OBJECTIVE A recent randomized controlled trial (RCT) indicated that individuals with higher levels of attachment anxiety exhibited better treatment outcomes in supportive-expressive therapy (SET) relative to supportive therapy (ST). But to gain insight into within-patient therapeutic changes, a within-individual design is required. The present study contrasts previous findings based on theory-driven between-patient moderators with data-driven moderators of within-patient processes to investigate whether findings converge or diverge across these two approaches. METHOD We used data of 118 patients from the pilot and active phases of a recent RCT for patients with major depressive disorder, comparing ST with SET, a time-limited psychodynamic therapy. The predefined primary outcome measure was the Hamilton Rating Scale for Depression. Supportive versus expressive techniques were rated based on patients' end-of-session perspective. We compared previous findings based on moderators of between-patient effects with a data-driven approach for identifying moderators of within-patient effects of techniques on subsequent outcome. RESULTS After false discovery rate corrections, of 10 preselected moderators, patients' attachment anxiety and domineering style remained significant. Of these, bootstrap resampling revealed significant differences between ST and SET techniques for the attachment anxiety moderator: Those with higher attachment anxiety benefited more from greater use of ST than SET techniques in a particular session, as evidenced by lower levels of symptoms at the subsequent session. CONCLUSIONS Our within-individual findings diverge from previously published between-individual analyses. This proof-of-concept study demonstrates the importance of complementing between-individuals with within-individual analyses to achieve better understanding of who benefits most from specific treatment techniques. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

中文翻译：

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确定谁从抑郁症心理治疗中的支持性技术和表达性技术中受益最多：个体内部与个体之间效应的调节因素。


目的 最近的一项随机对照试验（RCT）表明，依恋焦虑水平较高的个体在支持表达疗法（SET）中相对于支持疗法（ST）表现出更好的治疗结果。但为了深入了解患者内部的治疗变化，需要进行个体化设计。本研究将之前基于理论驱动的患者间调节因素的研究结果与数据驱动的患者内部过程的调节因素进行对比，以调查这两种方法的研究结果是否趋同或分歧。方法 我们使用了最近一项针对重度抑郁症患者的随机对照试验试验阶段和活跃阶段的 118 名患者的数据，将 ST 与 SET（一种限时心理动力学疗法）进行比较。预先确定的主要结果指标是汉密尔顿抑郁量表。根据患者治疗结束时的观点对支持性技术与表达性技术进行评级。我们将之前基于患者间效应调节因素的研究结果与数据驱动的方法进行了比较，以确定技术对后续结果的患者内部影响的调节因素。结果 经过错误发现率修正后，在 10 名预选的调节者中，患者的依恋焦虑和霸道风格仍然显着。其中，引导重采样揭示了 ST 和 SET 技术对于依恋焦虑调节剂的显着差异：依恋焦虑程度较高的人在特定疗程中更多地使用 ST 而非 SET 技术受益更多，后续疗程中症状水平较低就证明了这一点。结论 我们的个体内部研究结果与之前发表的个体间分析存在差异。 这项概念验证研究证明了通过个体内部分析补充个体之间的重要性，以更好地了解谁从特定治疗技术中受益最多。 （PsycInfo 数据库记录 (c) 2024 APA，保留所有权利）。