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：

---

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


目的 最近的一项随机对照试验 （RCT） 表明，与支持疗法 （ST） 相比，依恋焦虑水平较高的个体在支持性表达疗法 （SET） 中表现出更好的治疗结果。但要深入了解患者内部的治疗变化，需要个体内部设计。本研究将基于理论驱动的患者间调节因子与患者内部过程的数据驱动调节因子的先前发现进行了对比，以研究这两种方法的发现是趋同还是发散。方法 我们使用了 118 名来自最近一项针对重度抑郁症患者的 RCT 的试点和活跃期患者的数据，将 ST 与 SET （一种限时心理动力学疗法）进行了比较。预定义的主要结果指标是汉密尔顿抑郁量表。根据患者的治疗结束时视角对支持性与表达性技术进行评级。我们将基于患者间效应调节因子的先前发现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子。结果 错误发现率修正后，10 例预选调节因子中，患者的依恋焦虑和霸气风格仍然显著。其中，自举重采样揭示了依恋焦虑调节剂的 ST 和 SET 技术之间的显着差异： 在特定会话中，那些具有较高依恋焦虑的人从更多地使用 ST 而不是 SET 技术中受益更多，随后会话中症状水平较低证明了这一点。结论 我们的个体内研究结果与以前发表的个体间分析不同。 这项概念验证研究证明了通过个体内部分析来补充个体间的重要性，以更好地了解谁从特定治疗技术中受益最大。（PsycInfo 数据库记录 （c） 2024 APA，保留所有权利）。