Emotion Focused Therapy for Avoidant Personality Disorder: Pragmatic Considerations for Working with Experientially Avoidant Clients

Emotion-focused therapy (EFT), an empirically supported treatment for depression and interpersonal difficulties, is now being directed towards clients with personality disorders, such as borderline and avoidant personality disorder. In this paper, both the value of, but also potential difficulties therapists can encounter while engaging in, active EFT chair interventions with clients with avoidant personality disorder (AVPD) are described. While EFT interventions can effectively transform emotion schemes at the heart of both intra and interpersonal difficulties, avoidant clients may have difficulties engaging in EFT interventions that activate core maladaptive emotion schemes related to self and negative/unaccepting representations of ‘others’. Alliance ruptures, intransigent experiential avoidance, or ‘unresolvable stand-offs’ may result. To avoid these problems, the importance of working with a more refined and content based case conceptualization of the particular avoidant client is highlighted. Guidance in optimal emotional processing in order to transform layers of maladaptive emotion schemes present within the client with AVPD is provided. Supporting these clients’ full striving for life, and their capacity to self-soothe is also discussed. A case example illustrates application of the model and principles.     

Contemporary Directions in Theories and Psychotherapeutic Strategies in Treatment of Personality Disorders: Relation to Level of Personality Functioning

In this commentary on treatment strategies for personality disorders, we analyze each of the cases and the problem of low motivation in terms of how they fit with the Level of Personality Functioning scale. We then show how patients vary in terms of both level and breadth of pathology. Three of the articles describe patients who are severely impaired and strategies suggested are understood in terms of working with differentiation. The additional three articles present cases where patients have a higher level of personality functioning, and strategies are seen as interventions aimed at integration and improved adaptation. Based on this finding, we argue that the Level of Personality Functioning could be a useful assessment method for improving treatment selection. Finally, we raise questions and offer considerations regarding the understanding of empathy, low motivation and autobiographical memory in the cases presented.     

Adopting Metacognitive Interpersonal Therapy to Treat Narcissistic Personality Disorder with Somatization

Narcissistic personality disorder (NPD) is characterized by an intellectualizing narrative style, poor metacognition, maladaptive interpersonal schemas, a restricted set of states of mind, impaired agency and perfectionism. Metacognitive Interpersonal therapy targets these dysfunctions with a series of formalized procedures aimed at first forming a shared formulation of functioning which patients and therapists can then use to plan change. We describe here the core NPD pathology and illustrate the therapy process of a patient with NPD and a somatization disorder. Implications for treatment of NPD are discussed together with a call for empirical testing of therapies for this severe condition.     

Hitting the Bull’s Eye in Personality Disorders Psychotherapy

Psychotherapy of personality disorders (PD) is gaining momentum, though the progress has been mostly concerned borderline PD, with the other disorders largely neglected. In parallel, many empirically tested approaches focus on a limited understanding of psychopathology, for example poor mentalization or affect dysregulation, while PD are complex entities; they require clinicians paying attention to multiple therapy targets in order to be treated effectively and for a hope of actual recovery. I contend here that a more comprehensive account of psychopathology is needed; therefore the papers in this special issue focus on some of these aspects, such as difficulties in mental state understanding, dysfunctional representations of self with others, poor affect regulation and lack of access to adaptive and healthy self-aspects. The papers included in this special issue try and provide the readers with an intensive qualitative account of how therapists can act and yield improvements in these domains, with the hope of improving clinicians’ abilities to treat PD no matter what their preferred orientation is.     

Personality,self-regulated learning,and academic entitlement

The current study explored the relation between the Big-Five personality domains, self-regulated learning, and academic entitlement. Academic entitlement is defined as the tendency to possess expectations of unearned academic success, unearned/undeserved academic services, and/or the expectation of unrealistic accommodation (Chowning and Campbell in J Indiv Diff 101(4): 982, 2009; Singleton-Jackson et al. in Innov Higher Educ, 2010. doi: 10.1007/s10755-010-9151-y). Academic entitlement is a pervasive problem in today’s university environment (Twenge and Campbell in The narcissism epidemic: living in the age of entitlement. Simon and Schuster, New York, 2009), making it important to understand risk factors for academic entitlement. Previous research on academic entitlement has reported a relation between personality factors and academic entitlement (Chowning and Campbell 2009), and between academic entitlement and self-regulated learning (Achacoso 2002). The current study explores the relations among these three constructs from a multivariate perspective using canonical correlation analysis. Results suggested two significant canonical correlations that accounted for approximately 48% of the variance in the academic entitlement subscales.     

