Alliance rupture and repair processes in borderline personality disorder: A case study using dialogical sequence analysis

Objective: This study examined alliance rupture and repair processes in borderline personality disorder (BPD) and how the content of sessions interacts with the quality of the alliance.

Design: A mixed methods single case study design was employed incorporating quantitative and qualitative measures of process and outcome.

Methods: This case study examined a 22-year-old female with BPD who received 16 sessions of Cognitive Analytic Therapy. Measures of alliance, symptoms and global functioning were taken across multiple time-points. Selected sessions were analysed using dialogical sequence analysis (DSA), a theory-driven method of psychotherapy research that analyses utterances according to their author, addressee and referential object.

Results: Quantitative data indicated symptom reduction without functional improvement. DSA demonstrated that the first exchanges in therapy were reflective of key relational themes. The case suggests that, rather than simply negotiating tasks and goals, repairing ruptures involves systematically linking the manifest topic to the client’s core problems.

Conclusions: This case study points to the mediating role that the content of sessions has on alliance quality. Results underline the importance of the therapist stance, the need for a shared formulation to make sense of relational processes and the use of responsively timed interventions to decrease desperation and improve self-reflection.     

Non-Suicidal Self-Injury Among Male Adjudicated Adolescents: Psychosocial Concerns,Coping Responses,Diagnoses, and Functions

Non-suicidal self-injury (NSSI) refers to self-inflicted physical injury without suicidal intent. NSSI is particularly common in forensic settings and associated with several psychosocial concerns, coping responses, diagnoses, and functions, but little information is available regarding NSSI in adjudicated male adolescents. The present study examined the frequency and types of NSSI among adjudicated male adolescents (n?=?103) and assessed the relationships between NSSI history, psychosocial concerns, coping responses, diagnoses, and functions within this population. Approximately two-thirds (66%) reported NSSI history. Participants with NSSI history reported poorer social adaptation and greater alienation and boredom, aggression, and emotional lability than controls. Youth with high-frequency NSSI were also more likely to utilize emotional discharge as an unhealthy coping response than controls. In addition, participants with high-frequency NSSI were more likely than controls to meet criteria for a mood or anxiety disorder. Function of NSSI primarily surrounded anxiety reduction/affect regulation, punishment, dissociation reduction, and social/sensation-seeking. NSSI appears to be prevalent among male adjudicated youths, and the findings suggest that the relationship between NSSI history, psychosocial concerns, coping responses, and functions is nuanced and could inform more calibrated assessment and treatment strategies.     

Taxonomy of Psychological and Social Disturbances in Survivors of Group Psychological Abuse

The purpose of this study was to delimit the psychological and social disturbances that individuals who have suffered psychological abuse within a social group on an ongoing basis can experience. A comprehensive classification of these disturbances was developed based on a review of the scientific literature. Its content was revised by an international panel of 38 experts on the topic. Experts also judged the frequency and intensity with which each disturbance is commonly experienced by survivors of abusive groups. The taxonomy, which includes 20 components classified into four main categories, showed adequate content validity. The components considered the most frequent and intense were related to emotional difficulties, followed by those associated with relational and social integration difficulties, cognitive difficulties, and, finally, other specific problematic behaviors. Operationalizing and classifying the specific psychological and social disturbances commonly experienced by survivors of abusive groups contributes to a better delimitation of the phenomenon. Likewise, it contributes to the understanding of the long-term effects of psychological abuse, which is useful in both the academic and clinical settings.     

Revisiting a meta-analysis of helpful aspects of therapy in a community counselling service

This small scale mixed methods study examines helpful events in a community counselling setting, categorising impacts of events according to Timulak’s [(2007). Identifying core categories of client-identified impact of helpful events in psychotherapy: A qualitative meta-analysis. Psychotherapy Research, 17, 305–314] meta-synthesis of significant events research. Comparisons were made between the types of impacts reported as helpful by clients receiving cognitive behavioural therapy (CBT) or relational integrative counselling. Seventy-five clients identified 291 significant events on 216 Helpful Aspects of Therapy (HAT) forms. The findings broadly reflect all nine impacts identified by Timulak (2007). The study also suggests that a potential new category, ‘voicing’ may exist. Differences between the types of impacts reported as helpful by clients in CBT and integrative therapy showed a higher percentage of CBT clients reporting ‘behavioural change/problem solution’, ‘reassurance’ and ‘client involvement’ as helpful. Differences in other categories were not statistically significant.     

