Towards a Relational Affective Theory of personality disorder

This paper introduces a Relational Affective Formulation of severe narcissistic and borderline disorders. The formulation is grounded in psychoanalytic and neuroscientific theory, clinical observation and therapeutic work with hospitalised patients. It provides a conceptual framework for psychodynamic psychiatrists, therapists and psychosocial practitioners working in teams. Paying particular attention to the central place of affect, projective and introjective processes, claustro-agoraphobic phenomena, regression and the place of both deficits and dynamic defences in the failure of symbolisation, the case is made that this framework is suited to therapeutic work with patients who are highly suicidal and complex. The application of this formulation to service design and treatment pathways is described along with a summary of the body of psychoanalytic thinking which contributed to its development. The formulation is the cornerstone of a practice guide currently under development.     

The impact of the health professional on the individual's experience of cancer: A psychodynamic perspective

Abstract

This paper examines how interactions with health professionals may come to influence the patient's experience of cancer. It considers the idea that the experience of cancer returns an individual to a state of dependence and lack of integration similar to that of the young infant. The subsequent interactions with health professionals can then be considered in light of its ability to hold the patient's un-integrated self and facilitate its re-integration.     

Change management: Time for a change!

We discuss some core issues in the field of change management. We use these topics to identify some mindsets that dominate the practice of change management, and argue that these should be replaced by some alternatives. The alternatives are drawn largely from operations management and sociotechnical thinking. We characterize existing approaches as partial, and speculate that this may be one of the reasons why so many change initiatives are ineffective at meeting their goals. We identify some of the reasons why existing mindsets are sustained. We also point to some ways forward, focusing on changes in the mindsets and language we use. We speculate that these would improve the effectiveness of change initiatives.     

The use of artificial neural networks and multiple linear regression in modelling work–health relationships: Translating theory into analytical practice

Although psychological theory acknowledges the existence of complex systems and the importance of nonlinear effects, linear statistical models have been traditionally used to examine relationships between environmental stimuli and outcomes. The way we analyse these relationships does not seem to reflect the way we conceptualize them. The present study investigated the application of connectionism (artificial neural networks) to modelling the relationships between work characteristics and employee health by comparing it with a more conventional statistical linear approach (multiple linear regression) on a sample of 1003 individuals in employment. Comparisons of performance metrics indicated differences in model fit, with neural networks to some extent outperforming the linear regression models, such that R ² for worn-out and job satisfaction were significantly higher in the neural networks. Most importantly, comparisons revealed that the predictors in the two approaches differed in their relative importance for predicting outcomes. The improvement is attributed to the ability of the neural networks to model complex nonlinear relationships. Being unconstrained by assumptions of linearity, they can provide a better approximation of such psychosocial phenomena. Nonlinear approaches are often better fitted for purpose, as they conform to the need for correspondence between theory, method, and data.     

Influence of school-level variables on aggression and associated attitudes of middle school students

This study sought to understand school-level influences on aggressive behavior and related social cognitive variables. Participants were 5106 middle school students participating in a violence prevention project. Predictors were school-level norms opposing aggression and favoring nonviolence, interpersonal climate (positive student–teacher relationships and positive student–student relationships), and school responsiveness to violence (awareness and reporting of violence and school safety problems). Outcomes were individual-level physical aggression, beliefs supporting aggression, and self-efficacy for nonviolent responses. School norms and both interpersonal climate variables had effects on all three outcomes in theorized directions. Only one of the responsiveness measures, awareness and reporting of violence, had theoretically consistent effects on all outcomes. The other, school safety problems, affected self-efficacy later in middle school. Evidence of gender moderation was generally consistent with greater influence of school-level factors on female adolescents. Discussion focuses on implications in light of previous research and intervention possibilities.     