Fake Journals: Not Always Valid Ways to Distinguish Them

In their recent paper, Esfe et al. (Sci Eng Ethics, doi: 10.1007/s11948-014-9595-z 2014) present some criteria for fake journals and propose some ‘features’ to recognize them. While I share most of the authors’ concerns about this issue in general, some of the reported criteria are not fit to differentiate fake journals from genuine ones. Here are some examples derived from their list, which illustrate that such criteria are not necessarily specific to fake journals only, but they could also apply to well-established journals and, therefore, should not be considered as is.     

Against Hamri’s argument for the ultimate ground of being

In this paper, I reply to Hamri's (Int J Philos Relig.  https://doi.org/10.1007/s11153-017-9625-2, 2017) new kind of cosmological argument for the ultimate ground of being by blocking the argument in more than one place.     

No more than Conjectures: Popper and the Ethics of Scientific Enterprise

Karl Popper dealt with both problems Yurevich (Integrative Psychological and Behavioral Science, 43(2), 2009, doi: 10.1007/s12124-008-9082-7) deals: the crisis in Psychology and in the discourse about the nature of science. Although he failed to provide a complete response for both problems, his proposals can yet be fruitful to the reflection on these matters in the context of the present discussion. He offers some tentative answers to what could be considered a healthy epistemic activity, something Yurevich does not provide. More interestingly, some of the Popper proposals seem to fit, and in some extent correct, the quest for “collaborative work” proposed by Zittoun et al. (Integrative Psychological and Behavioral Science, 43(2), 2009, doi: 10.1007/s12124-008-9082-7) as a way of transforming crisis in development.     

Digging Deeper: Why Metaphysics is More Than a Toolbox

Steven French (J Gen Philos Sci,  https://doi.org/10.1007/s10838-018-9401-8, 2018) proposes a vindication of “scientifically disinterested” metaphysics that leaves little room to its original ambitions. He claims that (1) as a discipline that looks to find out truths about the world, it is untenable; and that (2) rather, its vindication lies in its use as a “toolbox” of concepts for a philosophical discipline that does have a claim at getting us closer to truth—the philosophy of science, and more specifically of physics. I respond to both his main claims. The first claim, I argue, neglects what I call (with Ralf Busse) “archaeological” metaphysics, which tries to impose some order on phenomena by “digging deeper” from the less to the more fundamental, or from the less to the more abstract questions. The second claim imposes a hierarchical relation between metaphysics and philosophy of science which should, I argue, be replaced with a more egalitarian picture of philosophy.     

Making Sense of Interlevel Causation in Mechanisms from a Metaphysical Perspective

According to the new mechanistic approach, an acting entity is at a lower mechanistic level than another acting entity if and only if the former is a component in the mechanism for the latter. Craver and Bechtel (Biol Philos 22(4):547–563, 2007. doi: 10.1007/s10539-006-9028-8) argue that a consequence of this view is that there cannot be causal interactions between acting entities at different mechanistic levels. Their main reason seems to be what I will call the Metaphysical Argument: things at different levels of a mechanism are related as part and whole; wholes and their parts cannot be related as cause and effect; hence, interlevel causation in mechanisms is impossible. I will analyze this argument in more detail and show under which conditions it is valid. This analysis will reveal that interlevel causation in mechanisms is indeed possible, if we take seriously the idea that the relata of the mechanistic level relation are acting entities and accept a slightly modified notion of a mechanistic level that is highly plausible in the light of the first clarification.     

Acoustic behavior associated with cooperative task success in bottlenose dolphins (<Emphasis Type="Italic">Tursiops truncatus</Emphasis>)

Although many species have proven capable of cooperating to achieve common goals, the role of communication in cooperation has received relatively little attention. Analysis of communication between partners is vital in determining whether actions are truly cooperative rather than serendipitous or learned via trial and error (Chalmeau and Gallo in Behav Process 35:101–111, 1996a. doi: 10.1016/0376-6357(95)00049-6, Primates 37:39–47, 1996b. doi: 10.1007/BF02382918). Wild cetaceans often produce sounds during cooperative foraging, playing, and mating, but the role of these sounds in cooperative events is largely unknown. Here, we investigated acoustic communication between two male bottlenose dolphins while they cooperatively opened a container (Kuczaj et al. in Anim Cogn 18:543–550, 2015b. doi: 10.1007/s10071-014-0822-4). Analyses of whistles, burst pulses, and bi-phonations that occurred during four contexts (i.e., no container, no animals interacting with container, one animal interacting with container, and two animals interacting with container) revealed that overall sound production rate significantly increased during container interactions. Sound production rates were also significantly higher during cooperative successes than solo successes, suggesting that the coordination of efforts rather than the apparatus itself was responsible for the phonation increase. The most common sound type during cooperative successes was burst pulse signals, similar to past recordings of cooperative events in bottlenose dolphins (Bastian in Animal sonar systems. Laboratoire de Physiologie Acoustique, Jouy-en Josas, pp 803–873, 1967; Connor and Smolker 1996).     

