Adaptational psychodynamics

The DSM-5 Section III alternative model for personality disorders (AMPD) is a personality disorder (PD) nosology based on severity of personality dysfunction and pathological traits. We examined the degree to which the personality constructs identified by McAdams and Pals (2006; dispositional traits, characteristic adaptations, narrative identity) and the paradigms of personality assessment described by Wiggins (2003; psychodynamic, interpersonal, personological, multivariate, empirical) are represented within the AMPD...

Despite the estimated 15% likelihood that a psychiatrist will become the victim of stalking, there is little formal recognition of its prevalence or its impact on well-being. Through narrative accounts, ten psychiatrists with psychodynamic orientations speak of their experiences including how each managed the anxieties consequent to stalking. These include a variety of adaptive psychic operations as well as concrete actions to curtail stalking.

Psychodynamic psychiatry remains a challenging subject to teach in underserved areas, where enthusiasm to learn is substantial. Besides logistical and psychiatric workforce shortcomings, sensible cultural adaptations to make psychodynamic psychiatry relevant outside of high-income countries require creative effort. Innovative pedagogical methods that include carefully crafted mentoring and incorporate videoconferencing in combination with site visits can be implemented through international collaborations. Emphasis on mentoring is essential to adequately train future psychodynamic psychotherapy supervisors...

Transference-focused psychotherapy (TFP) is one of the empirically validated treatments for patients with borderline personality disorder. TFP has roots in psychoanalytically informed psychotherapy, although important elements of the treatment have been adapted and refined for patients with significant personality disorder pathology. TFP's assessment process is informed by the structural interview, an approach that synthesizes standard DSM-5 nosology with the psychodynamic concept of the personality organization...

BACKGROUND: Functional neurological symptoms (FNS) are considered non-volitional and often very disabling, but are not explainable by neurological disease or structural abnormalities. Brief Augmented Psychodynamic Interpersonal Therapy (BAPIT) was adapted to treat the putative emotion processing deficits thought to be central to FNS aetiology and maintenance. BAPIT for FNS has previously been shown to improve levels of distress and functioning, but it is unknown whether improvements on such measures correlate with changes in emotion processing ‒ which this treatment focuses on...

OBJECTIVE: There is a growing literature on the intergenerational transmission of trauma, representing approaches across psychodynamic, family systems, epidemiological, sociological, and biological levels of analysis. Embitterment has been proposed as a response to severe, but normative, stressful events, different from the life-threatening trauma that precedes posttraumatic stress disorder (PTSD). METHOD: This article reviews the potential applicability of the construct of embitterment to trauma and intergenerational effects through (a) a historical review of the intergenerational transmission of trauma literature, (b) a discussion of embitterment versus PTSD, (c) a brief review of theories of mechanisms of transmission, and (d) a discussion of biological findings and their interpretation...

OBJECTIVES: In the literature, there is no research that would indicate how a change in specific personality elements may affect the therapeutic effect of short-term group psychodynamic psychotherapy (STGP). The aim of the study was to evaluate the effect of short-term group psychodynamic psychotherapy on personality traits in apopulation of patients with neurotic and personality disorders in a day ward of neurosis treatment. METHODS: The study involved 139 people with anxiety and personality disorders, including 110 who participated in the control measurements...

OBJECTIVE: The marked impulsivity and instability of clients suffering from borderline personality disorder (BPD) greatly challenge therapists' understanding and responsiveness. This may hinder the development of a constructive therapeutic relationship despite it being of particular importance in their treatment. Recent studies have shown that using motive-oriented therapeutic relationship (MOTR), a possible operationalization of appropriate therapist responsiveness, can enhance treatment outcome for BPD...

BACKGROUND: Given increasing mental health needs in the VA, identifying strategies to deliver new services is critical. AIMS: This paper describes the process of navigating provider, patient and systems barriers of an initiative to increase choice, access and quality of psychotherapy at the VA by incorporating an evidence-based short-term, psychodynamic psychotherapy. METHODS: Brief Dynamic Interpersonal Therapy (DIT) was selected as a viable model for implementation...

Since the adoption of the Swiss psychiatrist and psychotherapist double title in 1961, the medical training in psychotherapy must obey specific requirements. In parallel to the clinical practice, the supervisions and the personal experience, 180 hours of theoretical training are required, in each of the psychotherapeutic orientations chosen by the medical doctor (psychodynamic, family / systemic and behavioural and cognitive therapies). Even though the effectiveness of these treatments is well established and there is no significant difference between psychotherapeutic schools in this respect, the choice of an orientation for psychotherapy training requires an adequate pedagogic process, both on the theoretical side, and in the ability to choose a suitable form of psychotherapeutic treatment adapted to the psychiatrist's conversational style...