Reflections on coma: Man deprived of his consciousness

In this paper the authors reflect on the phenomena produced by the surprising communication between the unconscious of a therapist and that of a comatose patient. In a particularly disturbing context, when the patient’s sternum is open and exposed, the therapist communicates empathically with the comatose person, identifying the patient’s inexpressible experience and generating signs of a response from him in the form of the blinking of his eyelids. The absence of any reaction to pain, a pathognomonic sign of the comatose condition, could be related to the splitting‐off of the trauma, as if the situation were frozen, through a denial of the sensory and neurological perception of pain – a kind of self‐anaesthesia as a defence against the catastrophic anxieties raised by the threat of the return of the primary trauma. Starting from this encounter a relationship is formed whose guiding thread emerges in the shared illusion of a regression that makes it possible. It involves a process of returning to the past and a re‐actualization of the past that includes the question of its change through representation.     

A methodological note on the interactive and main effects of dualistic personality dimensions: An example using the 2 × 2 model of perfectionism

The goal of this methodological note was to outline the importance of considering the interactive and main effects of dualistic personality dimensions by presenting an example grounded in the 2 × 2 model of perfectionism (Gaudreau & Thompson, 2010). A study was conducted with a sample of 98 university students to examine the associations between four subtypes of perfectionism and academic performance. Results of moderated regression analyses revealed a non-significant interaction between self-oriented (SOP) and socially prescribed perfectionism (SPP). Nonetheless, the four hypotheses of the 2 × 2 model of perfectionism were supported in the context of a compensatory model showing a significant and positive main effect of SOP along with a negative and significant main effect of SPP. This methodological note contributes to the literature by offering clear guidelines on how the two main effects of SOP and SPP (and their resulting predicted values) can be used to test the four hypotheses of the 2 × 2 model despite the absence of a significant interaction between SOP and SPP.     

Why individuals in larger teams perform worse

Research shows that individuals in larger teams perform worse than individuals in smaller teams; however, very little field research examines why. The current study of 212 knowledge workers within 26 teams, ranging from 3 to 19 members in size, employs multi-level modeling to examine the underlying mechanisms. The current investigation expands upon Steiner’s (1972) model of individual performance in group contexts identifying one missing element of process loss, namely relational loss. Drawing from the literature on stress and coping, relational loss, a unique form of individual level process, loss occurs when an employee perceives that support is less available in the team as team size increases. In the current study, relational loss mediated the negative relationship between team size and individual performance even when controlling for extrinsic motivation and perceived coordination losses. This suggests that larger teams diminish perceptions of available support which would otherwise buffer stressful experiences and promote performance.     

Wellness Factors Decrease the Odds of Drinking and Driving Among College Students

The authors examined holistic wellness factors and drinking and driving behaviors among undergraduate students. Two factors of the Indivisible Self Wellness Model, the Coping Self and the Physical Self, decreased the odds of engaging in drinking and driving behavior.     

Perceived coach-autonomy support, basic need satisfaction and the well- and ill-being of elite youth soccer players: A longitudinal investigation

Objectives

Drawing from the basic needs theory [BNT; Ryan, R. M., & Deci, E. L. (2002). An overview of self-determination theory. In E. L. Deci, & R. M. Ryan (Eds.), Handbook of self-determination research (pp. 3-33). Rochester, NY: University of Rochester Press], the major purpose of the present study was to test a hypothesized sequence of temporal relationships between perceptions of coach-autonomy support, basic need satisfaction and indices of well- and ill-being. A subsidiary aim was to ascertain the assumed mediational role of basic need satisfaction in explicating the perceived autonomy support and well-/ill-being relationships over time.

Design

A field-based longitudinal design was employed.

Methods

Participants (N = 54 males) from an elite youth soccer academy in the UK completed a multi-section questionnaire tapping the targeted variables on six occasions across two competitive seasons.

Results

Multi-level regression analyses revealed that perceptions of coach-autonomy support positively predicted within-person changes and between-person mean differences in basic need satisfaction and well-being over time. Satisfaction scores for the needs for competence and relatedness were found to predict within-person changes in subjective vitality. These same needs partially mediated the coach-autonomy support-subjective vitality link over the two seasons.

Conclusions

The findings partially support the tenets of BNT, and are discussed in terms of their practical application to participants involved in an elite youth sport setting.