Three preparatory studies for promoting implementation of outpatient schema therapy for borderline personality disorder in general mental health care

ObjectiveThree studies were conducted to prepare for the implementation of Schema Therapy (ST) for Borderline Personality Disorder (BPD) in general mental healthcare settings. Two were surveys to detect promoting and hindering factors, one was a preliminary test of a training program in ST.MethodsIn 2004, a diagnostic analysis of factors promoting and hindering implementation of a new treatment for BPD was conducted among both managers (n = 23) and therapists (n = 49) of 29 Dutch mental healthcare institutes through a written survey (Study 1). Next, a training program, including a set of DVDs displaying the major therapeutic techniques, was developed and tested among eight therapists. The training program was evaluated by the participants. After the training, three independent raters evaluated therapists' adherence and competence, viewing videos of the therapists completing structured role-plays (Study 2). In 2008, a second written survey was conducted in 22 mental health institutes to study factors for future nationwide implementation of ST (Study 3).ResultsBoth surveys indicated that the situation in most institutes was favorable for implementing a new effective treatment, as participants were not satisfied with the existing treatments, had suitable professional backgrounds, worked in settings with (B)PD-oriented care programs, and expressed a need for change. The surveys yielded clear results for promoting or hindering successful implementation of ST. Promoting factors included scientific evidence for the effectiveness of the treatment, structural changes in the patient's personality, rapidly noticeable effects for the patient, low drop-out rates and a favorable cost-effectiveness. Possible barriers included implementation mandated unilaterally by management, choosing ST based on financial or organizational needs, extending implementation over a lengthy period of time and providing telephone support by therapists beyond office hours. The eight-day training program received very positive ratings. After the training, therapists were rated as sufficiently adherent and competent applying ST to treat BPD patients, with peer supervision and supervision recommended as a supplement to the training.ConclusionThis study showed that the situation in 2005 was advantageous to start implementation of ST. Evaluation of the training and the achieved competence scores of trainees concluded that the training program was a good basis for training therapists in ST. Outcome of the survey in 2008 demonstrated that there was a clear interest for implementation of ST for BPD patients in the future.     

Majority and minority influence in group negotiation: the moderating effects of social motivation and decision rules

In organizational groups, often a majority has aligned preferences that oppose those of a minority. Although such situations may give rise to majority coalitions that exclude the minority or to minorities blocking unfavorable agreements, structural and motivational factors may stimulate groups to engage in integrative negotiation, leading to collectively beneficial agreements. An experiment with 97 3-person groups was designed to test hypotheses about the interactions among decision rule, the majority's social motivation, and the minority's social motivation. Results showed that under unanimity rule, minority members block decisions, thus harming the group, but only when the minority has proself motivation. Under majority rule, majority members coalesce at the minority's expense, but only when the majority has a proself motivation. Implications for negotiation research and group decision making are discussed.     

Patterns of adaptation in obsessive-compulsive disorder: multivariate indicators of greater variability and linear change compared to controls

Patterns of adaptation to conflict in persons with Obsessive-Compulsive Disorder were assessed with the Serial Color-Word Test. Obsessive-Compulsive patients (n=50) were compared with an age- and sex-matched group of nonclinical volunteers. Measures of linear and nonlinear change in reading times during each of the five consecutive trials of the test were compared between groups by means of a multivariate model with doubly repeated measures. The multivariate analysis yielded a significant between-groups result (Wilks Lambda = .76, p < .001), mainly supported by higher values of nonlinear change in the Obsessive-Compulsive group. Thus, the discriminative ability of the Serial Color-Word Test was confirmed when individual differences were removed from the error term.     