Insecure and unresolved/disorganized attachment states of mind may impact affect regulation and interpersonal functioning that contribute to binge eating in women with binge-eating disorder (BED). Group psychological treatment may facilitate changes from insecure to secure and from unresolved-disorganized to non-unresolved/disorganized attachment states of mind. This study used attachment theory to understand better the psychopathology of BED and co-morbid overweight status and to understand better the treatment response of patients with BED who receive group psychotherapy...

The present research deals with the clinical and social problems present during linguistic and cognitive development of deaf children. Currently, the development of Theory of Mind represents an important research field in deafness studies. These international studies highlighted a significant alteration in the development of Theory of Mind in deaf children compared to normal hearing children, especially in cases of congenital or preverbal hearing loss. In particular, the research focuses on the skills of deaf children in recognising emotions and desires, through both perceptive and cognitive methods, by evaluation of psycho-cognitive skills of children with severe hearing loss using a set of questions to be administered to hearing loss patients...

This article demonstrates the utility of a theory-guided psychodynamic approach to the assessment of personality and personality pathology based on the object relations model developed by Kernberg (1984). We describe a clinical interview, the Structural Interview (SI; Kernberg, 1984), and also a semistructured approach, the Structured Interview of Personality Organization (STIPO; Clarkin, Caligor, Stern, & Kernberg, 2004) based on this theoretical model. Both interviews focus on the assessment of consolidated identity versus identity disturbance, the use of adaptive versus lower level defensive operations, and intact versus loss of reality testing...

Considerable overlap in symptoms between patients with borderline personality disorder (BPD) and schizotypal personality disorder (STPD) complicates personality diagnostics. Yet very little is known about the level of psychodynamic functioning of both personality disorders. Psychodynamic assessment procedures may specify personality characteristics relevant for differential diagnosis and treatment planning. In this cross-sectional study we explored the differences and similarities in level of personality functioning and psychodynamic features of patients with severe BPD or STPD...

The medical care of refugees and asylum seekers requires culturally sensitive and diverse structuring of the healthcare. In the psychotherapeutic and psychosomatic treatment of these patients the culture-specific and social aspects and also the high ratio of patients with post traumatic stress disorders and somatoform disorders have to be considered. The principles of stabilizing psychodynamic traumatherapie of refugees will be introduced, which efficacy was determined by controlled study. The specific adaptations of the trauma-orientated psychotherapy to the specific situation of refugees and asylum seekers will be described...

Introduction: The Rating Scale for Countertransference (RSCT) - originally, Escala para Avaliação de Contratransferência (EACT) - is a self-administered instrument comprising questions that assess 23 feelings (divided into three blocs, closeness, distance, and indifference) that access conscious countertransferential emotions and sentiments. This paper describes the process of translation and cross-cultural adaptation of the RSCT into American English. Methods: This study employed the guidelines proposed by the International Society for Pharmacoeconomics and Outcomes Research (ISPOR) Task Force for Translation and Cultural Adaptation which define 10 steps for translation and cross-cultural adaptation of self-report instruments...

This investigation's goal was to assess the concurrent validity of the four scales of the Anaclitic and Introjective Depression Assessment (AIDA), a newly developed clinician-rated measure, and the Inventory of Interpersonal Problems Circumplex Scales (IIP-64). The AIDA is composed of Shedler-Westen Assessment Procedure items and is comprised of two primitive and two more mature scales of introjective and anaclitic personality types. Specific predictions of relationships were made and are discussed further in this paper...

Suspicious thinking in given situations can be useful and helps the adaptation as events occurring in the world also corroborate this. Factors participating in the development of paranoia can be listed as psychodynamic (projection), salience attributional, neurobiological (dopamine), impaired perceptual (hearing loss), sociocultural (minority, pseudocommunity), self-esteem (worrying, depression, mania), and cognitive (jump-to-conclusion) mechanisms. Along the spectrum of thinking, from the mild to the severe, enhanced worrying, salience attribution, overvalued concepts, suspicion/mistrust, paranoid ideations, and crystallized delusions may occur with different contents...

The Wechsler intelligence tests (currently Wechsler, 2008 , 2014) have traditionally been part of the multimethod test battery favored by psychodynamically oriented assessors. In this tradition, assessors have used Wechsler data to make inferences about personality that transcend cognition. Recent trends in clinical psychology, however, have deemphasized this psychodynamic way of working. In this article, I make a conceptual and clinical case for reviving and refining a psychodynamic approach to inference making about personality using the Wechsler Verbal Comprehension subtests...

Aim: Even though there is substantial evidence that play based therapies produce significant change, the specific play processes in treatment remain unexamined. For that purpose, processes of change in long-term psychodynamic play therapy are assessed through a repeated systematic assessment of three children's "play profiles," which reflect patterns of organization among play variables that contribute to play activity in therapy, indicative of the children's coping strategies, and an expression of their internal world...