Validation of the Interpersonal Relationships in Eating Disorders (IR-ED) Scale in an Eating Disorder Sample.

OBJECTIVE: Interpersonal problems have been identified as a plausible mechanism underlying the onset and maintenance of eating disorders. The Interpersonal Relationships in Eating Disorders (IR-ED) scale is the first eating disorders-specific measure of interpersonal problems, which was developed in a nonclinical sample. The aims of the current study were to (a) confirm the factor structure of the IR-ED within a large clinical sample, (b) investigate measurement invariance of the IR-ED across nonclinical and clinical samples, (c) examine the convergent validity of the IR-ED using a generic measure of interpersonal problems, and (d) investigate the incremental clinical utility of the IR-ED in uniquely predicting eating disorder symptomatology. METHOD: Treatment-seeking individuals (N = 437) completed the IR-ED at their initial assessment appointment at a specialist eating disorder outpatient service. RESULTS: A multiple-group confirmatory factor analysis supported an invariant bifactor structure comprising a general interpersonal problems factor and two group factors-Avoidance of Body Evaluation and Food-Related Interpersonal Tension. Convergent validity was demonstrated by a large, statistically significant correlation with a generic measure of interpersonal problems (r = 0.62, p < 0.001). A series of structural equation models further revealed unique incremental predictive utility of the IR-ED for eating disorder symptomatology. DISCUSSION: The IR-ED has strong psychometric properties and may prove beneficial in the assessment, formulation, and treatment of eating-specific interpersonal problems among patients with eating disorders.

A Longitudinal Network Analysis of Emotion Regulation, Interpersonal Problems, and Eating Disorder Psychopathology in Chinese Adolescents.

OBJECTIVE: The present longitudinal study examined sex-specific, symptom-level relationships among emotion regulation (ER), interpersonal problems (IP), and eating disorder (ED) psychopathology in a large sample of Chinese adolescents. METHOD: Data were from a project with four waves of data collection (N = 1540; 710 boys and 830 girls) at 6-month intervals over 18 months. Questionnaires assessed ED psychopathology, ER, and IP at each wave of data collection. Longitudinal network analyses were conducted separately for boys and girls. Sex differences in the network structures were also examined. RESULTS: The results revealed pronounced heterogeneity in the presentation of ED psychopathology, ER, and IP across Chinese adolescent boys and girls longitudinally and intra-individually. For example, weight/shape preoccupation in ED psychopathology and awareness in ER emerged as important nodes in the temporal network for boys. However, weight/shape preoccupation and dissatisfaction in ED psychopathology were identified as the most important nodes in the temporal network for girls. Regarding bridge strength, awareness in ER emerged as the node with the highest connectivity in the temporal network for boys. At the same time, weight/shape dissatisfaction in ED psychopathology was the node with the highest connectivity for girls. DISCUSSION: The current study extended network theory to better understand the longitudinal interplay among ER, IP, and ED psychopathology in Chinese adolescents and their sex differences in the importance of symptoms. Such insights may pave the way for developing targeted prevention and treatment strategies for adolescent boys and girls in China.

Hostile attributional biases in severe alcohol use disorder: replication, gender specificity, and mechanistic insights.

AIMS: Despite their importance in the emergence and persistence of severe alcohol use disorder (SAUD), social cognition impairments remain understudied in this population. Hostile attributional biases (HAB), a key component of social cognition, may be involved in interpersonal problems and SAUD maintenance. However, current evidence for HAB in SAUD is highly preliminary, as it relies on a single study based on a small sample and on a task that cannot dissociate increased hostile from reduced benign attributions. We therefore used an improved methodology to further characterize this bias and disentangle underlying mechanisms. In addition, we explored potential gender differences. METHOD: A total of 56 patients (28 women) diagnosed with SAUD and 66 (27 women) demographically matched controls completed the Word-Sentence Association Paradigm-Hostility, which provides a valid, spontaneous, and relatively implicit assessment of both hostile and benign social attributions related to ambiguous situations. They also completed self-report measures of psychopathology and interpersonal problems. RESULTS: At the group-level, patients with SAUD presented higher HAB than controls, without group differences for benign attributions. Gender analyses revealed that this effect selectively emerged in men with SAUD. Further, patients' benign attributions did not differ from their hostile attributions. Finally, HAB (not benign attributions) were associated with interpersonal problems and state anxiety in patients. CONCLUSIONS: The association between SAUD and HAB at the group level is genuine and replicable across samples and tasks. This association may further selectively emerge in men. Our results also confirm the functional significance of HAB in SAUD, and point to potential mechanisms and clinical recommendations.

