Derner School of Psychology, Adelphi University, Garden City, New York, United States.
Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Clin Psychol Psychother. 2023 Nov-Dec;30(6):1512-1519. doi: 10.1002/cpp.2891. Epub 2023 Aug 6.
We examined discrepancies in 81 patient-therapist dyads' alliance ratings early in treatment (3rd or 4th session) in relation to Personality Assessment Inventory clinical scales, subscales and global psychopathology. Results indicated that PAI global psychopathology (mean clinical elevation) and the scales of Aggression [AGG], Somatization [SOM], and Anxiety-Related Disorders [ARD] were significantly, negatively associated with an absolute difference of patient and therapist alliance ratings at Session 3. Higher initial scores on these clinical scales at treatment onset are associated with less difference (i.e., more convergence) in patient/ therapist ratings of alliance at Session 3. Correlations between PAI clinical subscales and absolute differences of patient and therapist alliance ratings at Session 3 also demonstrated statistically significant inverse relationships for several PAI subscales of Aggression- Attitude [AGG-A], Aggression-Physical [AGG-P], Somatic- Health Concerns [SOM-H], Anxiety-Related Disorders-Traumatic Stress [ARD-T], Anxiety-Related Disorders- Obsessive Compulsive [ARD-O], Borderline Features-Affective Instability [BOR-A], Borderline- Self-Harm [BOR-S], Anxiety-Physiological [ANX-P], Depression-Physiological [DEP-P] and Antisocial-Stimulus Seeking [ANT-S]. Again, higher scores on these subscales at treatment onset are associated with less difference (i.e., more convergence) in patient/therapist ratings. We also examined group differences between patients rating alliance higher (Group 1) and therapists rating alliance higher (Group 2) and found that Group 1 had significantly lower scores on Mania-Activity Level [MAN-A]. Clinical implications of results are discussed.
我们研究了 81 对患者-治疗师的联盟评级在治疗早期（第 3 或第 4 次治疗）的差异，与人格评估量表的临床量表、亚量表和总体心理病理学有关。结果表明，PAI 总体心理病理学（平均临床升高）和攻击[AGG]、躯体化[SOM]和焦虑相关障碍[ARD]的量表与第 3 次治疗时患者和治疗师联盟评分的绝对差异显著负相关。在治疗开始时，这些临床量表的初始得分较高与患者/治疗师在第 3 次治疗时对联盟的评分差异（即，更多趋同）较小有关。PAI 临床亚量表与第 3 次治疗时患者和治疗师联盟评分绝对差异的相关性也表明，几个 PAI 亚量表的攻击性态度[AGG-A]、攻击性-身体[AGG-P]、躯体健康问题[SOM-H]、焦虑相关障碍创伤后应激[ARD-T]、焦虑相关障碍-强迫性[ARD-O]、边缘特征-情绪不稳定[BOR-A]、边缘-自我伤害[BOR-S]、焦虑-生理[ANX-P]、抑郁-生理[DEP-P]和反社会-寻求刺激[ANT-S]之间存在统计学上显著的反向关系。同样，在治疗开始时，这些亚量表的得分较高与患者/治疗师的评分差异较小（即，更多趋同）有关。我们还检查了对联盟评价较高的患者（第 1 组）和治疗师（第 2 组）之间的组间差异，发现第 1 组的躁狂-活动水平[MAN-A]得分显著较低。讨论了结果的临床意义。
