Ferkauf Graduate School of Psychology, Yeshiva University, New York City, New York, USA.
Department of Counseling Psychology, Santa Clara University, Santa Clara, California, USA.
Clin Psychol Psychother. 2023 Jan;30(1):141-151. doi: 10.1002/cpp.2784. Epub 2022 Sep 17.
Interpersonal guilt often encompasses pathogenic beliefs that imply omnipotent responsibility for others and concerns about abandoning, humiliating or threatening others. This study sought to examine how interpersonal guilt may influence patients' and therapists' ratings of early working alliance and the potential moderating effect of perceived adverse parenting in childhood. Ninety-five patients and their 19 therapists in an outpatient psychotherapy clinic rated their early working alliance after the first and the fifth session in treatment. We conducted separate moderation analyses for patient and therapist-reported working alliance and controlled for psychological distress at baseline. Results suggest that perceived adverse parenting in childhood significantly moderated the effect of interpersonal guilt on the working alliance in such a way that for patients reporting very low levels of perceived adverse experiences, the interpersonal guilt beliefs had a positive effect on working alliance, whereas for those with very high levels of perceived adverse experiences, interpersonal guilt had a negative effect on working alliance. This same pattern of moderation was found for patient- and therapist-reported working alliance at session 1 and therapist-reported working alliance at session 5. Thus, although the effect of interpersonal guilt on the working alliance depends somewhat on the perspective of the working alliance rating (patient or therapist), it mainly depends on developmental experiences of the patient.
人际内疚通常包含致病性信念，暗示对他人具有全能的责任，以及对抛弃、羞辱或威胁他人的担忧。本研究旨在探讨人际内疚如何影响患者和治疗师对早期工作联盟的评估，以及童年期感知到的不良养育对其的潜在调节作用。在一个门诊心理治疗诊所中，95 名患者及其 19 名治疗师在治疗的第一和第五次治疗后对他们的早期工作联盟进行了评估。我们对患者和治疗师报告的工作联盟分别进行了调节分析，并在基线时控制了心理困扰。结果表明，童年期感知到的不良养育对工作联盟的影响存在显著的调节作用，以至于对于报告极低水平的感知到的不良经历的患者来说，人际内疚信念对工作联盟有积极影响，而对于那些报告极高水平的感知到的不良经历的患者来说，人际内疚对工作联盟有消极影响。这种调节模式在第 1 次治疗时的患者和治疗师报告的工作联盟以及第 5 次治疗时的治疗师报告的工作联盟中都存在。因此，尽管人际内疚对工作联盟的影响在某种程度上取决于工作联盟评估的视角（患者或治疗师），但它主要取决于患者的发展经历。
