AUTHOR=Probst Thomas , Sattel Heribert , Gündel Harald , Henningsen Peter , Kruse Johannes , Schneider Gudrun , Lahmann Claas 

TITLE=Moderating Effects of Alexithymia on Associations between the Therapeutic Alliance and the Outcome of Brief Psychodynamic-Interpersonal Psychotherapy for Multisomatoform Disorder

JOURNAL=Frontiers in Psychiatry

VOLUME=Volume 8 - 2017

YEAR=2017

URL=https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2017.00261

DOI=10.3389/fpsyt.2017.00261

ISSN=1664-0640

ABSTRACT=This secondary analysis of a trial on brief psychodynamic-interpersonal therapy (PIT) for patients with multisomatoform disorder investigated whether alexithymia moderates the association between the therapeutic alliance and the outcome of PIT and whether moderating effects of alexithymia remain significant when controlling for depression. Eighty-three patients with multisomatoform disorder receiving PIT were statistically analyzed. Moderation analyses were performed with the SPSS macro PROCESS. The primary outcome (Y), self-reported physical quality of life at 9-month after the end of PIT, was measured with the physical component summary (PCS) of the SF-36 Health Survey. The potential moderator alexithymia (M) was operationalized with the Toronto Alexithymia Scale (TAS-20) at pre-treatment and the predictor (X) the therapeutic alliance was rated by both patients and therapists via the Helping Alliance Questionnaire (HAQ) at the end of PIT. Moreover, the PCS at pre-treatment functioned as covariate in all models. When the patients’ alliance ratings were analyzed, alexithymia did not moderate the effect the alliance exerted on the outcome. When the therapists’ alliance ratings were evaluated, alexithymia moderated the effect of the alliance on the outcome at 9-month follow-up (p<0.05): The higher the patients’ alexithymia, the more a strong alliance in the therapists’ perspective improved the outcome. This moderating effect of alexithymia was, however, not statistically significant anymore when adding the pre-treatment depression scores (PHQ-9) as a covariate to the model. The results underline the importance of a good therapists’ view of the alliance when treating alexithymic patients and highlight the complex interaction between alexithymia and depression. Future studies are needed to extend the research question on which psychotherapeutic mechanisms of change are beneficial for which patients.