ISSN 2043-8087
Journal of Experimental Psychopathology
 Volume 7, Issue 4, 671-683, 2016
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Within-person process-outcome relationships in residential cognitive and interpersonal psychotherapy for social anxiety disorder: A reanalysis using disaggregated data

Authors
  Asle Hoffart - Modum Bad Psychiatric Center and University of Osl
  Finn-Magnus Borge - Modum Bad Psychiatric Center
  David M. Clark - University of Oxford

Volume 7, Issue 4, 2016, Pages 671-683
DOI: http://dx.doi.org/10.5127/jep.056116

Abstract
Process-outcome research in psychotherapy has mainly focused between-person data (e.g., how differences in psychological process among patients are related to differences in outcome among the patients). However, this level of analysis is in danger of missing its target because psychotherapy models and therapists focus primarily on within-person relationships (e.g., whether change in a patient’s cognitive process during the course of therapy may lead to a reduction of symptoms in that client). The study of within-person processes requires collection of repeated data and a disaggregation of the between- and within-person components of time-varying process predictors. The purpose of this study was to examine whether the results of a previously published longitudinal process-outcome study of cognitive and interpersonal therapy for social anxiety disorder (SAD) (Hoffart, Borge, Sexton, & Clark, 2009) were maintained when the process predictors were disaggregated. Eighty social phobic patients were randomized to 10-week residential cognitive (RCT) or interpersonal psychotherapy (RIPT). In the present reanalysis, time-varying predictors were disaggregated by use of person-mean centering. For the cognitive process predictors (self-focus, estimated probability and estimated cost of negative social events, safety behaviors), the within-person relationships between predictors and subsequent social anxiety remained significant when disaggregating the predictors. On the other hand, the previously significant within-person relationship between the interpersonal variable of perceived acceptance by others and subsequent social anxiety disappeared with disaggregation. Disaggregated social anxiety also predicted fluctuations in self-focus, estimated probability and estimated cost of negative social events, but not safety behaviors.

Table of Contents
Introduction
Method
 Subjects
 Treatments
 Therapists and Therapist Training
 Diagnostic Interviews
 Integrity Ratings
 Process Measures
 Weekly Outcome Measure
 Procedure
 Statistical Analyses
Results
 Changes over the Course of Treatment
 Within-person Relationships
Discussion
Acknowledgements
References

Correspondence to
Professor Asle Hoffart, Research Institute, Modum Bad Psychiatric Center, Badeveien 287, N-3370 Vikersund, Norway.

Keywords
Cognitive therapy, interpersonal psychotherapy, social phobia, process-outcome, disaggregation of within- and between-person effects.

Dates
Received 17 Feb 2016; Revised 6 Jul 2016; Accepted 6 Jul 2016; In Press 25 Sep 2016









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