Effects of Monitoring and Social Reprimands on Instruction-Following in Undergraduate Students

The effects of the magnitude of nonverbal consequences, monitoring, and social consequences on instruction-following were evaluated. Twenty-four undergraduates were exposed to a matching-to-sample procedure. The undergraduates underwent four experimental phases that differed regarding the presence or absence of the observer and the correspondence or non-correspondence of the instructions with the nonverbal contingency. In Experiments 1 and 2, the magnitudes of the nonverbal consequences were manipulated, and in Experiment 3, the effects of verbal reprimands on instruction-following were evaluated. The results revealed that alterations in the magnitudes of nonverbal consequences did not influenced the performances of the participants and that monitoring increased the probability that the participants would follow the instructions but not to an extent sufficient to maintain performance when the consequences did not correspond to the nonverbal contingency. The inclusion of verbal reprimands was necessary to achieve this effect. These results support the proposition that social control is important for maintaining instruction-following.

     

The Measurement of Subjective Wellbeing: Item-Order Effects in the Personal Wellbeing Index—Adult

When multi-item questionnaires are included in psychological research, many factors can influence the response given. One such factor that has traditionally been overlooked is the potential impact of item-order effects. This paper extends upon the work of Kaplan et al. (J Happiness Stud 14:1443–1458, 2013. doi:  10.1007/s10902-012-9388-5) who explored item-order effects in measures of job satisfaction, and applies similar principles to the measurement of life satisfaction, or subjective wellbeing, by exploring item-order effects within the Personal Wellbeing Index (PWI; IWBG in Personal Wellbeing Index, 5th edn. Australian Centre on Quality of Life, Deakin University, Melbourne, 2013. http://www.deakin.edu.au/research/acqol/intruments/wellbeing-index/index.php). In a preliminary study, participants completed the PWI in its standard format (general-specific) and psychometric properties were compared to those who completed the PWI in an alternate format (specific-general). Analyses revealed that the PWI performed adequately for both groups, though there were subtle indications of item-order effects. In a second study, the order of the PWI domains was randomised (random-order) and compared to the standard format (fixed-order). Results revealed lower mean scores and more variation in scores when items were randomised. Overall, the PWI performed as expected for most interrogative analyses. It achieved a single factor solution, no matter the order of items, and the same domains emerged as significant unique predictors of general life satisfaction. The study highlights the importance of exploring item-order effects as part of the psychometric validation procedure, and it is recommended that all new scales be subject to this investigation to reduce measurement error and improve accuracy in psychological assessment.     

Moral Injury and Definitional Clarity: Betrayal,Spirituality and the Role of Chaplains

This article explores the developing definition of moral injury within the current key literature. Building on the previous literature regarding ‘Moral Injury, Spiritual Care and the role of Chaplains’ (Carey et al. in JORH 55(4):1218–1245, 2016b. doi: 10.1007/s10943-016-0231-x), this article notes the complexity that has developed due to definitional variations regarding moral injury—particularly with respect to the concepts of ‘betrayal’ and ‘spirituality’. Given the increasing recognition of moral injury and noting the relevance and importance of utilizing a bio-psycho-social-spiritual model, this article argues that betrayal and spirituality should be core components for understanding, defining and addressing moral injury. It also supports the role of chaplains being involved in the holistic care and rehabilitation of those affected by moral injury.     

Implementing Effective Educational Practices at Scales of Social Importance

Implementing evidence-based practices is becoming both a goal and standard across medicine, psychology, and education. Initial successes, however, are now leading to questions about how successful demonstrations may be expanded to scales of social importance. In this paper, we review lessons learned about scaling up evidence-based practices gleaned from our experience implementing school-wide positive behavioral interventions and supports (PBIS) across more than 23,000 schools in the USA. We draw heavily from the work of Flay et al. (Prev Sci 6:151–175, 2005. doi: 10.1007/s11121-005-5553-y) related to defining evidence-based practices, the significant contributions from the emerging “implementation science” movement (Fixsen et al. in Implementation research: a synthesis of the literature, University of South Florida, Louis de la Parte Florida Mental Health Institute, The National Implementation Research Network (FMHI Publication #231), Tampa 2005), and guidance we have received from teachers, family members, students, and administrators who have adopted PBIS.     

