A moderating factor for patients with vindictive interpersonal problems.

Individuals high in vindictive interpersonal problems tend to experience and express anger and irritability. In treatment, they have poor prognosis for alliance and outcome. We propose that positive expectation may serve as a moderating factor for these patients. In the current study, we examined the ability of expected alliance to act as a moderating factor in the early process and early progress of treatment for patients with vindictive interpersonal problems. A sample of 65 patients received short-term dynamic psychotherapy. At intake, before meeting the therapist, participants completed assessments for vindictive interpersonal problems and expected alliance. All therapy sessions were videotaped, and Session 2 was coded for confrontation ruptures. Early progress was assessed using the improvement from intake to Week 2 in the measure of distress from interpersonal relations. Our results show that, at high levels of vindictive interpersonal problems, higher expected alliance was associated with fewer confrontation ruptures. At high levels of vindictive interpersonal problems, higher expected alliance was associated with greater early improvement in distress from interpersonal relations. The findings demonstrate how positive expectations may function as a moderating factor that enables patients with vindictive tendencies to achieve a positive process and progress early in treatment. (PsycInfo Database Record (c) 2021 APA, all rights reserved).