title: Predictive value of object relations for therapeutic alliance and outcome in psychotherapy for depression: an exploratory study.
abstract: The concept of object relations has been shown to be relevant for the process and outcome of psychodynamic psychotherapies. However, little is known about its relevance for the psychotherapeutic treatment of depression. In this study, we explored the predictive value of object relational functioning (ORF) for the therapeutic alliance and outcome of short-term psychodynamic supportive psychotherapy in patients with mild to moderately severe depression. The ORF of 81 patients was rated by using the Developmental Profile. The overall maturity of ORF measured at baseline was higher in patients who showed a better treatment response. In multiple regression analysis, the adaptive level of individuation appeared to be specifically predictive of outcome. Patients with a recurrent depression showed less mature levels of ORF, lower adaptive levels and a higher score on the symbiotic level. No association was found between ORF and therapeutic alliance during treatment. In contrast to the single measure of alliance early in therapy, the growth of the alliance was related to outcome. The study indicated the relevance of ORF for depression and established that it is distinctive from the actual therapeutic alliance.
authors.affiliation: Depression Research Group of Mentrum Mental Health Care Amsterdam, The Netherlands. rien.van@mentrum.nl
authors.forename: Henricus L
authors.initials: HL
authors.lastname: Van
authors.forename: Mariëlle
authors.initials: M
authors.lastname: Hendriksen
authors.forename: Robert A
authors.initials: RA
authors.lastname: Schoevers
authors.forename: Jaap
authors.initials: J
authors.lastname: Peen
authors.forename: Robert A
authors.initials: RA
authors.lastname: Abraham
authors.forename: Jack
authors.initials: J
authors.lastname: Dekker
mesh_terms: D000328:Adult; D000368:Aged; D000928:Antidepressive Agents / Q000627:therapeutic use*; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009769:Object Attachment; D017060:Patient Satisfaction; D010553:Personality Development; D010555:Personality Inventory / Q000706:statistics & numerical data; D010817:Physician-Patient Relations; D011237:Predictive Value of Tests; D011575:Psychoanalytic Therapy; D011594:Psychometrics / Q000706:statistics & numerical data; D011614:Psychotherapy, Brief; D012008:Recurrence; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
chemical_list: D000928:Antidepressive Agents