(PS1-D77) Attachment and Older Adults in Psychotherapy: A Latent Profile Analysis of Psychological Distress Across Treatment

Older adults are increasingly becoming a larger proportion of the United States population, but remain underrepresented in psychotherapy research. This dearth of research may leave providers more vulnerable to making misinformed conceptualizations and treatment decisions with their older clients. The present study is an archival study was conducted to aid researchers and clinicians in the conceptualization and treatment of older adult clients through the development of clinical profiles. To establish the number of valid profiles, their characteristics, and how they differ in treatment outcomes across the first six sessions of psychotherapy, a latent profile analysis (LPA) and subsequent analysis of covariates (ANCOVA) were conducted. Because attachment theory’s potential application to the unique social experiences of older adults and the transdiagnostic nature of psychological distress, the subscales of the Experiences of Close Relationship scale and Outcome Questionnaire 45.2 were used as the LPA’s indicator variables. With a sample of 172 clients who are 55 years or older, a three-profile model was identified, and each participant was assigned to a profile. Each profile was characterized based on mean scores of each indicator variable: Profile 1 was identified as “Secure Attachment and Low Psychological Distress”; Profile 2 was identified as “High Attachment Anxiety and Psychological Distress”; and Profile 3 was identified as “High Attachment Avoidance and Moderate Attachment Anxiety and Psychological Distress.” Next, ANCOVAs were conducted to evaluate differences in change in psychological distress across the first six sessions of therapy. Results suggested that while Profile 2 experienced the greatest change in psychological distress across the first six session of therapy, they were also the only profile to remain within the clinically significant range of distress.  Overall, the development of the three-profile model and examination of profile differences in treatment outcomes provides a novel and potentially useful tool in the psychological treatment of the largely under-studied population of older adults. Further clinical and research applications will be explored.