Search PubMed⌕ Search

Biomedical subjects

M Barkham

Publications and source records attributed to M Barkham.

32 records · Page 2Linked to original sources
PubMed1996

The IIP-32: a short version of the Inventory of Interpersonal Problems.

Three related studies are presented focusing on the development of a short 32-item version of the Inventory of Interpersonal Problems (IIP). Study 1 presents the procedures for item selection on the IIP short version; Study 2 presents a confirmatory analysis of the IIP short version on an independent sample; and Study 3 provides preliminary normative (general population and out-patient) data and additional evidence of the psychometric properties of the IIP short form. The results suggest that the short version sacrifices little compared to the original 127-item version in terms of its psychometric properties while being considerably more convenient for routine clinical practice.

Adolescent↗
PubMed1995

Effects of treatment duration and severity of depression on the maintenance of gains after cognitive-behavioral and psychodynamic-interpersonal psychotherapy.

One hundred four clients completed a mailed follow-up 1 year after completing 8 of 16 sessions of treatment, either cognitive-behavioral (CB) or psychodynamic-interpersonal (PI) psychotherapy. Although mean scores on outcome measures at 1 year suggested that gains were, in general, well maintained, only 29% of clients were asymptomatic on all 3 occasions of testing (end of treatment, 3 months and 1 year later) without recourse to further treatment. However, only 11% of those asymptomatic at end of treatment experienced relapse or recurrence of depression, albeit on the limited evidence of just two follow-up assessments. The results of comparisons among treatment conditions at 1 year differed substantially from those obtained earlier: Eight-session PI treatment now appeared less efficacious than the other 3 treatment conditions, and there was now no measurable benefit of 16-session over 8-session CB, irrespective of initial severity of depression. These findings confirm the importance of follow-up in evaluation of psychotherapies for depression.

Adult↗
PubMed1995

Impact of Cluster C personality disorders on outcomes of contrasting brief psychotherapies for depression.

Twenty-seven of 114 depressed clients, stratified for severity of depression, obtained a Diagnostic and Statistical Manual of Mental Disorders (3rd ed.; DSM-III; American Psychiatric Association, 1980) diagnosis of Cluster C personality disorder--that is, avoidant, obsessive-compulsive or dependent personality disorder (PD clients)--whereas the remaining 87 did not (non-personality-disorder [NPD] clients). All clients completed either 8 or 16 sessions of cognitive-behavioral (CB) or psychodynamic-interpersonal (PI) psychotherapy. On most measures, PD clients began with more severe symptomatology than NPD clients. Among those who received PI therapy, PD clients maintained this difference posttreatment and at 1-year follow-up. Among those who received CB therapy, posttreatment differences between PD and NPD groups were not significant. Treatment length did not influence outcome for PD clients. PD clients whose depression was also relatively severe showed significantly less improvement after treatment than either PD clients with less severe depression or NPD clients.

Adult↗
PubMed1995

Credibility and outcome of cognitive-behavioural and psychodynamic-interpersonal psychotherapy.

Depressed psychotherapy clients (N = 117) rated the treatment principle credibility of cognitive-behavioural (CB) and psychodynamic-interpersonal (PI) before they were randomly assigned to receive either eight or 16 sessions of one of these treatments, and they rated their expectations of the treatment to which they were assigned immediately before (initial credibility) and immediately after their first session (emergent credibility). Results indicated that before they were assigned to a treatment, clients rated CB treatment principle credibility higher than PI treatment principle credibility. After assignment, however, clients rated initial credibility similar regardless of whether they were assigned to CB or PI therapy, and their ratings of emergent credibility increased to a similar degree from immediately before to immediately after the first session in both treatments. Clients' endorsement of CB and PI treatment principle credibility predicted improvement in PI therapy but not improvement in CB therapy. Initial and emergent credibility of clients' assigned treatment predicted improvement for clients who received eight sessions of therapy, but not for clients who received 16 sessions of therapy. The implications of these findings are discussed.