Is meta-worry relevant to interpersonal problems? Testing the metacognitive model of generalized anxiety disorder in an analogue- and a clinical sample of GAD.

Interpersonal problems are common in individuals with generalized anxiety disorder (GAD) and improved interpersonal functioning is an important goal in treatment. In the metacognitive model of worry and generalized anxiety disorder, emotional distress and psychological dysfunction are related to two distinct types of worry. Particular emphasis is put on meta-worry which refers to "worry about worrying" or appraisal of worrying as threatening in itself. Meta-worry impairs effective mental regulation and might therefore be an important predisposition to self-regulate via others and thereof interpersonal problems. In the current study, we tested the prediction that meta-worry is uniquely associated with interpersonal problems in two samples. The first consisted of 135 individuals with analogue GAD and the second of 56 individuals with a diagnosis of GAD. Using hierarchical linear regressions controlling for anxiety, depression and worry, meta-worry showed a unique relationship with interpersonal problems in both samples. These findings indicate that meta-worry may be relevant to formulate and treat interpersonal problems in individuals with GAD.

Self-Perceived Interpersonal Problems Among Long-Term Unemployed Individuals, and Vocational Rehabilitation Programs (In)ability to Change Them.

OBJECTIVE: Self-perceived interpersonal problems can challenge one's access to the work market, making it harder to attain and keep a job while adding to the distress of being outside of the labor market. METHODS: In this study, we compared the self-perceived interpersonal problems among long-term unemployed individuals taking part in vocational rehabilitation programs (VRPs) (N = 220) with those of the general population. In addition, we examined whether their self-perceived interpersonal problems changed while taking part in the VRPs. RESULTS: We found that participants report significantly higher levels of self-perceived interpersonal problems as measured by the Inventory of Interpersonal Problems (IIP), especially with regard to feeling cold/distanced, socially inhibited, vindictive/self-centered, and non-assertive. The participants did not report a significant decrease in self-perceived interpersonal problems after being part of VRPs for one year. CONCLUSION: These results are relevant as they may inform interventions targeted this population aimed at increasing employability and/or individual well-being. Importantly, the findings may be viewed as a reflection of both social and individual processes. Long-term unemployed individuals' tendency to feel insufficiently engaged may reflect difficulty with keeping up with a job market in constant change.

Do Patient's Interpersonal Problems Improve Following Metacognitive Therapy? A Systematic Review and Meta-Analysis.

Metacognitive therapy (MCT) aims to modify dysfunctional metacognitions that are thought to be universal determinants of emotional distress and psychological dysfunction more generally. MCT is an effective treatment for emotional distress symptoms, but less is known about its effect for other types of psychological problems. Interpersonal problems are common in psychological disorders and should be improved following psychotherapy. Therefore, we conducted a systematic review and meta-analysis of trials on the effects associated with MCT for interpersonal problems among adults with mental health disorders published until 15 November 2023 using PubMed, Cochrane Library and PsycNet. Trials with a minimum of 10 participants were included. A total of six studies based on five trials reported on the effectiveness of MCT for interpersonal problems and met our inclusion criteria. Two trials evaluated MCT for patients with major depressive disorders, two for patients with anxiety disorders and one for borderline personality disorder. Three of the trials were randomized controlled trials. Four of the trials reported follow-up data but varied in their time-points. The within-group effect size estimate from pretreatment to posttreatment across five trials was large (g = 0.865, 95% CI [0.512-1.218]). Our results indicate that MCT is an effective treatment for improving interpersonal problems in individuals with common mental disorders, even though the treatment is short and primarily concern improving mental regulation through modifying metacognitions. While this finding is in line with metacognitive theory, more trials evaluating personality and interpersonal functioning are needed to draw firm conclusions.