Understanding the Veiling of Muslim Women in the Netherlands

In this study we analyze veiling as an Islamic religious practice among Turkish and Moroccan immigrant women in the Netherlands, investigating whether the strength of religious identity, education, contact with natives, and gender role attitudes can explain who veils and who does not. Confirming stereotypical interpretations of the veil as a religious symbol of a strongly gendered religion, we find that a strong Muslim identity and traditional gender role attitudes are positively associated with veiling. While our results seem to support predictions that contact with natives and education relate negatively with wearing a headscarf, these relationships with veiling are more complex. Education strengthens the positive relation between religious identification and veiling, indicating that most highly educated women endorse veiling as a religious practice if they are more religious. Contact with Dutch, however, weakens the association between religious identification and veiling, meaning socially well integrated women veil less often even if they are religious. We discuss our findings against the background of previous qualitative research on veiling as a religious practice and regarding theories on immigrant religion in Europe.     

A Pilot Study Addressing the Impact of Religious Practice on Quality of Life of Breast Cancer Patients During Chemotherapy

The aim of this preliminary study was to investigate whether religious practice can modify quality of life (QoL) in BC patients during chemotherapy. QoL and religion practice questionnaire (RPQ) scores were evaluated in a sample of BC patients in different moments. Before chemotherapy initiation, women with lower physical and social functional scores displayed higher RPQ scores. On the other hand, low RPQ patients worsened some QoL scores over time. Body image acceptance was positively correlated with religious practice and specifically praying activity. This preliminary study suggests the importance of religion in coping with cancer chemotherapy.     

A Protocol for Improving Loneliness in People with Multiple Sclerosis

Loneliness is a subjective and unpleasant emotional state that occurs when people feel social networks or social relationships are deficient in some way. People with multiple sclerosis are often lonely and frequently withdraw from participating in meaningful social activities. Common symptoms, such as cognitive changes, decreased physical functioning, fatigue, incontinence, visual changes, or depression, may contribute to decreased social participation, which can lead to loneliness. This article presents an intervention protocol for improving loneliness in people with multiple sclerosis. This protocol is based on Bandura’s Social Learning Theory, which focuses on improving self-efficacy to reduce loneliness in people with multiple sclerosis.     

God image and mood in old age: Results from a community-based pilot study in the Netherlands

Religious involvement is frequently found to be associated with less depression in later life. The emotional aspects of religiousness, such as pertaining to the God–object relationship, have not received substantial attention in empirical research among older adults, and especially not in European samples. As part of a pilot study of the Longitudinal Aging Study Amsterdam, a small sample of older church-members (n?=?60), aged 68–93, filled out a questionnaire, including the Questionnaire God Image on feelings to God and perceptions of God, two of the God Image Scales designed by Lawrence on perceptions of God, the brief positive and negative religious coping scale designed by Pargament, and items on hopelessness, depressive symptoms, and feelings of guilt. Feelings of discontent towards God correlated positively with hopelessness, depressive symptoms, feelings of guilt, and also with depressive symptoms assessed 13 years earlier; these findings pertained to Protestant participants in particular. Most facets of God image, positive, critical, and about punishment reappraisals, were associated with more feelings of guilt. A possible explanation for the most pervasive finding, that feelings of discontent towards God are related to depressive symptoms, is that both, throughout life, remain rooted in insecure attachment styles.     

When (not) to empathize: The differential effects of combined emotion recognition and empathic concern on client satisfaction across professions

Motivation and Emotion - Previous research found inconsistent associations between individuals’ emotion recognition ability and their work-related outcomes. This research project focuses on...     

Linguistic and Perceptual Mapping in Spatial Representations: An Attentional Account

Building on evidence for embodied representations, we investigated whether Spanish spatial terms map onto the NEAR/FAR perceptual division of space. Using a long horizontal display, we measured congruency effects during the processing of spatial terms presented in NEAR or FAR space. Across three experiments, we manipulated the task demands in order to investigate the role of endogenous attention in linguistic and perceptual space mapping. We predicted congruency effects only when spatial properties were relevant for the task (reaching estimation task, Experiment 1) but not when attention was allocated to other features (lexical decision, Experiment 2; and color, Experiment 3). Results showed faster responses for words presented in Near‐space in all experiments. Consistent with our hypothesis, congruency effects were observed only when a reaching estimate was requested. Our results add important evidence for the role of top‐down processing in congruency effects from embodied representations of spatial terms.