A systematic review of the effectiveness of psychoanalysis,psychoanalytic and psychodynamic psychotherapy with adults with intellectual and developmental disabilities: progress and challenges

Objectives: This systematic review aimed to critically appraise the literature on the efficacy and effectiveness of psychoanalysis, psychoanalytic and psychodynamic psychotherapy in adults with intellectual and developmental disabilities (IDD). Method: A systematic search of electronic databases was carried out. The methodological quality of the studies was assessed using a quality assessment tool and comparisons were made with a review of the quality of research on the effectiveness of cognitive behavioural therapy (CBT) for people with IDD. Results: The search yielded 13 papers which provided evidence for the effectiveness but not efficacy of psychoanalytic and psychodynamic psychotherapy; but none were found for psychoanalysis. The quality of the research was generally poor compared to the current research on the effectiveness of CBT. Conclusions: Positive outcomes have been indicated for psychoanalytic and psychodynamic psychotherapy with people with IDD. Larger scale, more controlled research is necessary to advance the evidence base.     

Envy: the canker in the bud

This paper explores the relevance of the concept of moral masochism as a response to early trauma and the implications of this for psychotherapy.

Consideration is given to early conceptualisations of moral masochism within the psychoanalytic literature, in particular, the move from drive theory to object relations. More recent developments in relation to trauma and defences, such as disassociation, are explored. It is suggested that a more complex and fuller understanding requires thinking about the subtle and shifting interaction of both these levels. This allows the possibility of building a more nuanced understanding which can look at both behaviour, as described in the trauma literature, and meaning which is the core of a more classical psychoanalytic approach.

Case histories are used to illustrate the linkages between moral masochism and trauma and the transference and countertransference dynamics and challenges involved. Progress varied in these cases, with both positive and negative outcomes. This theoretical background is used to suggest why this may be so.     

Body image variability: the influence of body-composition information and neuroticism on young women's body dissatisfaction

The current studies consider the effect of body size, body composition feedback, and the moderating influence of neuroticism (N) on three measures of body dissatisfaction (BD) in young women. In Study One, normal-sized subjects who were given false feedback indicating that they were either fatter or leaner than average showed heightened BD compared to groups who received either accurate or no feedback about body size. There was no evidence of a moderating effect of N. In Study Two, thinner-than-average subjects who received accurate body-size feedback showed greater satisfaction than a control group receiving no information. For heavier than average subjects, feedback only increased BD for those low on N. Although these results show mixed support for N as a moderator, they are the first to show an effect of body composition information on BD.     

The relevance of being “on the same page” to succeed as a project team: A moderated mediation model

Taking a motivational approach, this study deepens the role of team members’ shared understanding of the work to be done in a project team setting. More specifically, the goal of this study is to test a second stage moderated mediation model in which the mediating role of team members’ proactive behavior in the relationship between perceived shared understanding and team performance is moderated by team adaptability. Based on a multisource and multimethod approach, data were collected from 111 teams of undergraduate and graduate students (521 participants) participating in a project management simulation. Results support the hypothesized moderated mediation model. Indeed, the results indicate that the relationship between perceived shared understanding and team performance is mediated by proactive behavior. The results also show that the relationship between proactive behavior and team performance is moderated by team adaptability. Overall, results reveal that the indirect effect of perceived shared understanding on team performance is moderated by team adaptability, such that this indirect effect is stronger when the level of team adaptability is high. In terms of practical implications, the study highlights the importance of fostering the perception of being “on the same page” in order to motivate members to be proactive and to enhance project team performance.     

The respective role of low and high spatial frequencies in supporting configural and featural processing of faces

One distinctive feature of processing faces, as compared to other categories, is thought to be the large dependence on configural cues such as the metric relations among features. To test the role of low spatial frequencies (LSFs) and high spatial frequencies (HSFs) in configural and featural processing, subjects were presented with triplets of faces that were filtered to preserve either LSFs (below 8 cycles per face width), HSFs (above 32 cycles per face width), or the full frequency spectrum. They were asked to match one of two probe faces to a target face. The distractor probe face differed from the target either configurally, featurally, or both featurally and configurally. When the difference was at the configural level, performance was better with LSF faces than with HSF faces. In contrast, with a featural difference, a strong performance advantage was found for HSF faces as compared to LSF faces. These results support the dominant role that LSFs play in the configural processing of faces, whereas featural processing is largely dependent on HSFs.     

