Integrating empirically supported therapies for treating personality disorders: a synthesis of psychodynamic and cognitive-behavioral group treatments

Abstract This paper describes the theoretical foundations and components of an intensive group treatment program for individuals diagnosed with personality disorders. The Chrysalis Community Day Treatment Program integrates aspects of three empirically supported therapies: Transference-Focused Psychotherapy and Mentalization-Based Therapy, both psychodynamic psychotherapies, and Dialectical Behavior Therapy, a cognitive-behavioral therapy. Each of these modalities is structured for the treatment of individuals suffering from the symptoms of borderline personality disorder, and each of the treatments addresses problems that occur across a wide spectra of beliefs, capacities, and behaviors. The program is comprised of expressive, psycho-educational and skills-training groups, and participants attend three days per week, for 15 weeks. Preliminary evaluation is promising, reflecting decreases in self-injurious behavior, suicide attempts, psychiatric hospitalizations, and psychiatric symptoms at a one-year follow-up.     

Executive functioning as a mediator of the relationship between age and episodic memory in healthy aging

The extent to which age-related differences in executive functioning account for age-related differences in recall from episodic memory was examined in a group of healthy older adults. Fifty-one subjects between the ages of 60 and 91 years were given tests of general cognitive abilities, episodic memory, and executive functioning. A mediational model was proposed with executive functioning as the mediator of the relationship between age and delayed recall. Consistent with this model, regression analyses indicated that, when considered alone, age was a significant predictor of recall (p <.001); however, age was not a significant predictor of recall when the effect of executive functioning was partialled out of the equation (p=.37). Furthermore, the unique contribution of executive functioning accounted for 36% of the variance in recall performance. A significant portion of age-related differences in episodic memory recall, therefore, may be due to age-related differences in the executive skills required for optimal performance on such tests.     

Using Kindergarten Language,Dialect Variation,and Child Behavior to Predict Second Grade Reading Ability in African American Children

Previous research has demonstrated mixed findings pertaining to the risk conferred by variation from Mainstream American English (MAE) for African American children in our education system. Based on the research on language, behavior, and reading, the present study sought to examine the relative and combined contributions of culturally appropriate measures of risk status for disordered language and density of dialect use and classroom behavior (both competencies and problems) in predicting reading ability in a sample of typically developing African American elementary school students. 53 African American Kindergartner's (27 boys, 26 girls) were followed up with two years later in 2nd grade. In Kindergarten, children were screened for density of dialect use and risk of language impairment; teachers rated each child on behavior, social/emotional adjustment, and academic performance. Reading achievement was assessed in 2nd grade. Risk for disordered language development was the best predictor of 2nd grade reading, outperforming density of dialect use. Positive classroom behaviors were more predictive of reading than negative behaviors. This research supports the notion that language, classroom behavior, and reading achievement are intertwined in a complex manner and that when designing interventions for one, the entire system must be considered.     

Standing up for a change: reducing bias through interpersonal confrontation

Three experiments examined the effectiveness of interpersonal confrontations as a means for decreasing stereotypic responding. After making stereotypic inferences about Black individuals, participants were confronted and reactions were measured across various intrapersonal and interpersonal response domains. Confrontations varied in level of hostility (Experiment 1) and whether they were expressed by a Black or White person (Experiment 2). Results indicate that although confrontations (and particularly hostile ones) elicited negative emotions and evaluations toward the confronter, participants also experienced negative self-directed affect. Furthermore, regardless of who did the confronting or how much hostility was expressed, confronted participants subsequently were less likely to provide stereotypic responses (Experiments 1-2), and the effect of the confrontation generalized to reporting less prejudiced attitudes (Experiment 3).     

Are juvenile offenders extreme future discounters?