Mediation role of interpersonal problems between insecure attachment and eating disorder psychopathology.

PURPOSE: Although insecure attachment and interpersonal problems have been acknowledged as risk and maintaining factors of eating disorders (EDs), the mediating role of interpersonal problems between attachment style and ED psychopathology has been poorly explored. The purpose of this study was to investigate the mediating role of interpersonal problems between insecure attachment and ED psychopathology. METHODS: One-hundred-nine women with anorexia nervosa and 157 women with bulimia nervosa filled in the Eating Disorder Inventory-2 (EDI-2) and the Experiences in Close Relationships (ECR) revised scale to assess ED core symptoms and attachment styles, respectively. Interpersonal difficulties were evaluated by the Inventory of Interpersonal Problems (IIP-32). A mediator's path model was conducted with anxious and avoidant attachment subscores as independent variables, ED core symptoms as dependent variables and interpersonal difficulties as mediators. The diagnosis was entered in the model as a confounding factor. RESULTS: The socially inhibited/avoidant interpersonal dimension was a mediator between avoidant attachment and the drive to thinness as well as between avoidant attachment and body dissatisfaction. An indirect connection was found between attachment-related anxiety and bulimic symptoms through the mediation of intrusive/needy score. CONCLUSIONS: Social avoidance and intrusiveness mediate the relationships between avoidant and anxious attachment styles and ED psychopathology. These interpersonal problems may represent specific targets for psychotherapeutic treatments in individuals with EDs and insecure attachment. LEVEL OF EVIDENCE: Level III: Evidence obtained from well-designed cohort or case-control analytic studies.

A Model of Trust Processes in Borderline Personality Disorder: A Systematic Review.

PURPOSE OF REVIEW: Unstable relationships are a core feature of borderline personality disorder (BPD). Impairments in trust processes (i.e., appraisal and learning regarding others' trustworthiness) can subserve interpersonal problems associated with BPD, but the determinants, mechanisms, consequences, and variations in trust impairments among individuals with BPD remain poorly characterized. Thus, a better understanding of such impairments could help target interventions that address the interpersonal problems of individuals with BPD beyond emotion dysregulation, impulsivity, and aggression. RECENT FINDINGS: We conducted a pre-registered systematic review of empirical studies on trust processes and BPD features (k = 29). Results are organized around a heuristic model of trust processes in BPD comprising the following stages: developmental factors, prior beliefs and dispositions, situation perception, emotional states, trust appraisal, behavioral manifestations, and trust learning. Based on the synthesis of the findings, we recommended directions for future research and clinical assessment and intervention, such as managing trust during the early stages of therapy and considering improvements in trust processes as a central mechanism of change in treating individuals with BPD.

Alexithymia and interpersonal problems in healthy young individuals.

BACKGROUND: Alexithymia refers to a multidimensional personality trait with the facets difficulties identifying feelings (DIF), difficulties describing feelings (DDF), and externally orientated thinking (EOT). Alexithymia is a risk factor for mental and somatic disorders. Previous research with patients suffering from various disorders showed positive relationships between alexithymia and interpersonal problems. Only one study analyzed the link between alexithymic features and interpersonal difficulties in healthy individuals but yielded inconclusive findings because participants' negative affects were not controlled. A widely accepted conceptualization of interpersonal problems relies on the interpersonal circumplex, which is defined by two orthogonal dimensions, agency and communion. In the present study, we analyzed which facets of alexithymia are associated with the two interpersonal problem dimensions and the global severity of interpersonal distress, after adjusting for negative affect. METHODS: Two-hundred healthy young individuals (100 women) participated in the study. Alexithymic features were assessed using the 20-Item Toronto Alexithymia Scale (TAS-20). Interpersonal problems were measured with the Inventory of Interpersonal Problems (IIP-D). Participants' state and trait anxiety, depressive symptoms, and verbal intelligence were also assessed. RESULTS: All alexithymia scales were positively correlated with general interpersonal distress. Regression results suggested that the TAS-20 subscale DIF was the primary predictor of general interpersonal distress after controlling for negative affectivity. The scale DDF correlated negatively with the IIP-D dimension agency. According to our regression analysis, DDF was a predictor of (low) agency controlling for negative affects. Moreover, DDF correlated negatively with the IIP-D dimension communion. Our regression results indicate that DDF was a predictor of (low) communion independent of negative affect. Correlations between alexithymia facets and IIP-D subscales did not differ between genders. CONCLUSIONS: Difficulties identifying feelings seem to be linked to a high level of general interpersonal distress. Difficulties in recognizing one's feelings may disrupt emotion regulation, which could heighten the general risk of interpersonal problems. Difficulties describing feelings could be a central factor contributing to interpersonal problems related to low communion as well as low agency, since emotion expression and communication are crucial in establishing experiences of social closeness and directing other people's behavior.

