Two-year stability of personality disorder in older adolescent outpatients

The 2-year stability of categorical and dimensional personality disorder (PD) in an older adolescent psychiatric outpatient sample was examined. One hundred and one 15-18-year-old participants were assessed using the Structured Clinical Interview for DSM Axis II Disorders (SCID-II) at baseline and 97 were re-interviewed, face-to-face, at 2 years. Of those with a categorical PD diagnosis at baseline, 74% still met criteria for a PD at follow-up, with marked gender differences (83% of females and 56% of males). Kappa for specific PDs was low for all except antisocial. Rank order and mean level dimensional stability ranged from high (antisocial, schizoid) to moderate (borderline, histrionic, schizotypal) to low (other PDs), with no decline in PD scores over the 2 years. There was no substantial influence upon stability of dimensional PD from the presence of Axis I disorder at baseline or from outpatient or inpatient treatment. However, categorical PD endured in 100% of those receiving inpatient care. The study supports that, in late teenage outpatients, the 2-year stability of the global category of PD is high and the stability of dimensionally rated PD appears to be similar to that found in young adults in a variety of settings, especially for some cluster A and B PDs. Diagnosis and early intervention appears to be justified in this age group.     

Early maladaptive schemas in personality disordered individuals

The present study aimed to examine the specificity of schema domains in three personality disorder (PD) groups, namely borderline (BPD), obsessive-compulsive (OCPD), and avoidant PD (AvPD), and to correctly identify the three PD groups on the basis of these schemas. The sample consisted of 48 clinical participants diagnosed with PDs and assigned to 1 of 3 groups on the basis of their Axis II diagnoses (BPD: n = 13; OCPD: n = 13; AvPD: n = 22). High scores on Dependence/Incompetence, Defectiveness/ Shame and Abandonment were found for the BPD group. Such pattern appears to be most consistent with Young's theory of BPD. Consistent with the theory and empirical findings of Beck et al. (1990, 2001), OCPD was associated with elevations on the Unrelenting Standards schema domain, but not on Emotional Inhibition, which was found to be elevated for AvPD. In conclusion, the present study suggests that there are different patterns of schema domains across different PDs and that the Schema Questionnaire (SQ) is potentially useful in differentiating between these PDs.     

Neuromotor speech deficits in children and adults with spina bifida and hydrocephalus

Acquired cerebellar lesions are associated with motor speech deficits. Spina bifida with hydrocephalus (SBH) is a neurodevelopmental disorder that involves significant dysmorphology of the cerebellum. Videotaped narratives produced by 40 children and adults with SBH and their 40 age-matched controls were coded for three motor speech deficits: dysfluency, ataxic dysarthria (articulatory inaccuracy, prosodic excess, and phonatory-prosodic insufficiency) (Brown, Darley, & Aronson, 1970; Darley, Aronson, & Brown, 1969a), and speech rate. Individuals with SBH had more motor speech deficits than controls. Dysfluency was related to an interaction between chronological age and SBH. Speech rate was related independently to chronological age and SBH. Ataxic dysarthria was related to the biology of SBH, and was associated with both physical phenotype (level of spinal cord lesion) and medical history (number of shunt revisions). The data show that developmental as well as acquired lesions of the cerebellum disrupt motor speech, and add to the developmental role of the cerebellum in the automatization of motor skills, including speech.     

Age and ethnicity differences in storytelling to young children: emotionality,relationality, and socialization

Research has shown that age and ethnicity are associated with individuals' motivations for emotional regulation and social interaction. The authors proposed that these age and ethnicity-related motives would be reflected in storytelling. Women representing 2 age and 2 ethnic groups (young adulthood, oldage, African American, European American) told stories to young girls. Stories were coded for emotional, relational, and socialization focus. They predicted that older adults would selectively emphasize positive over negative emotions and would direct more utterances toward their interaction with their listener. The authors expected that African Americans would be more likely to emphasize socialization themes. Results suggest that older adults positively modulate emotional content while storytelling; qualified support was found for hypotheses concerning socialization and interrelational emphasis.     

Temenos regained: reflections on the absence of the analyst

The importance of the temenos as a metaphor to conceptualize therapeutic containment is discussed. Jung drew the analogy between the consulting room and the temenos, at the centre of the Greek Temple as a sacred and inviolate place where the analysand might encounter the Self. Although Jung believed that whether called or not, the gods would appear, under certain conditions, patients may experience 'temenos lost', the loss of the holding function of the analytic space. Two cases are presented in which temenos issues played a central role. In one case, an unorthodox method was used to preserve the analytic container during the absence of the analyst and in the other, the impact of an extra-analytical encounter had a dramatic effect on the holding function of the temenos. A discussion is presented of the appropriate circumstances in which analysts may deviate from traditional analytic practice in order to preserve the temenos and transform a 'temenos lost' into a 'temenos regained'.     

Ties to influential adults among black and white adolescents: culture,social class,and family networks

Although prior research suggests the importance of nonparental adults to adolescents, the ecological context of those relationships has received little attention. This study examined ties to influential adults among 122 adolescents who varied by race, family structure, and gender. The strongest effects were for race. Blacks reported stronger ties than Whites to the maternal grandmother as well as more supportive interactions with adult males. While race differences in grandparental ties were robust across social class (SES), ties to an influential adult male became nonsignificant upon controlling for SES. African American girls from divorced families consistently reported the strongest ties. Discussion considers the role of culture versus SES in explaining race differences. Implications for mentoring interventions are proposed, with special attention to the role of actualizing latent ties to already existing network members.     

Multimethod Psychoeducational Intervention for Preschool Children with Disruptive Behavior: Two-Year Post-Treatment Follow-up

This paper describes the 2-year post-treatment follow-up of preschool children identified as having high levels of disruptive behavior at kindergarten entry. They were assigned to four treatment conditions: A no-treatment group, parent-training only, treatment classroom only, and the combination of parent training with the treatment classroom. Interventions lasted the entire kindergarten academic year. Initial post-treatment results reported previously indicated no effects for the parent-training program but some efficacy for the classroom intervention program. For this report, the disruptive behavior (DB) children were subdivided into those who did (n = 74) and did not (n = 77) receive the treatment classroom. Two-year post-treatment follow-up results indicated no differences between the classroom treated and untreated DB groups. These groups also failed to differ in the percentage of children using available treatments across the follow-up period. The DB children in both groups had significantly more symptoms of ADHD and ODD than a community control group (N = 47) at follow-up. They also received higher ratings of externalizing problems on the parent Child Behavior Checklist, more severe ratings of behavior problems at home, and ratings of more pervasive behavior problems at school, and had poorer academic skills. Results suggested that early intervention classrooms for DB children may not produce enduring effects once treatment is withdrawn, and that better approaches are needed for identifying those DB children at greatest risk for later maladjustment.     

Forgiveness and responsibility: A case study

Pastoral Psychology -