It has been the prevailing view that young offenders are more present oriented than their peers, but this view has little empirical basis other than the actions that have defined these youth as offenders. In the present study, we used a decision task with actual monetary consequences to assess the tendency of young offenders and a control group of high school students to discount the future. The young offenders were not significantly different from the students in discounting the future, even though the young offenders scored significantly higher on a sensation-seeking personality scale, were less likely to have lived with their fathers, and had changed schools more often. Young offenders and control participants were also similar in the extent to which they manifested a clear vision of the future by anticipating which future milestones would occur sooner, in a task pairing milestones with each other and with year markers.     

Dyadic short forms of the Wechsler Adult Intelligence Scale-III

Various short forms of the Wechsler Adult Intelligence Scale (WAIS)/WAIS-R have been developed to obtain estimates of overall intellectual level, although little research of WAIS-III short forms has been published to date. Full Scale IQ (FSIQ) estimatesfromfour WAIS-III dyadic short forms were obtained by entering selected subtest scores from a mixed neurologic/ psychiatric sample (n = 196) into regression equations. Results were cross validated on a second sample (n = 57). Within both samples, WAIS-III FSIQ scores were highly correlated (r = .90-.92, p < .001) with estimated FSIQ scores. Estimated FSIQ fell within 5 points of actual FSIQ in 49% to 74% of cross-validation cases and within 10 points of actual FSIQ in 81% to 93% of the sample. Comparable to findings from previous short-form investigations, actual and estimated FSIQ classification levels agreed in 46% to 67% of cases in the cross-validation sample. These dyadic WAIS-III forms appear appropriate for obtaining gross estimates of FSIQ in similar populations, although caution is recommended in interpreting estimated IQ scores.     

Contents of Volume 7

Volume Contents

Contents of Volume 7     

The support gap for dual clergy couples

Within this study six levels of support for dual clergy couples with and without children were investigated. Seven dual clergy couples of several synods of the Lutheran Church in two western Canadian provinces were asked open-ended questions about the support they had received in several employment and family related areas. While findings in each of the areas varied, overall, most individuals received the most support from their spouse and little from close friends and relatives often due to physical distance. Support provided by other clergy and church administrators was mixed. Only one major difference was found between couples with and without children. The group without children were more optimistic about the support that would be provided by family and friends in the area of child care while couples with children failed to mention support from friends and family.     

Scheduling and programming of rapid finger sequences: tests and elaborations of the hierarchical editor model

Is a response sequence executed only after the sequence has been fully programmed, as discrete processing models predict, or does execution begin before programming has been completed, as continuous processing models predict? To address this issue, we tested a discrete processing model of human motor performance, the hierarchical editor model of Rosenbaum, Inhoff, and Gordon (1984). This model was developed to account for data from experiments in which people perform one of two possible finger sequences, depending on the identity of a choice signal. The model assumes a hierarchically organized motor program that is first "edited" to resolve any uncertainties and is then "executed" to produce the desired responses. Three experiments reported here show that, contrary to the model's predictions and some well-known motor programming results (Sternberg, Monsell, Knoll, & Wright, 1978), the reaction time to begin a response sequence actually decreases with the length of the sequence under some choice conditions. We account for these results with a model that allows execution to begin while editing is still in progress. A key assumption in the model is that subjects schedule execution so that means and variances of interresponse times are minimized.     

Specificity of interoceptive fear to panic disorders

It has been argued that fear of interoceptive sensations is a maintaining factor in panic disorders. This study investigated whether interoceptive fears are specific to panic disorders or whether they are a feature of neurosis in general. Twenty-nine panic patients, 28 nonpanicking neurotic controls, and 29 normal controls were compared for their scores on a 14-item questionnaire intended to measure interoceptive fears. Indeed it was found that panic patients scored considerably higher than both control groups, whereas no significant differences emerged between the two control groups. It is concluded that interoceptive fear is diagnostically specific to panic disorders.This study was partly supported by the Dutch Organization for Fundamental Research (ZWO/Psychon., 560-268-001) and was carried out at the unit for clinical behavior therapy at Vijverdal Mental Hospital, Maastricht, The Netherlands.