Louise Gaston

Alliance Prediction of Outcome Beyond in-Treatment Symptomatic Change as Psychotherapy Processes

For older depressed adults treated in behavioral, cognitive, or brief dynamic therapy, we examined alliance-outcome associations over and above initial symptomatology and in-treatment symptomatic c...

Alliance and Technique for Predicting Outcome in Short-and Long-Term Analytic Psychotherapy

A previous clinical trial provided the opportunity to examine the roles and interaction of alliance and technique in both short- and long-term analytic psychotherapy. Two separate teams of trained clinical judges rates either alliance on the CALPAS or therapist interventions on the ITS. Outcome included symptomatology and interpersonal problems. In short-term therapy, working and therapeutic alliance ratings contributed significantly to the reduction of symptomatology only. In long-term therapy, working alliance ratings contributed significantly to the reduction of interpersonal problems, and the interaction of working alliance ratings with supportive or exploratory intervention rating were found to account for significant amounts of the variance of both symptomatology and interpersonal problems at termination. These findings should be considered with caution, given the restricted sample sizes.

Client satisfaction and social desirability in psychotherapy

In this study, the authors examined whether reports of client satisfaction in psychotherapy are biased by client tendency to provide socially desirable answers. This question was explored in the context of dynamic, eclectic, and cognitive/behavioral modalities of psychotherapy, which were provided in private practice settings. The Client Satisfaction Questionnaire-8 (CSQ-8) was employed to assess satisfaction, and the Marlowe-Crowne Social Desirability Scale (MCSD) was used to measure social desirability. The relation of CSQ-8 scores was also examined with respect to sociodemographic variables, symptomatology, and treatment characteristics. A very weak correlation between CSQ-8 and MCSD scores was obtained (r(146) = −.05, p > .05), which was not found to be significant. This association also was not found to be moderated by clients and therapists gender, therapy modality, or treatment length. These results could be only partially explained by the restricted variance associated with CSQ-8 scores. It thus appears that client satisfaction represents a legitimate outcome dimension of psychotherapy.

Consistency of retrospective reports of peritraumatic responses and their relation to PTSD diagnostic status

Few studies have examined whether trauma-exposed individuals are consistent in their retrospective reports of how they reacted at the time of trauma exposure, and whether this phenomenon has any implications at the diagnostic level. In a series of three longitudinal studies (N = 113) with different timeframes, the authors prospectively investigated the consistency of peritraumatic response scores as a function of posttraumatic stress disorder (PTSD) diagnostic status. Across the three studies, consistency of scores was better among individuals who either did not develop PTSD or who remitted from it than among those whose PTSD did not remit. These results are consistent with the literature suggesting that compromised memory processes are related to sustained PTSD.

MMPI profiles of acute and chronic PTSD in a civilian sample

In a treatment setting, a group of 165 subjects presenting with either acute or chronic posttraumatic stress disorder (PTSD) were compared to 72 subjects presenting with panic disorder only in order to determine whether the MMPI PTSD assessment strategy developed with Vietnam veterans could be validly used with civilians. Results indicated that the MMPI profile, codetype, diagnostic decision rule, and PK scale developed with samples of Vietnam veterans did not apply well to civilians, especially those presenting with acute PTSD. It is thus recommended that specific assessment strategies be developed for these populations.

MMPI Scales for Diagnosing Acute and Chronic PTSD in Civilians

To develop new Minnesota Multiphasic Personality Inventory (MMPI) scales for diagnosing acute and chronic posttraumatic stress disorder (PTSD), 237 civilians with PTSD or panic disorder (controls) completed the MMPI-R. All 399 items were submitted to chi-square analysis to select those differentiating acute or chronic PTSD from controls. The analyses yielded an MMPI Acute PTSD scale (32 items) and a MMPI Chronic PTSD scale (41 items). Discriminating between acute PTSD and controls, the MMPI Acute PTSD scale had a hit rate of 83% and the MMPI Chronic PTSD scale produced a hit rate of 75% to 80%. Cross-validation produced similar hit rates. These scales scores were not substantially influenced by gender or types of traumatic events, and only the MMPI Acute PTSD scale seemed to not be sensitive to co-morbidity.