Adult↗
PubMed1994

Effects of treatment duration and severity of depression on the effectiveness of cognitive-behavioral and psychodynamic-interpersonal psychotherapy.

A total of 117 depressed clients, stratified for severity, completed 8 or 16 sessions of manualized treatment, either cognitive-behavioral psychotherapy (CB) or psychodynamic-interpersonal psychotherapy (PI). Each of 5 clinician-investigators treated clients in all 4 treatment conditions. On most measures, CB and PI were equally effective, irrespective of the severity of depression or the duration of treatment. However, there was evidence of some advantage to CB on the Beck Depression Inventory (Beck, Ward, Mendelson, Mock, & Erbaugh, 1961). There was no evidence that CB's effects were more rapid than those of PI, nor did the effects of each treatment method vary according to the severity of depression. There was no overall advantage to 16-session treatment over 8-session treatment. However, those presenting with relatively severe depression improved substantially more after 16 than after 8 sessions.

Adult↗
PubMed1994

Resolving a challenge to the therapeutic relationship: a single-case study.

The selection of a case of demonstrated change using a quantitative criterion preceded an exploration of possible change mechanisms in therapy. Between-session variations in the therapeutic relationship revealed by a quantitative measure prompted an intensive qualitative investigation of in-session events. Within these events, the study focused on challenges to the therapeutic relationship and their subsequent resolution. Understanding the resolution of such challenges to the relationship was guided by a rational model derived from the treatment rationale. A tentative account of the process of change is offered, and case replications are required to confirm and extend the findings.

Anxiety Disorders↗
PubMed1994

The structure, validity and clinical relevance of the Inventory of Interpersonal Problems.

This paper presents preliminary data on the psychometric and clinical properties of the Inventory of Interpersonal Problems (IIP: Horowitz, Rosenberg, Baer, Ureno & Villasenor, 1988) obtained from a UK sample of clients presenting with depression/anxiety for individual psychotherapy as part of two concurrent outcome studies: the Second Sheffield Psychotherapy Project (SPP2) and the Medical Research Council/NHS Collaborative Psychotherapy Project (CPP). The factor structure of the IIP is reported on a sample of 250 clients and eight factor-analytically derived scales are presented. Data on the reliability of the IIP together with its relationship to the Symptom Checklist-90R (SCL-90R: Derogatis, 1983) are investigated in a subsample of 143 clients. In addition, data are presented on the clinical relevance of the IIP using case material. The structure of the IIP was further analysed using ipsatized scores. Four bipolar factors were extracted and these findings are discussed with reference to four primary sets of social competencies.

Adult↗
PubMed1993

Lack of synchronized seasonal variation in the intensity of psychological problems.

Temporal variation in the subjective intensity of psychological problems identified by 40 psychotherapy clients (most diagnosed as depressed) was investigated longitudinally. Each client rated the intensity of 10 individualized problems 3 times per week (on Tuesdays, Thursdays, and Sundays) for an average of 6 months. Ratings from all clients were spread over 3 years. When scores were statistically adjusted for client differences and average rate of improvement, no significant variation among months was found, regardless of problem content or client gender. Standard assessment measures administered 4 times to each client also failed to show systematic seasonal variation.

Adult↗
PubMed1993

The shape of change in psychotherapy: longitudinal assessment of personal problems.

We propose 4 parameters that describe the course of change in the subjective intensity of personal problems during psychotherapy: (a) the problem's initial severity; (b) its rate of change (deterioration or improvement); (c) its instability (day-to-day variability in intensity); and (d) its curve (change in the rate of change during treatment). We constructed indexes of these parameters for 10 individualized personal problems rated 3 times per week by each of 40 clients (most were diagnosed as depressed) over the course of their 16-session treatment and associated assessment periods. Initial severity predicted problems' reported salience to clients. The rate of change parameter was correlated (across clients) with traditional pretreatment to posttreatment outcome measures. Instability was high, and problems dealing with tension symptoms and mood were more unstable than were problems dealing with relationships or self-esteem. Cutting across problem content were large individual differences among clients in the patterns of change.

