Stability and Change in Personality Disorder

ABSTRACT— The standard view of personality disorder is that it is a maladaptive expression of personality traits, which are relatively stable and unchanging. Thus, personality disorder has been considered to have its roots in childhood and adolescence, to persist in adulthood, and to be difficult to change. However, recent research has challenged this view, revealing that personality continues to change, albeit more slowly, well into adulthood, and that the maladaptive manifestations of personality disorder are much less stable than previously believed. These research findings are described, and factors that influence stability and change in personality disorder are discussed. The emerging view of personality disorder has important implications for diagnosis, assessment, and treatment of personality pathology.     

Improving access to psychological therapy: Initial evaluation of two UK demonstration sites

Recently the UK Government announced an unprecedented, large-scale initiative for Improving Access to Psychological Therapies (IAPT) for depression and anxiety disorders. Prior to this development, the Department of Health established two pilot projects that aimed to collect valuable information to inform the national roll-out. Doncaster and Newham received additional funds to rapidly increase the availability of CBT-related interventions and to deploy them in new clinical services, operating on stepped-care principles, when appropriate. This article reports an evaluation of the new services (termed ‘demonstration sites’) during their first thirteen months of operation. A session-by-session outcome monitoring system achieved unusually high levels of pre to post-treatment data completeness. Large numbers of patients were treated, with low-intensity interventions (such as guided self-help) being particularly helpful for achieving high throughput. Clinical outcomes were broadly in line with expectation. 55-56% of patients who had attended at least twice (including the assessment interview) were classified as recovered when they left the services and 5% had improved their employment status. Treatment gains were largely maintained at 10 month follow-up. Opening the services to self-referral appeared to facilitate access for some groups that tend to be underrepresented in general practice referrals. Outcomes were comparable for the different ethnic groups who access the services. Issues for the further development of IAPT are discussed.     

Mixed effects modeling of Morris water maze data: Advantages and cautionary notes

Morris water maze data are most commonly analyzed using repeated measures analysis of variance in which daily test sessions are analyzed as an unordered categorical variable. This approach, however, may lack power, relies heavily on post hoc tests of daily performance that can complicate interpretation, and does not target the nonlinear trends evidenced in learning data. The present project used Monte Carlo simulation to compare the relative strengths of the traditional approach with both linear and nonlinear mixed effects modeling that identifies the learning function for each animal and condition. Both trend-based mixed effects modeling approaches showed much greater sensitivity to identifying real effects, and the nonlinear approach provided uniformly better fits of learning trends. The common practice of removing a rat from the maze after 90 s, however, proved more problematic for the nonlinear approach and produced an underestimate of y-axis intercepts.     

Talking about others: Emotionality and the dissemination of social information

There is evidence that we may be more likely to share stories about other people to the extent that they arouse emotion. If so, this emotional social talk may have important social consequences, providing the basis for many of our social beliefs and mobilising people to engage or disengage with the targets of the talk. Across three studies, we tested the situated communicability of emotional social information by examining if the ability of emotionality to increase communicability would depend on the emotion that was aroused and the identity of the audience. Study 1 showed that participants were more willing to share social anecdotes that aroused interest, surprise, disgust and happiness with an unspecified audience. Study 2 provided a behavioural replication of these findings. Study 3 showed that the communicability of emotional social talk did vary with audience identity (friend or stranger). Together, these findings suggest that emotional social events (particularly those that arouse disgust and happiness) are likely to become part of a society's social beliefs, with important consequences for the structure of social relationships. Copyright © 2008 John Wiley & Sons, Ltd.     

Suppose Freud had chosen Orestes instead

Abstract :  The paper argues that the story of Oedipus, however understood, conveys psychic truth of no greater or more central importance to human development than do the stories of many other myths. A distinction is made between sophisticated theories developed out of Freud's original concept of the Oedipus complex, and the adherence by some clinicians to his original sexual theory. The meaning of Sophocles' play Oedipus the King is found to lie in the clash between Oedipus' omnipotent narcissism ( hubris) and the power of the unconscious psyche, rather than in cross-generational sex. Emphasis is placed on the clinical usefulness of understanding all myths symbolically. The Oresteia by Aeschylus is offered as a story about pre-Oedipal (in the Freudian sense) psychic states. This trilogy shows symbolically the developing of an ego, the establishment of moral judgement and the integration of our shadow (the Furies). It also shows the parallel development of structures of law in society to replace instinctive blood feuds. It is suggested that had Freud chosen Orestes instead of Oedipus, the course of both psychoanalysis and of Western society would have had a different emphasis.     

A semantics-based approach to the "no negative evidence" problem

Previous studies have shown that children retreat from argument-structure overgeneralization errors (e.g., * Don't giggle me ) by inferring that frequently encountered verbs are unlikely to be grammatical in unattested constructions, and by making use of syntax-semantics correspondences (e.g., verbs denoting internally caused actions such as giggling cannot normally be used causatively). The present study tested a new account based on a unitary learning mechanism that combines both of these processes. Seventy-two participants (ages 5–6, 9–10, and adults) rated overgeneralization errors with higher (* The funny man's joke giggled Bart ) and lower (* The funny man giggled Bart ) degrees of direct external causation. The errors with more-direct causation were rated as less unacceptable than those with less-direct causation. This finding is consistent with the new account, under which children acquire—in an incremental and probabilistic fashion—the meaning of particular constructions (e.g., transitive causative = direct external causation) and particular verbs, rejecting generalizations where the incompatibility between the two is too great.