Who Returns to work? Exploring the Role of Interpersonal Problems in Occupational Rehabilitation.

PURPOSE: Current interventions designed to facilitate return to work (RTW) after long-term sick leave show weak effects, indicating the need for new approaches to the RTW process. The importance of social relationships in the workplace is widely recognized in existing RTW literature, but very little is known about the role of the interpersonal problems of the returning worker. Current research indicates that a subset of these - hostile-dominant interpersonal problems - give particular disadvantages in several life areas. This prospective cohort study aims to test whether higher levels of interpersonal problems predict lower likelihood of RTW when controlling for symptom levels (H1); and whether higher levels of hostile-dominant interpersonal problems specifically predict lower likelihood of RTW (H2). METHODS: 189 patients on long-term sick leave completed a 3½-week transdiagnostic RTW program. Before treatment, self-reported interpersonal problems, chronic pain, insomnia, fatigue levels, anxiety and depression were collected. RTW data for the following year were collected from the Norwegian Labour and Welfare Administration. RESULTS: A multivariable binary logistic regression analysis found that (H2) hostile-dominant interpersonal problems significantly predicted RTW (OR = 0.44, [95% CI: 0.19, 0.98], p = .045), while a corresponding analysis (H1) found that general interpersonal problems did not. CONCLUSION: Hostile-dominant interpersonal problems negatively predict RTW after long-term sick leave, suggesting an overlooked factor in the field of occupational rehabilitation. The findings could open up new avenues for research and interventions entailed to individuals in the field of occupational rehabilitation.

The association between trauma and interpersonal problems in a United States community mental health setting.

OBJECTIVE: Previous research has documented associations between trauma and interpersonal problems. We examined the impact of trauma on interpersonal problems among depressed patients seeking treatment in a community mental health setting. METHODS: A total of 453 patients seeking treatment and screened for a comparative effectiveness study of therapies for depression were included. We conducted analyses relating the 32-item inventory of interpersonal problems (IIP-32) to trauma measures. RESULTS: 99.1% of the sample experienced a traumatic event. There were significant associations between the total number of traumas, the number of sexually and physically assaultive traumas, and both gender and race. The number of sexually assaultive traumas was significantly related to the IIP-32 "too caring" subscale (simple r = 0.167, p < 0.001). Controlling for demographics and other IIP-32 subscales, the total number of traumas remained significantly related to the IIP-32 "too caring" domain (partial r = 0.163, p < 0.001). CONCLUSIONS: Traumatic events are prevalent among community populations and these experiences are associated with certain interpersonal problems. Trauma and interpersonal problems are key issues for the treatment of patients in the community mental health setting.

Metacognitive beliefs predict interpersonal problems in patients with social anxiety disorder.

