Exploring an implicit test to measure affective outcomes in routine psychotherapy evaluations

Area of Science:

• Psychology
• Clinical Psychology
• Psychotherapy Research

Background:

• Routine outcome monitoring in psychotherapy predominantly uses self-report measures.
• There is a need for complementary implicit measures to provide a more comprehensive assessment of patient distress.
• The Affect Misattribution Procedure (AMP) is a cognitive task that can assess implicit attitudes and self-perceptions.

Purpose of the Study:

• To develop and evaluate a brief implicit measure using the Affect Misattribution Procedure (AMP).
• To assess the AMP's ability to complement existing explicit measures like the CORE-OM in routine outcome monitoring.
• To examine the reliability and sensitivity to change of the AMP in a clinical and non-clinical population.

Main Methods:

• Participants included individuals seeking psychotherapy (n=109) and non-clinical controls (n=46).
• Both groups completed a self-referential Affect Misattribution Procedure (AMP) and the CORE Outcome Measure (CORE-OM).
• Analyses included group differences, correlations between implicit and explicit distress, reliability (split-half), and longitudinal change.

Main Results:

• The clinical group scored significantly higher on the implicit AMP measure compared to controls (g=0.41).
• The CORE-OM showed a larger group difference (g=1.07), with moderate convergence between implicit and explicit distress measures (CORE-OM explained 12% of AMP variance).
• The AMP demonstrated high split-half reliability (rsβ=.92) and preliminary sensitivity to therapeutic change over 12 sessions (dz=0.54).

Conclusions:

• The findings support the feasibility of using a brief AMP task as a reliable implicit measure.
• The AMP provides a partially distinct index of self-identification related to distress.
• The AMP can serve as a valuable complementary tool for triangulating implicit and explicit measures in routine psychotherapy outcome monitoring.