Misrecollection prevents older adults from benefitting from semantic relatedness of the memoranda in associative memory

Memory for episodic associations declines in aging, ostensibly due to decreased recollection abilities. Accordingly, associative unitization - the encoding of associated items as one integrated entity - may potentially attenuate age-related associative deficits by enabling familiarity-based retrieval, which is relatively preserved in aging. To test this hypothesis, we induced bottom-up unitization by manipulating semantic relatedness between memoranda. Twenty-four young and 24 older adults studied pairs of object pictures that were either semantically related or unrelated. Participants subsequently discriminated between intact, recombined and new pairs. We found that semantic relatedness increased the contributions of both familiarity and recollection in young adults, but did not improve older adults' performance. Instead, they showed associative deficits, driven by increased recollection-based false recognition. This may reflect a “misrecollection” phenomenon, in which older adults make more false alarms to recombined pairs with particularly high confidence, due to poorer retrieval monitoring regarding semantically-related associative probes.     

Long-term meditation: the relationship between cognitive processes,thinking styles and mindfulness

The aim of this study is to examine the relationship between meditation and cognitive functions. More in depth the purpose is to demonstrate that long-term meditation practice improves attention skills and cognitive flexibility. Eighteen long-term meditation practitioners were compared to a matched control group, who never practiced meditation. Each subject was tested, using computerized software (Presentation Software 9.90), which measured: attention, visual search abilities, working memory and Stroop’s interference tasks. Furthermore, we examined the relationship between long-term meditation practice, mindfulness skills and thinking styles, namely styles of processing information. The results showed significant differences between the two groups, demonstrating that long-term meditation is linked to improvements of attentional functions, working memory and cognitive flexibility.     

Action observation produces motor resonance in Parkinson's disease

Observation of movement activates the observer's own motor system, influencing the performance of actions and facilitating social interaction. This motor resonance is demonstrated behaviourally through visuomotor priming, whereby response latencies are influenced by the compatibility between an intended action and an observed (task‐irrelevant) action. The impact of movement disorders such as Parkinson's disease (PD) on motor resonance is unclear, as previous studies of visuomotor priming have not separated imitative compatibility (specific to human movement) from general stimulus‐response compatibility effects. We examined visuomotor priming in 23 participants with mild‐to‐moderate PD and 24 healthy older adults, using a task that pitted imitative compatibility against general stimulus‐response compatibility. Participants made a key press after observing a task‐irrelevant moving human finger or rectangle that was either compatible or incompatible with their response. Imitative compatibility effects, rather than general stimulus‐response compatibility effects, were found specifically for the human finger. Moreover, imitative compatibility effects did not differ between groups, indicating intact motor resonance in the PD group. These findings constitute the first unambiguous demonstration of imitative priming in both PD and healthy ageing, and have implications for therapeutic techniques to facilitate action, as well as the understanding of social cognition in PD.     

I feel you feel what I feel: Perceived perspective‐taking promotes victims' conciliatory attitudes because of inferred emotions in the offender

In the context of bullying in a nursing workplace, we test the argument that an offender's perspective‐taking promotes victim conciliation, mediated by perceived perspective‐taking, that is, the extent to which the victim perceives the offender as taking their perspective. Perceived perspective‐taking facilitates the attribution of moral emotions (remorse, etc.) to the offender, thereby promoting conciliatory victim responses. However, perceived perspective‐taking would be qualified by the extent to which the severity of consequences expressed in the offender's perspective‐taking matches or surpasses the severity for the victim. In Studies 1 and 2 (Ns = 141 and 122, respectively), victims indicated greater trust and/or forgiveness when the offender had taken the victim's perspective. This was sequentially mediated by perceived perspective‐taking and victim's inference that the offender had felt moral emotions. As predicted, in Study 2 (but not Study 1), severity of consequences qualified victims' perceived perspective‐taking. Study 3 (N = 138) examined three potential mechanisms for the moderation by severity. Victims attributed greater perspective‐taking to the offender when the consequences were less severe than voiced by the offender, suggesting victims' appreciation of the offender's generous appraisal. Attributions of perspective‐taking and of moral emotions to the offender may play an important role in reconciliation processes. Key outcome: To the extent that victims perceive the offender as taking their perspective (perceived perspective‐taking), they infer that the offender feels more moral emotions, prompting victims to be more conciliatory. Perceived perspective‐taking benefits from the offender over‐stating the consequences to the victim.     

Merleau‐Ponty on painting and the problem of reflection

The challenge of “catching experience in the act” is commonly recognized as a problem for phenomenological reflection. After tracing this “problem of reflection” to its origin in Natorp's Allgemeine Psychologie and discussing Husserl's critical response, I argue that Merleau‐Ponty recognizes that a version of it poses a genuine problem for phenomenology in the form of what he calls “objective thought.” Seen in light of his concern for the distortion of objective thought, his attention to indeterminacy and distortion in the portraits and still lifes of Cézanne takes on philosophical significance. I analyze how Merleau‐Ponty sees phenomenological concepts such as style, horizons, and coherent deformation at work in a number of paintings and suggest how such features remedy objective thought by resisting the tendency for reflection on ordinary perception to mistake objective properties of objects for properties of the experience in which they are given.