Patients with Social Anxiety Disorder (SAD) typically report interpersonal problems, and these are important targets in treatment beyond social anxiety symptoms as they impair quality of life, maintain emotion symptoms and effect on social functioning. What factors contribute to interpersonal problems? In the current study we set out to explore the role of metacognitive beliefs as correlates of interpersonal problems in patients treated for SAD when controlling for the effect of social phobic cognitions and symptoms. The sample consisted of 52 patients with a primary diagnosis of SAD participating in a randomized controlled trial comparing cognitive therapy, paroxetine, pill placebo, or the combination of cognitive therapy and paroxetine in treating SAD. Two hierarchical multiple linear regression analyses were conducted to explore change in metacognitions as predictors of change in interpersonal problems when controlling for change in social phobic cognitions and social anxiety. Change in metacognitions accounted for unique variance in interpersonal problems improvement beyond change in cognitions. Furthermore, change in cognitions overlapped with change in social anxiety symptoms, and when controlling the overlap between these three predictors, only change in metacognitions was uniquely associated with improvement in interpersonal problems. This finding indicates that metacognitions are linked to interpersonal problems in patients with SAD with the implication that treatment should aim to modify metacognitive beliefs to alleviate interpersonal dysfunction.

Trajectories of interpersonal problems in residential eating disorder treatment: Exploring the influence of primary diagnosis.

Baseline interpersonal problems have been associated with treatment outcome in eating disorders (ED) and are important for understanding ED maintenance and aetiology. Despite this evidence, little is known about trajectories of change in interpersonal problems in the context of treatment, particularly in intensive ED treatment. This study examined the trajectory of total interpersonal problems in residential ED treatment, as well as two subdomains previously highlighted in ED research of being overly Cold (interpersonally distant) or overly Domineering (interpersonally controlling), as a function of different primary presenting ED diagnoses: anorexia nervosa restricting subtype (AN-R), binge-purge subtype (AN-BP), and bulimia nervosa or binge eating (BN/BED). Interpersonal problem data were collected at admission, discharge, and 6-month follow-up. Trajectories were analysed with multilevel models. Results showed small-to-medium statistically significant reductions in interpersonal problems across diagnostic groups from admission to discharge for total interpersonal scores, and gains appeared to be maintained at follow-up for both AN groups. Patients diagnosed with primary AN experienced steeper declines in total interpersonal problems from admission to follow-up compared with patients diagnosed with BN/BED, with AN-R experiencing the steepest trajectory. Planned contrasts indicated anyone with relevant binge eating behaviours had higher average levels of both Cold, as well as Domineering problems. Exploratory contrasts suggested that patients who had more Domineering problems also exhibited more binge symptoms and were typically slower to improve. Overall, results suggest interpersonal problems are generally malleable in residential ED treatment, yet change patterns differ by presenting ED symptoms and interpersonal problem subdomain.

Change in interpersonal problems and metacognitive beliefs as predictors of improvement in patients with generalized anxiety disorder.

INTRODUCTION: Generalized anxiety disorder (GAD) is characterized by persistent worry and anxiety, often with a chronic course. We tested the role of two suggested underlying factors in GAD, interpersonal problems and negative metacognitive beliefs, as predictors of trait-worry and trait-anxiety. METHODS: The sample consisted of 56 patients with a primary diagnosis of GAD from a randomized controlled trial. We first estimated the proportion of variance lying between the higher level of the data structure to account for potential therapists' effects. Two hierarchical regression analyses were conducted testing change in interpersonal problems and negative metacognitive beliefs as predictors of change in trait-worry and trait-anxiety following treatment. Change in depression and anxiety symptoms was controlled. RESULTS: Change in negative metacognitive beliefs was the strongest predictor of improvement of both trait-worry and trait-anxiety. Change in interpersonal problems was not a unique predictor of change in trait-worry but did make a significant and unique contribution to trait-anxiety. CONCLUSIONS: Negative metacognitive beliefs may be important targets to improve trait-worry and trait-anxiety in GAD. Interpersonal problems may be relevant for trait-anxiety but could also be a surface marker of higher order vulnerability factors. Implications for treatment are discussed.

Baseline overly accommodating interpersonal problems in relation to parsed alliance-outcome associations in cognitive behavioral therapy for generalized anxiety disorder.

