A STRUCTURED INTERVIEW METHOD FOR PSYCHIATRIC RESEARCH

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Abstract
A method is presented for objective clinical assessment in psychiatric research, based on a content analysis of verbal behavior in a structured interview situation. This technique involves the selective reinforcement of self-referred affect statements in a specific period of the interview. With such a procedure it is hoped ultimately to elicit dimensions descriptive of the patient''s pattern of interpersonal responsiveness within the interview, and changes in the pattern that occur following treatment. Preliminary data are presented concerning the clinical validity of the method in a study of drug-treated depressive inpatients. The interview codes showed significant relations to independent measures of mental status and its changes, as evaluated by psychological tests and behavior rating scales. Changes in within-interview adapta-tion, that is, in reinforcement responsiveness, were demonstrated to be sensitive to varying drug treatment conditions. In addition to showing correspondence to the usual measures of clinical status, the interview suggested areas of particular sensitivity which may aid in the understanding of treatment-induced changes in the depressive syndrome; thus one treatment effect was identified as an overall decrease in Affect Denial, and it was further demonstrated that a specific increase occurred in Positive Affect responsiveness to reinforcement with drug treatment, and a decrease with placebo treatment. A more extensive examination of the trends reported here based on a larger number of cases is in progress. The authors feel that the technique presented may be useful in various areas of research in the field of psycho-pathology. The technique should be useful in: (1) elucidating treatment responsiveness in states other than depression; (2) elucidating the nature and meaning of symptom alteration which is not provided by target-symptom evaluation; (3) establishing differences in the effects on patients of interviewers, when the same technique is applied to the same patients by different examiners, and (4) relating individual differences in reinforcement responsiveness to the patient''s clinical condition, history and diagnosis.

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