Hierarchical Diagnostic Classification Models Morphing into Unidimensional ‘Diagnostic’ Classification Models—A Commentary

This commentary addresses the modeling and final analytical path taken, as well as the terminology used, in the paper “Hierarchical diagnostic classification models: a family of models for estimating and testing attribute hierarchies” by Templin and Bradshaw (Psychometrika, doi:10.1007/s11336-013-9362-0, 2013). It raises several issues concerning use of cognitive diagnostic models that either assume attribute hierarchies or assume a certain form of attribute interactions. The issues raised are illustrated with examples, and references are provided for further examination.     

Response to Pashler et al. (2016)

Pashler, Rohrer, Abramson, Wolfson, and Harris (2016/this issue) in their critique of Chatterjee, Rose, and Sinha (2013 Chatterjee, P., Rose, R., &; Sinha, J. (2013). Why money meanings matter in decisions to donate time and money. Marketing Letters, 24, 109–118. doi:10.1007/s11002-012-9215-0[Crossref], [Web of Science ®] , [Google Scholar]) data argue that (a) large effect sizes in Study 1 and Study 2 undermine the credibility of the data; (b) in a lexical task that is part of Study 3, a concentration of participants in (5,0) and (0,5) benefit/cost word data points and the similarity of 9 neutral word responses at these points are extremely unlikely; and (c) there are apparent errors in the execution of Study 3. In this response, I examine these issues in detail. A recent review of money prime literature (Vohs, 2015 Vohs, K. (2015). Money priming can change people’s thoughts, feelings, motivations, and behaviors: An update on 10 years of experiments. Journal of Experimental Psychology: General, 144(4), e86–e93. doi:10.1037/xge0000091[Crossref], [PubMed], [Web of Science ®] , [Google Scholar]) notes many effect sizes that are as big as or bigger than ours. Although 8 coding errors were discovered in Study 3 data and this particular study has been retracted from that article, as I show in this article, the arguments being put forth by the critics are untenable. For instance, my analysis shows that results hold even without the concentration of (5,0) and (0,5) participants, and I offer statistical simulations to counter critics’ arguments. Regarding the apparent errors in Study 3, I find that removing the target word stems SUPP and CE do not influence findings in any way. I also report findings from MacDonnell and White (2015 MacDonnell, R., &; White, K. (2015). How construals of money versus time impact consumer charitable giving. Journal of Consumer Research, 42, 551–563. doi:10.1093/jcr/ucv042[Crossref] , [Google Scholar]), who replicate the basic finding of Chatterjee et al. in a different context.     

Further evidence in favor of prior entry from endogenous attention to a location in space

Titchener’s (1908) law of prior entry states that “the object of attention comes to consciousness more quickly than the objects which we are not attending to,” or otherwise, that attended stimuli are perceived earlier than unattended stimuli. Shore, Spence, and Klein (Psychological Science, 12, 205–212. doi: 10.1111/1467-9280.00337, 2001) showed that endogenous visuospatial orienting does in fact elicit prior-entry effects, albeit to a smaller degree than does exogenous visuospatial orienting. In disagreement with this finding, Schneider and Bavelier (Cognitive Psychology, 47, 333–366. doi: 10.1016/S0010-0285(03)00035-5, 2003) found no effect of their instruction to attend. They concluded that nonattentional effects could masquerade as prior entry, which could account for findings such as those in Shore et al.’s endogenous condition. We investigated this empirical and theoretical discord by replicating the temporal-order judgment task used by Shore, Spence, and Klein, while manipulating and measuring endogenous orienting by way of an orthogonal color probe task. We showed evidence of prior entry as a consequence of endogenous orienting, supporting the conclusions of Shore, Spence, and Klein.     

A Patchier Picture Still: Biases,Beliefs and Overlap on the Inferential Continuum

It has been proposed that, whilst implicit attitudes, alike beliefs, are propositionally structured (Mandelbaum Noûs, 50(3), 629–658, 2016), the former respond to evidence and modulate other attitudes in a fragmented manner, and so constitute a sui generis class, the “patchy endorsements” (Levy Noûs, 49(4), 800–823, 2015). In the following, I demonstrate that the patchy endorsements theorist is committed to the truth of two claims: (i) no implicit attitude is responsive to content to the same extent as any belief; and (ii) there is a significant gap between the most responsive implicit attitude and the least responsive belief. I argue that both (i) and (ii) fail to hold. Many implicit attitudes respond to evidence and modulate other attitudes. Meanwhile, at least some ordinary beliefs exhibit lower evidence-responsiveness and inferential efficacy than at least some implicit attitudes, defeating (i) and (ii). A better interpretation is that attitudes may be ordered along a continuum according to their responsiveness to content. At one extreme end, we find attitudes usually identified as implicit, and at the other, attitudes usually identified as beliefs, but in the middle, there is an area of overlap. I consider the consequences of the continuum view for existing folk psychological concepts.