Through their own eyes: a media-based group approach to adolescent trauma

This paper describes the process of two groups of students from high schools located in the immediate vicinity of the World Trade Center grappling to make sense of the events of September 11 through the creation of a documentary chronicling their experiences. The process of creating these videos mirrored the process and curative factors of a psychotherapy group in a non-stigmatizing, innovative, and accessible format, one generated by the students themselves with the assistance of professionals in the visual and performing arts. After reviewing the literature on the potential impact of violence on adolescents and the use of group treatment, especially in school settings, as an optimal choice for this population, we describe the distinctive process of the two separate groups of students, each culminating in different expressions of their very personal experience of September 11. We understand and contextualize their process through the lens of the therapeutic dynamics and elements of group work.     

A Trait‐Interpersonal Analysis of Suicide Proneness Among Lesbian,Gay, and Bisexual Community Members

Suicide remains a concerning issue for lesbian, gay, and bisexual (LGB) persons. The integrated effects of five‐factor model personality traits and interpersonal‐psychological theory of suicide (IPTS) constructs on suicide proneness in a community sample of 336 LGB adults were examined. Results supported a model inclusive of all five‐factor model domains predicting IPTS constructs leading to suicide proneness. Effects of neuroticism and extraversion were both mediated by perceived burdensomeness and thwarted belongingness. Thwarted belongingness mediated the effect of agreeableness on suicide proneness. Identified mediation pathways build on existing trait‐interpersonal theory and may inform clinical services for sexual minority persons.     

Investigating Correlates of Suicide Among Male Youth: Questioning the Close Affinity Between Suicide Attempts and Deaths

This study was based on a sample of male high school students who completed National Longitudinal Adolescent Health Surveys in 1994, 1995, and 2001. We studied these students prospectively, comparing those who later died by suicide (n = 21) with those who were still living (n = 10,101). We employed chi‐square and analysis of variance tests for statistical significance between suicide decedents and living respondents. Results showed suicide decedents were more likely to have experienced the suicide loss of another family member, to have been expelled from school, to have engaged in more delinquent actions including fighting, and to have greater involvement with the criminal justice system. Although one might have expected suicide casualties to have exhibited a greater amount of suicidal thoughts, attempts, and higher incidences of suicidality among their friends, our analyses did not find that these factors were associated with actual suicides. Should these findings be replicated, this would point to a need to refine youth suicide risk assessments. Collecting life histories, as well as identifying patterns of delinquency and fighting, may serve as more potentially fruitful means for assessing genuine suicide risk than some traditional risk assessment methods.z     

A meta-analysis of the relationship between moral disengagement and bullying roles in youth

Over the last several years, researchers have become increasingly interested in the influence of moral factors on bullying behaviors. This is the first meta-analytic review to exclusively examine the relationship between moral disengagement (MD) and the key bullying roles of bully, victim, defender, and bystander. Forty-seven independent samples examining a total of 43,809 children/adolescents (aged 7–19) were included in this meta-analysis. Results indicated a positive relationship between MD and bullying (r = 0.31; 95% CI [0.27, 0.34]), MD and victimization (r = 0.08; 95% CI [0.05, 0.12]), and a negative relationship between MD and defending (r = −0.11; 95% CI [−0.17, −0.04]). No significant relationship was found for MD and bystanding behavior. Moderators of bullying type (traditional vs. cyberbullying), reporting type (self vs. peer report), age, and gender were included in the analyses. The results are discussed in the context of relevant literature with particular emphasis on the importance of distinguishing between guilty and unconcerned bystanders, and the significant overlap between bullying and victimization in the cyber context.