Preoperational Thinking in Patients with Anxiety or Chronic Back Pain: Two Cross-Sectional Studies to improve the Understanding of the CBASP

Background: In the treatment of persistent depressive disorder (PDD) psychotherapies with an interpersonal focus are recommended. An example of this is the Cognitive Behavioral Analysis System of Psychotherapy (CBASP), which assumes that people with PDD tend to have a preoperational thinking style. The aim of this work is to examine if this style of thinking can also be observed in people with panic disorder or chronic back pain. Methods: In one study, patients with panic disorder (n = 20) were compared with patients with depressive disorder (n = 20) and healthy controls (n = 20). In a separate study, patients with a chronic back pain (n = 30) were compared with healthy controls (n = 32). All participants were interviewed with the Lubeck Questionnaire of Preoperational Thinking (LQPT). In addition, the significant others of participants were asked to rate the participants' interpersonal behavior with the Interpersonal Message Inventory (IMI). Results: The first study found that only the depressed patients differed significantly from the healthy controls on the LQPT (p < .001). In the "hostile - subscale of the IMI, controls differed from both patient groups, but only the finding for panic disorder was statistically significant (p = .008). In the second study, the patients with pain disorder differed from the healthy controls only on the IMI subscale "hostile" (p = .005) but not on the LQPT. Conclusion: Preoperational thinking was only observed in patients with depressive disorder, although the other two groups of patients were also perceived as hostile by their significant others. These findings suggest that the interpersonal problems of patients with mental disorders are not always due to preoperational thinking.