Given its interpersonal underpinnings, relational factors may be salient in psychotherapy for generalized anxiety disorder (GAD). Supporting this point, research has indicated a positive total alliance-improvement correlation in cognitive behavioral therapy (CBT) for GAD. However, less research has disaggregated this correlation into within- and between-patient components, or examined theory-informed ways in which patient characteristics influence to these components. Thus, we first investigated parsed alliance-outcome associations in CBT for GAD. Second, consistent with theory that alliance may represent a direct interpersonal change correlate, we tested whether within-patient alliance improvements were especially therapeutic for patients with higher levels of an interpersonal problem prototypical of GAD-over accommodation. Also, consistent with theory that between-patient differences in overall alliance may be influenced by patients' preexisting relational characteristics, we tested whether more overly accommodating patients reported poorer average alliances that, in turn, related to worse outcomes.Sixty-nine patients received variants of CBT. Patients rated over accommodation at baseline, and alliance and outcome across treatment.As hypothesized, within-patient alliance improvements correlated with subsequent anxiety reduction, and this association was stronger for more overly accommodating patients. All between-patient associations were nonsignificant.Results help clarify the nuanced role of alliance in CBT for GAD.

Investigating the effect of inquiry-based stress reduction on mortality awareness and interpersonal problems among intensive care unit nurses.

INTRODUCTION: Caring for dying patients is one of the job stressors. Nurses in intensive care units are among the medical staff who have a close interaction with dying patients. Studies have shown that psychological interventions are very helpful in improving thinking about death and its problems. Therefore, this study was conducted to investigate the effect of Inquiry-Based Stress Reduction on mortality awareness and interpersonal problems among intensive care unit nurses in southeastern Iran. MATERIALS AND METHODS: This was a Quasi-experimental study with a pretest-posttest design in southeast of Iran in 2021. Nurses were selected using the convenience sampling method and divided into intervention (n = 32) and control (n = 35) groups using the block randomization method. The intervention group received a two-hour Inquiry-Based Stress Reduction counseling session every week for 6 weeks. Data were gathered using Multidimensional Mortality Awareness Measure and Inventory of Interpersonal Problems before, immediately after, and 6 weeks after the intervention. IBM SPSS Statistics software version 25 was used for data analysis. RESULTS: In the intervention group, the mean scores of Mortality Awareness before, immediately after, and 6 weeks after the intervention were 130.41 ± 5.91, 164.47 ± 8.66, and 163.91 ± 9.29, respectively. Therefore, in the intervention group, the increase of Mortality Awareness mean score was statistically significant (P < 0.001). In the control group, the mean scores of Mortality Awareness before, immediately after, and 6 weeks after intervention were 129.63 ± 5.59, 135.26 ± 11.14, and 132.66 ± 5.62, respectively. Difference between the two groups was significant (P < 0.001). The results also showed that in the intervention group the mean scores of Interpersonal Problems immediately after and 6 weeks after the intervention were lower than before the intervention (P < 0.001). In the control group, Interpersonal Problems increased over time (P < 0.001). Accordingly, the difference between the two groups in terms of Interpersonal Problems during the study was statistically significant (P < 0.001). CONCLUSION: The study results suggest that the Inquiry-Based Stress Reduction is an appropriate intervention method to improve mortality awareness and reduce interpersonal problems in intensive care unit nurses.

Interpersonal Psychotherapy's problem areas as an organizing framework to understand depression and sexual and reproductive health needs of Kenyan pregnant and parenting adolescents: a qualitative study.

BACKGROUND: Peripartum adolescents experience significant interpersonal transitions in their lives. Depression and emotional distress are often exacerbated by adolescents' responses to these interpersonal changes. Improved understanding of pregnancy-related social changes and maladaptive responses to these shifts may inform novel approaches to addressing the mental health needs of adolescents during the perinatal period. The paper aims to understand the sources of psychological distress in peripartum adolescents and map these to Interpersonal Psychotherapy's (IPT) problem areas as a framework to understand depression. METHOD: We conducted interviews in two Nairobi primary care clinics with peripartum adolescents ages 16-18 years (n = 23) with experiences of depression, keeping interpersonal psychotherapy framework of problem areas in mind. We explored the nature of their distress, triggers, antecedents of distress associated with an unplanned pregnancy, quality of their relationships with their partner, parents, and other family members, perceived needs, and sources of support. RESULTS: We found that the interpersonal psychotherapy (IPT) framework of interpersonal problems covering grief and loss, role transitions, interpersonal disputes, and social isolation was instrumental in conceptualizing adolescent depression, anxiety, and stress in the perinatal period. CONCLUSION: Our interviews deepened understanding of peripartum adolescent mental health focusing on four IPT problem areas. The interpersonal framework yields meaningful information about adolescent depression and could help in identifying strategies for addressing their distress.