Adult↗
PubMed1993

The California Psychotherapy Alliance Scales: a pilot study of dimensions and elements.

The reliability and clinical utility of the rater form of the California Psychotherapy Alliance Scales (CALPAS-R) was investigated on a sample of 12 one-hour audiotapes representing differing therapeutic dyads and sampled from sessions two to six of a relationship-oriented (exploratory) therapy within pilot cases of a large outcome study. Both global dimensions and element-based ratings were used to test the feasibility of employing the elements as a way of obtaining a finer-grained analysis of the therapeutic alliance. Results are reported in terms of the interrater reliability of the dimensions and elements, and show element ratings to yield dimensional measures similar or superior to global ratings in reliability. In addition, CALPAS-R ratings were analysed in conjunction with client ratings of session depth and smoothness as well as helpfulness.

Adult↗
PubMed1992

Components of major depression examined via the Beck Depression Inventory.

Although more than 20 factor analytic studies have been published on the Beck Depression Inventory (BDI), only Steer and co-workers (1987) have used a sample composed exclusively of patients diagnosed with depression. The component structure found in their study of depressed patients differs in important respects from the structure summarised in several reviews. The main aim of the present study was to investigate whether this structure could be confirmed with the BDI responses of an independent sample of 139 patients diagnosed with DSM-III Major Depressive Episode. Three principal components were extracted and rotated to maximum congruence with a target based on the results of Steer et al. (1987). The significance of the fit to this target was then evaluated by rotating the same matrix of loadings to 5000 random permutations of the target. The fit was found to be highly significant, though some possible improvements could be identified ad hoc. An alternative factor structure for the BDI, derived from covariance structure analysis by Tanaka and Huba (1984), was also tested but could not be confirmed.

Adolescent↗
PubMed1990

The Second Sheffield Psychotherapy Project: rationale, design and preliminary outcome data.

The cost-efficiency of psychotherapy research can be enhanced by (a) dissemination of the rationale and design of large-scale investigations whilst still under way, (b) incorporation of process measures within comparative outcome studies, (c) cumulative development of a series of related studies, and (d) sharing of recordings and other data with other investigators. We present the rationale and design, including full details of process and outcome measures, of the second Sheffield psychotherapy project, in which 120 white-collar, professional and managerial employees presenting with major depressive disorder receive either eight or 16 sessions of either prescriptive (cognitive/behavioural) or exploratory (relationship-oriented) therapy in a 2 x 2 design. Ethical considerations prompted the analysis of preliminary outcome data on 48 clients. Results suggested substantial clinical improvement, of similar magnitude for both methods and both durations of treatment, except that exploratory therapy appeared more effective than prescriptive in relation to interpersonal difficulties. Other workers are invited to build collaboratively on this research by making their own process analyses of recordings available from this study, relating these analyses to the existing impact and outcome data, and developing comparable data sets based on the design and initial results of this project.

Depressive Disorder↗
PubMed1984

The reliability of a modified helper behaviour rating system.

Response mode analysis seeks to classify the utterances of psychotherapists and others offering personal help, with respect to the interpersonal function of the utterance. It is applicable in diverse settings, and irrespective of the theoretical orientation of the helper or the researcher. The present study presents reliability data on a new such system of analysis, incorporating a novel mode, termed exploration. Intermediate between interpretation and reflection, this mode taps the theoretically important effort by the helper to construct a frame of reference shared with the client. Results indicated that the additional precision gained by the introduction of this new mode was not accompanied by any loss in reliability as compared with previous research. Overall, the system achieved acceptable reliability although the data cautioned against overinterpretation of the codings of individual response units.

Counseling↗