Clients' emotional experience as a dynamic context for client-therapist physiological synchrony.

OBJECTIVE: Client-therapist physiological synchrony has recently attracted significant empirical attention. Recent theoretical accounts propose that physiological linkages should not be considered a stable dyadic virtue but rather a dynamic process that depends on the situational context in which they transpire. The present study adopted a "momentary" (vs. "global") approach that focuses on therapist-client physiological synchrony over relatively short periods of time. These temporal data served to examine the interplay between patterns of synchrony (in-phase vs. antiphase) and clients' momentary emotional experiences (inhibited/unproductive, productive, and positive). Synchrony was assessed by measuring respiratory sinus arrhythmia (RSA), an autonomic index that is known to be associated with interpersonal emotion regulation. METHOD: Data were drawn from 28 clients undergoing a 16-session supportive-expressive dynamic therapy for depression. Clients' and therapists' electrocardiography were recorded in five sessions; clients' emotional experiences were coded at the speech-turn level. After each session, the clients also completed the session evaluation scale. RESULTS: Client-therapist dyads had greater momentary RSA synchrony than would be predicted by chance. Compared to moments of unproductive emotional experience, greater antiphase synchrony was observed during moments of productive emotional experiences. In addition, compared to moments of unproductive emotional experience, greater in-phase and antiphase synchrony were observed during moments of positive emotional experiences. These patterns of synchrony were associated with clients' favorable evaluations of the session. CONCLUSION: By considering the dynamic nature of synchrony, these findings provide a fine-grained picture of physiological synchrony and its potential effects on therapy. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

The moderation of attachment in the association between depressive symptoms and self-harm among a clinical sample.

BACKGROUND: Self-harm is a severe health problem worldwide and in particular in clinical settings. The association of depression and self-harm has been extensively studied alongside various variables that have been examined as moderating this association. However, no previous study has examined the moderating role of attachment in this association. AIM: We explored the role of attachment orientation in moderating the association between depressive symptoms and self-harm among a sample of patients in a community mental health clinic. METHOD: This study was a de-identified archival study of patients' medical charts, and used a convenience sample of 199 patients, which completed self-report measures following the initial intake appointment as part of clinic procedures. RESULTS: Findings showed that both attachment anxiety and avoidance moderated the association between depressive symptoms and self-harm, such that depressive symptoms were positively associated with self-harm only when attachment anxiety scores were high, and attachment avoidance scores were high or average. CONCLUSIONS: Attachment anxiety and avoidance should be assessed in the initial intake of patients as it has a contribution to understanding self-harm vulnerability among new patients. Future studies should explore this moderation longitudinally so causality could be inferred.