Changes in schemas of patients with severe borderline personality disorder: The Oulu BPD study

Borderline personality disorder (BPD) is a relatively common and severe psychiatric disorder that can impair quality of life in many ways. The aim of this study was to determine whether a combined treatment model for BPD patients, utilising major principles from schema‐focused therapy (SFT) and dialectical behavioral therapy (DBT), could be more effective in relieving early maladaptive schemas of BPD patients, compared to treatment as usual (TAU). This study is a part of the Oulu BPD study conducted at mental health care services run by Oulu city social and health care services. The study is a multisite, randomized controlled trial conducted over a one year period, involving two groups of patients with severe BPD: (1) Community Treatment By Experts (CTBE) patients (n = 18) receiving the combined treatment model, and 2) TAU patients (n = 27). The patients' schemas were assessed using the Young Schema Questionnaire (YSQ‐L3a) before and after one year of treatment. The results reveal that CTBE patients who attended the combined treatment model showed a statistically significant reduction in eight out of 18 early maladaptive schemas, while patients receiving treatment as usual did not demonstrate any significant changes in schemas. The cognitive therapeutic treatment model can be applied for clinical use in public mental health settings using existing professionals, and appears to produce positive changes in patients with BPD.     

The Swedish Hayling task,and its relation to working memory,verbal ability,and speech‐recognition‐in‐noise

Cognitive functions and speech‐recognition‐in‐noise were evaluated with a cognitive test battery, assessing response inhibition using the Hayling task, working memory capacity (WMC) and verbal information processing, and an auditory test of speech recognition. The cognitive tests were performed in silence whereas the speech recognition task was presented in noise. Thirty young normally‐hearing individuals participated in the study. The aim of the study was to investigate one executive function, response inhibition, and whether it is related to individual working memory capacity (WMC), and how speech‐recognition‐in‐noise relates to WMC and inhibitory control. The results showed a significant difference between initiation and response inhibition, suggesting that the Hayling task taps cognitive activity responsible for executive control. Our findings also suggest that high verbal ability was associated with better performance in the Hayling task. We also present findings suggesting that individuals who perform well on tasks involving response inhibition, and WMC, also perform well on a speech‐in‐noise task. Our findings indicate that capacity to resist semantic interference can be used to predict performance on speech‐in‐noise tasks.     

Countertransference as object of empirical research?

Abstract

The concept of countertransference as a robust cornerstone of psychoanalytic work has gained momentum over the last five decades. It is a prime example of elastic concepts covering the range from microprocesses to global clinical phenomena. Empirical research on the treatment process has for a long time – and for good reasons – avoided even trying to measure countertransference. We report here on various efforts for approaching a methodology for measuring it. The paper organizes the various approaches in terms of stages of research.     

The cultural dimension of tightness–looseness: An analysis of situational constraint in Estonia and Greece

The importance of tightness–looseness as a dimension that explains a considerable amount of variance between cultures was demonstrated by Gelfand et al. (2011). Tight nations have many strong norms and a low tolerance of deviant behaviour, whereas loose nations have weak social norms and a high tolerance of deviant behaviour. The main aim of the current studies was to examine situational constraint in Estonia and Greece: that is, how the cultural dimension of tightness–looseness is manifested in everyday situations in those two countries. The findings of a questionnaire study (Study 1) suggested that, in general, there is higher constraint across everyday situations in Greece than in Estonia, but situational constraint in Greece is especially strong in school and organisational settings where people have hierarchically structured roles. The results of an observational study (Study 2) revealed a relatively high agreement between appropriateness of certain behaviours as judged by the respondents in Study 1 and the frequencies of observed behaviours in the two countries. Our findings suggest that the strength of situations may substantially vary both within and across cultures, and that the attitudes of the members about situational strength in their respective cultures are in concordance with observations of situations by neutral observers in how people in general behave in their culture.     

Judgements,Expertise, and Counterfactuals

Abstract

In The Philosophy of Philosophy (Oxford: Blackwell, 2007), Tim Williamson has offered a sophisticated account of thought experiments and of modal epistemology. More recently, he has also engaged in a variant of the so-called ‘expertise defence’ of traditional philosophical methodology. In this paper I argue that if Williamson’s account of thought experiments and of modal epistemology is right, this seriously undermines his version of the expertise defence.     

Analytic change: Assessing ways of being in a psychoanalytic follow‐up interview

The article argues that the concepts of relational scenario, structuralized affect and actualized affect are proposed candidates for observation of changes in relational ways of being as it is expressed in transference. A psychoanalytic follow‐up interview of a former analytic patient is presented in order to illustrate how change in relational ways of being may be registered and studied. By triangulating the patient's verbal report of change with nonverbal information and transference–countertransference dynamics, one may grasp qualitative changes in relational ways of being. The case presented illustrates a former patient's on‐going process of working towards representing aggression in a more direct manner and how this process is made observable with the aid of the proposed concepts in the interview situation. The proposed concepts of relational scenario, structuralized and actualized affect discussed are compared to the concept of transference used in studies of core conflictual relationship theme (CCRT).