An examination of the relationships among childhood abuse, introject style and psychotherapy outcome for depression

The current study explored the relationship between client's history of childhood abuse and psychotherapy outcome, specifically, depressive symptoms, interpersonal problems, dysfunctional attitudes, self-esteem and attachment. The study also explored the relationship between client's history of childhood abuse and current introject style, as well as the relationship between client introject style and psychotherapy outcome. The current study consisted of a sample of 60 clients and was drawn from an archival database of clients who were diagnosed with Major Depressive Disorder and received 16 weeks of psychotherapy treatment (Watson, Gordon, Stermac, Kalogerakos & Steckley (2003). Client's history of childhood abuse was determined using the Traumatic Stress Inventory (TSI short-form McCann & Pearlman, 1992). Introject styles were established using the Structural Analysis of Social Behaviour (SASB Benjamin, 1974), an observer rated process measure. The middle 15 minutes of an early (session 3) and late session (session 15) were rated using the SASB. Results indicated that women who experienced childhood abuse showed a reduction in levels of their self-accepting introject style in session 15 compared to session 3 while women without childhood abuse showed increased levels of the self-accepting introject style in session 15 compared to session 3. Results also indicated that clients with managing and cultivating of self introject styles as measured at session 3 showed improvements in dysfunctional attitudes, interpersonal problems and self-esteem by the end of 16-weeks of psychotherapy. Having a history of childhood abuse was not related to any of the outcome measures clients, regardless of history of childhood abuse improved over time. Results did show history of childhood abuse to be related to perceptions of early childhood attachment experiences specifically, clients with histories of childhood abuse showed higher scores overall for perceptions of experiences with caregivers as rejecting and angry. Finally, results indicated that clients with a history of childhood abuse have a significantly greater number of depressive episodes on average than clients without a history of childhood abuse. Implications for future research and clinical work are discussed.