l'impact négatif du perfectionnisme s'est manifesté dans les quatre approches offertes dans cette étude (PTI, TCC, pharmacothérapie avec CM, placebo avec CM) la réponse au traitement semble davantage influencée par l'impact des caractéristiques des patients sur la qualité des relations interpersonnelles (dans le traitement et dans leur vie) que par des techniques thérapeu-tiques spécifiques.…”