Interpersonal problems as a predictor of outcome in psychotherapy for depressive and anxiety disorders: a multilevel meta-analysis

GÓMEZ PENEDO, JUAN MARTÍN; FLÜCKIGER, CHRISTOPH

Journal of Consulting and Clinical Psychology

APA

Año: 2023

Objective: Although interpersonal problems are assumed to play an important role in the treatment of depression and anxiety, meta-analytic attempts to explore the association between interpersonal problems and outcome in psychotherapy for these patients are missing. This study aims to conduct a systematic review and meta-analytic synthesis of the association between patients’ baseline interpersonal problems and outcome in psychotherapy for depressive and anxiety disorders. Method: We conducted a three-level meta-analysis (i.e., disaggregating sampling variance, within-study variance, and between-study variance)of the interpersonal problems–outcome prediction (IPOP; as measured by the total distress factor of Inventory of Interpersonal Problems). Results: We found 40 effect sizes nested within 21 primary studies. The three-level model showed a significant aggregated effect size of IPOP, r = −.13, SE = 0.02, 95% CI [−.18, −.09]; t(39) = −5.71, p < .001; d = −0.27, with greater interpersonal distress being associated with worse psychotherapy outcome. Results showed significant heterogeneity across effect sizes with considerable variability across studies (I2 = .39) and to a lower extent across reported outcomes (I2 = .19). Graphicalmeasures did not show evidence of a substantial publication bias. Conclusions: This meta-analysis showed that baseline overall interpersonal problems are a small but robust negative predictor of psychotherapy outcome. Therapists might benefit from exploring patients’ interpersonal problems at the beginning of therapy to enhance their prognostic inferences.