Effectiveness of dialectical behaviour therapy for borderline personality disorder in an inpatient setting

This study evaluates the effectiveness of dialectical behaviour therapy (DBT) for borderline personality disorder (BPD) in an unselected, comorbid population seeking 3-month inpatient treatment. We studied 50 consecutively admitted individuals (44 women, six men) with BPD as defined by DSM-IV at three time points (at admission, at discharge, and at the 15-month follow-up). For the clinical diagnoses, we used the Structured Clinical Interview for DSM-IV (SCID) and compared the frequencies of comorbid axis I and axis II disorders at admission and at the 15-month follow-up. Overall, participants showed a high degree of comorbidity. Psychopathology was significantly reduced at post-treatment and at follow-up. Effect sizes for outcome measures were within the range of those of previous studies. Our findings support the notion that the results of the DBT efficacy research can be generalized to an inpatient setting and to patients with BPD disorder with high comorbidity.     

Psychodynamic focal group treatment for psychosomatic inpatients--with an emphasis on work-related conflicts

Conflicts arising from the work setting have remained a neglected issue in psychotherapy. To address this, the present study investigated the effectiveness of a manualized focal group treatment for psychotherapeutic inpatients suffering from vocational strains and conflicts and identified predictors of outcome. Cohorts of patients were assigned either to a treatment (N=144) or control condition (N=135). The group therapy intervention was found to be highly accepted by participants who were also more optimistic about returning to work and more favorable in their evaluations of treatment than patients in the treatment-as-usual condition. Group climate was found to be a predictor of favorable outcome. The findings suggest that a group therapy intervention with a strong emphasis on motivations and attitudes about work may be particularly suitable to deal with vocational conflicts and strains.     

Opening What Has Been Closed,Relaxing What Has Been Clenched: Dissociation and Enactment Over Time in Committed Relationships

I use dissociation and the concept of the multiple self to link Mitchell's profound insight with Goldner's critique. In the process, I use the idea of dissociation to think about the nature of different kinds of long-term relationships.     

A Method for the Evaluation of Affective Associations to Figure Drawings

Usual scoring systems for figure drawing techniques are based on structural and content aspects of the drawing, and ignore the affectively toned associations that occur when an observer first sees a drawing. A system for measuring two components of judgment, (a) emission of affective associations (b) evaluation of affective associations, has been developed. This method was applied with some success in studying individuals who had represented in their drawings an image that corresponded to their actual physical appearance. The research so far suggests that the evaluation component of judgment may contribute more to discrimination than the emission component.     

Mental Health and Adverse Childhood Experiences

The theoretical basis of occupational therapy interventions was investigated in two mental health facilities in the Midwestern United States. Using retrospective cohort and grounded theory designs, 121 medical records were reviewed and five occupational therapy practitioners were interviewed. Theoretical reasoning was not explicitly documented, but according to analysis, the behavioral/cognitive-behavioral model, client-centered models, and the model of human occupation were the most frequently used theories to guide interventions. Lack of documentation of theory use has significant implications for the value accorded to occupational therapy skills in health care. A larger study is recommended to increase external generalizability of the findings.     

Developing Roles and Skills in Community-Living Adults With Severe and Persistent Mental Illness

People with severe and persistent mental illness often experience a disruption in the development of social roles, and the skills within these roles. Role Development, a set of guidelines for practice, is an intervention to develop roles and skills. The purpose of this study was to continue to examine the efficacy of this intervention. Ten people attending two community mental health programs participated in evaluation and treatment based on Role Development. Quantitative pretest and posttest measures were used. Qualitative components were incorporated to get a sense of the experience involved in developing roles and skills. Quantitative results indicated statistical significance (p < .05) in the development of roles and skills. Qualitative data revealed multiple trends experienced by the participants. This study contributes to the evidenced-based knowledge regarding development of roles and skills for persons living with severe and persistent mental illness.     

Elevated disgust sensitivity in blood phobia

In order to demonstrate elevated disgust sensitivity and facilitated disgust learning in patients suffering from blood injection injury phobia, 23 phobics and 20 controls underwent an evaluative conditioning experiment. They were presented with picture pairs consisting of affectively neutral pictures (CS), which were followed by either disgust-inducing, fear-inducing, pleasant, or neutral scenes (US). During the presentation we recorded the electromyogram (EMG) of the musculus levator labii as a specific disgust indicator. Affective ratings for the pictures were determined before and after conditioning. Also, CS-US contingency verbalisation (CV) was assessed. Phobics reported a greater overall disgust sensitivity, experienced stronger feelings of disgust, and showed greater EMG responses while viewing disgust-eliciting scenes than control subjects. Evaluative conditioning occurred equally in both groups and depended on CV.     

Effects of a Peer Engagement Program on Socially Withdrawn Children with a History of Maltreatment

Children with a history of child maltreatment often have limited social interactions with other children and adults. This study examined the effects of a Peer Engagement Program, consisting of peer mentoring and social skills training with positive reinforcement, in three children with low levels of oral and social interaction. A multiple baseline, single-subject research design was used to test whether introduction of the intervention was associated with increased, directly observed oral interaction and engagement in social activities with peers and adults. The Child Behavior Checklist (CBCL) and the Social Skills Rating Scale (SSRS) were administered before and after intervention. All children showed increased levels of oral and social interaction and improved scores on the SSRS and the CBCL.