Clinical factors and early life experiences associated with therapeutic alliance development in treatment for depression or binge eating

Figures & data

Table I. Clinical characteristics in the total sample and by diagnostic group.

			Diagnostic group
	Total sample (N = 212)		Depression (n = 100)		Bulimia nervosa (n = 58)		Binge eating disorder (n = 54)
	M/N	SD/%	M/n	SD/%	M/n	SD/%	M/n	SD/%
Primary illness onset	21.2	10.0	21.75	11.49	20.91	8.39	21.52	10.40
GAF	55.12	7.26	55.16	9.37	54.17	5.30	56.06	3.69
MADRS	18.91	9.84	24.31	6.48	15.33	9.58	12.76	10.05
Prior self-harm	58	27%	25	25%	20	35%	13	24%
Suicide attempt	46	22%	26	26%	13	22%	7	13%
BDI	26.28	9.66	26.28	9.66
Eating Disorder Inventory
Thinness drive	12.42	5.47			14.05	5.25	10.67	5.19
Bulimia	10.17	4.23			10.83	4.52	9.46	3.83
Dissatisfaction	19.40	7.80			19.02	8.27	19.81	7.32

Note. BDI: Beck Depression Inventory; GAF: Global Assessment of Functioning; MADRS: Montgomery-Asberg Depression Rating Scale.

Table II. Perceived parental bonding and childhood trauma in the total sample and by diagnostic group.

			Diagnostic group
	Total sample (N = 212)		Major depression (n = 100)		Bulimia nervosa (n = 58)		Binge eating disorder (n = 54)
	M/n	SD/%	M/n	SD/%	M/n	SD/%	M/n	SD/%
Maternal bonding
Care	20.96	9.85	21.28	9.14	21.98	10.80	19.28	10.02
Overprotection	15.09	8.62	15.31	8.61	15.00	9.43	14.78	7.89
Paternal bonding
Care	18.20	9.77	16.18^a	9.13	19.07^ab	10.95	20.75^b	8.95
Overprotection	13.03	7.47	13.21	7.85	12.43	7.38	13.35	6.99
Childhood trauma
Impersonal trauma	7	3%	5	5%	1	2%	1	2%
Psychological abuse	66	31%	29	29%	20	35%	17	32%
Physical abuse	50	23%	17	17%	12	20%	15	28%
Sexual abuse	63	30%	28	29%	20	34%	15	28%

Table III. Final linear mixed models for therapeutic alliance ratings in the total sample.

	VPPS patient participation	VPPS patient dependency	VPPS patient distress	VPPS patient hostility	VTAS patient contribution
	Estimates [CI]	Estimates [CI]	Estimates [CI]	Estimates [CI]	Estimates [CI]
Predictors
Intercept	4.26 [4.01, 4.50]**	2.07 [1.86,2.27]**	1.47 [1.20, 1.75]**	1.16 [1.06, 1.27]**	4.33 [4.10, 4.57]**
Phase of therapy	0.04 [0.006, 0.07]*	−0.005 [−0.02, 0.01]	−0.04 [−0.09, 0.006]	−0.008 [−0.08, 0.07]	0.06 [0.03, 0.10]**
Therapy (CBT)	0.07 [−0.06, 0.20]	0.003 [−0.11, 0.11]	−0.05 [−0.20, 0.10]	−0.05 [−0.10, 0.009]	0.07 [−0.06, 0.19]
Diagnosis (MD)	−0.08 [−0.21, 0.05]	−0.39 [−0.50, −0.28]**	0.36 [0.21, 0.51]**	−0.03 [−0.09, 0.22]	−0.18 [−0.31, −0.05]**
Childhood trauma
Impersonal trauma	−0.28 [−0.65, 0.09]	−0.03 [−0.34, 0.28]	−0.12 [−0.53, 0.30]	0.03 [−0.14, 0.19]	−0.05 [−0.41, 0.31]
Physical abuse	−0.06 [−0.23, 0.10]	0.03 [−0.11, 0.17]	−0.02 [−0.20, 0.16]	−0.002 [−0.07, 0.07]	−0.10 [−0.26, 0.05]
Sexual abuse	0.07 [−0.07, 0.22]	−0.04 [−0.16, 0.08]	−0.04 [−0.20, 0.12]	0.03 [−0.03, 0.09]	0.04 [−0.10, 0.18]
Psychological abuse	0.16 [−0.009, 0.33]	0.04 [−0.10, 0.18]	0.12 [−0.06, 0.31]	0.01 [−0.06, 0.09]	0.12 [−0.04, 0.28]
PBI
Maternal care	−0.002 [−0.01, 0.006]	−0.004 [−0.01, 0.002]	0.003 [−0.005, 0.01]	−0.0003 [−0.004, 0.003]	0.002 [−0.006, 0.01]
Maternal OP	−0.002 [−0.01, 0.008]	−0.004 [−0.01, 0.004]	0.001 [−0.01, 0.01]	−0.0008 [−0.005, 0.004]	0.003 [−0.006, 0.01]
Paternal care	0.009 [0.001, 0.02]*	−0.004 [−0.01, 0.002]	−0.003 [−0.01, 0.005]	0.0008 [−0.002, 0.004]	0.004 [−0.003, 0.01]
Paternal OP	0.007 [−0.003, 0.02]	−0.0003 [−0.009, 0.008]	0.001 [−0.01, 0.01]	−0.0001 [−0.004, 0.004]	0.003 [−0.006, 0.01]
Interactions
Therapy (CBT) x phase				−0.004 [−0.04, 0.04]
Diagnosis (MD) x phase				0.03 [−0.01, 0.07]
Impersonal trauma x phase				−0.02 [−0.13, 0.09]
Physical abuse x phase				0.01 [−0.04, 0.06]
Sexual abuse x phase				−0.05 [−0.09, −0.004]*
Psychological abuse x phase				−0.003 [−0.05, 0.004]
Maternal care x phase				−0.002 [−0.004, 0.0008]
Maternal OP x phase				−0.001 [−0.004, 0.002]
Paternal care x phase				−0.0007 [−0.003, 0.002]
Paternal OP x phase				0.001 [−0.001, 0.004]
Random effects
Intercept standard deviation	0.37 [0.32, 0.42]	0.21 [0.07, 0.56]	0.38 [0.33, 0.45]	0.11 [0.08, 0.15]	0.35 [0.30, 0.40]
Slope standard deviation				0.06 [0.28, 0.11]
Intercept-slope correlation				0.16 [−0.9, 0.99]
Residual	0.03	0.44	0.38	0.03	0.32
Model Comparison
R^2 marginal	0.07	0.15	0.12	0.04	0.07
R^2 conditional	0.61	0.30	0.57	0.52	0.57
Observations (N)	504 (168)	504 (168)	504 (168)	504(168)	504 (168)

Note. CI: Confidence intervals; CBT: cognitive behavioural therapy; MD: Major depression; OP: Overprotection, *p < 0.05, **p < 0.01.

Data Availability Statement

The data included in this manuscript have not been made publicly available for ethical and privacy reasons.