My problem or yours? Interpersonal problems and marital quality.

OBJECTIVE: Research has consistently illustrated the impact of personality on marital quality. Given the inherent dyadic nature of relationships, recent investigations have integrated spouse-rated personality to account for both spouses' perspectives. Grounded in Contemporary Integrative Interpersonal Theory, we viewed personality through an interpersonal lens and conceptualized maladaptive interpersonal functioning as interpersonal problems. The present study examined the incremental validity of spouse-rated interpersonal problems beyond self-reported interpersonal problems to predict marital quality within an expanded actor-partner interdependence model (APIM). METHOD: Within a community sample of heterosexual, married couples (N = 110), we used expanded APIMs, integrating both self-report and spouse-rating, to test the incremental validity of spouse-perceived interpersonal problems over self-perceived interpersonal problems on marital quality through a model comparison approach. We tested for possible gender differences in effects. RESULTS: Spouse perception, notably spouse-rated partner effects, appears to be the most frequent predictor of marital quality, and self-perception had less impact. CONCLUSION: Given the implications marital quality has on health and well-being, intervention efforts capitalizing on acceptance of spouses' perspectives are likely to lead to greater improvements in quality and overall health.

Interpersonal problems and cooperative behavior in patients suffering from prolonged grief disorder as compared to bereaved healthy controls.

OBJECTIVES: Interpersonal factors, such as impairments in social interaction or lack of social support, have an important share when it comes to the development, maintenance, and progression of various mental disorders. METHODS: Individuals suffering from prolonged grief disorder (PGD) and matched bereaved healthy controls (n = 54) underwent a thorough diagnostic procedure, further completed the Inventory of Interpersonal Problems (IIP-D-32), and participated in a finitely iterated prisoner's dilemma (FIPD). RESULTS: Individuals suffering from PGD reported significantly more interpersonal problems. Both groups behaved differently in the FIPD with healthy controls being more carefully, adapting their behavior more flexible, whereas PGD patients displayed a lower responsiveness, which may indicate an inability to adapt to changes in relationships. CONCLUSION: We conclude that interpersonal problems appear to be a relevant feature of PGD. Future studies need to clarify the causal relation behind this link, and should also include measures of attachment, social support, and disconnectedness.

Interpersonal dysfunction in individuals high in chronic worry: relations with interpersonal problem-solving.

BACKGROUND: Interpersonal dysfunction has been proposed as an important maintenance factor in chronic worry and generalized anxiety disorder (GAD). Perceptions of problems and the problem-solving process as threatening, and unhelpful (e.g. avoidant, impulsive) problem-solving styles are implicated in worry and have also been suggested to be associated with dysfunctional interpersonal styles. AIMS: The present study assessed the relationships between interpersonal dysfunction and problem-solving orientation, approach, and effectiveness in a sample of individuals high in chronic worry and investigated the indirect effect of interpersonal dysfunction on GAD symptom severity through negative problem-solving beliefs and approaches. METHOD: Fifty-nine community participants completed questionnaires and an interpersonal problem-solving task. RESULTS: Greater interpersonal dysfunction was significantly associated with greater negative problem-solving orientation and greater habitual avoidant and impulsive/careless problem-solving styles. Greater interpersonal dysfunction was associated with poorer effectiveness of solutions when the task problem involved conflict with a romantic partner. Negative problem-solving orientation fully mediated the relationship between interpersonal dysfunction and GAD symptoms. CONCLUSIONS: These findings support that problem-solving processes are implicated in interpersonal dysfunction and that negative beliefs about problem-solving account for the relationship between interpersonal dysfunction and GAD symptoms. Theoretical implications are discussed.