Interventions for Family Members and Carers of Patients with Borderline Personality Disorder: A Systematic Review

Carers of patients with borderline personality disorder (BPD) experience high levels of distress. Several studies have been carried out on interventions designed to decrease their burden. However, the evidence from these studies has not been summarized. The objective of this work is to explore the clinical utility of interventions developed for family members of patients with BPD. A systematic review was conducted following the PRISMA guidelines (registration number CRD42018107318), including psychological interventions focused on relatives of patients with BPD. The following databases were used: PsycINFO, PubMed, EBSCOhost, and Web of Science. Two independent researchers reviewed the studies to determine whether the eligibility criteria were met. A total of 2,303 abstracts were identified. After duplicates had been removed, 1,746 studies were screened. Finally, 433 full‐text articles were reviewed, yielding 11 studies that satisfied the inclusion criteria. Results show that these interventions with different clinical formats and settings are effective. The quality of the included studies varies, and the empirical support for these programs is still preliminary. The results help to establish a general framework for interventions specifically developed for family members of patients with BPD, but additional efforts should be made to improve the methodological quality of this field of research and more solidly determine the utility of these interventions. Given the paucity of data so far, this information may open up new lines of research to improve the effectiveness of future programs for carers of patients with BPD and help to reduce their burden.     

Exploratory Evaluation and Initial Adaptation of a Parent Training Program for Hispanic Families of Children with Autism

The present paper takes a translational approach in applying the themes of the current special section to prevention and intervention science in Latino families. The paper reviews the current literature on cultural processes in prevention and intervention research with Latino families. Overall, many prevention and intervention programs have either been developed specifically for Latino families or have been modified for Latino families with great attention paid to the socio‐cultural needs of these families. Nevertheless, few studies have tested the role of cultural values or acculturation processes on outcomes. We make recommendations based on findings within basic science and in particular this special section on the incorporation of these values and processes into prevention and intervention science with Latino families.     

Long-term outcomes of Acceptance and Commitment Therapy in drug-dependent female inmates: A randomized controlled trial

The general aim of this randomized controlled trial was to test the long-term efficacy of acceptance and commitment therapy (ACT) compared to a cognitive behavioural therapy (CBT) condition in the treatment of drug abuse. Participants were 37 polydrug incarcerated females assessed with Mini International Neuropsychiatric Interview, Addiction Severity Index-6, Anxiety Sensitivity Index (ASI) and Acceptance and Action Questionnaire II at pre, post, and at 6-, 12- and 18-months follow-ups. The mixed lineal model analyses showed reductions in drug abuse, ASI levels and avoidance repertoire in both conditions, without any differences between groups. However, the percentages of mental disorders were reduced only in ACT participants. At the 18-month follow-up, ACT was better than CBT in the maintaining of abstinence rates. This data support the incubation pattern showed in previous ACT studies. To conclude, the ACT intervention seems to be an adequate treatment option for addictive behaviours and co-occurring disorders in incarcerated women.     

The Uses of Emotion Maps in Research and Clinical Practice with Families and Couples: Methodological Innovation and Critical Inquiry

We explore how “emotion maps” can be productively used in clinical assessment and clinical practice with families and couples. This graphic participatory method was developed in sociological studies to examine everyday family relationships. Emotion maps enable us to effectively “see” the dynamic experience and emotional repertoires of family life. Through the use of a case example, in this article we illustrate how emotion maps can add to the systemic clinicians’ repertoire of visual methods. For clinicians working with families, couples, and young people, the importance of gaining insight into how lives are lived, at home, cannot be understated. Producing emotion maps can encourage critical personal reflection and expedite change in family practice. Hot spots in the household become visualized, facilitating dialogue on prevailing issues and how these events may be perceived differently by different family members. As emotion maps are not reliant on literacy or language skills they can be equally completed by parents and children alike, enabling children's perspective to be heard. Emotion maps can be used as assessment tools, to demonstrate the process of change within families. Furthermore, emotion maps can be extended to use through technology and hence are well suited particularly to working with young people. We end the article with a wider discussion of the place of emotions and emotion maps within systemic psychotherapy.     

Entrevista con Julián de Ajuriaguerra

RESUMEN

En esta entrevista Julián de Ajuriaguerra describe su historia científica desde que era interno en hospitales psiquiátricos y alumno de Thomas y Lhermitte, comentando los trabajos que realizó con adultos, ancianos y dementes aunque su interés estuviese desde un principio en los niños. Responde, entre otras, a cuestiones tales como si lo biológico se complementa con lo social en el desarrollo, cómo son los vínculos de los padres con el niño, cuál es su posición respecto al psicoanálisis, si es necesaria la interdisciplinariedad para hacer psicología o qué opina del problema de los estadios. También realiza un balance del estado actual de la psicomotricidad, ejemplifica qué entiende por “diálogo tónico” y explica las diferencias entre los juegos de niños y niñas de siete, ocho y nueve años, admitiendo la distinta organización tónica de los sexos. Por último el autor se centra en el trabajo clínico, ofreciendo sugerencias para aquéllos que empiezan a llevarlo a cabo en España. Los comentarios que Ana María Pardo y Ángel Rivière realizan del autor y su obra introducen esta entrevista.     

Factores psicosociales y cáncer: una revisión crítica

Resumen

Se presenta en este artículo una introducción al campo de estudio de las relaciones entre factores psicosociales y neoplasia, enmarcándolo dentro de la medicina conductual y desde un enfoque interdisciplinar. A continuación se discute el papel que pueden desempeñar las variables psicosociales (estrés) en la vulnerabilidad del ser humano a la enfermedad en general a través de su acción sobre el sistema inmune. En el apartado III se realiza una revisión crítica en la investigación en la que se ha intentado delimitar la influencia de factores psicosociales en la aparición y pronóstico del cáncer, en animales (cáncer experimental) y en el ser humano. Se discute por último el papel de los mediadores biológicos propuestos como más importantes hasta el momento en la literatura del área (sistemas neuroendocrino e inmune). De esta revisión se desprende que los resultados de la investigación, aunque su- gerentes no son definitivos, ni tampoco están claros los mecanismos biológicos a través de los cuales se puede producir la influencia. Después de analizar algunas de las deficiencias metodológicas más importantes de los trabajos realizados, creemos que en enfoque más adecuado para poner a prueba la hipótesis de que los factores psicosociales afectan al desarrollo del cáncer debería ser longitudinal, utilizando grandes muestras y estudiando variables psicosociales y biomédicas conjuntamente.     

«Modelos de Mundo», como marco de referencia de una psicología del conocimiento

RESUMEN

En el estado actual de cosas es importante apuntar dos reflexiones. En primer lugar, existe un desfase entre la psicología que se desea hacer y la que efectivamente se logra construir, entre los motivos profundos de este desfase se puede situar la confusión epistemológica, la desconexión teórica y la falta de una orientación hacia la eficacia real. Una segunda reflexión, se situaría sobre nuestro propio trabajo y, especialmente, sobre las discusiones y reflexiones que lo acompañan. Nuestro trabajo parece tomar un rumbo determinado y resulta epistemológicamente relevante el intento de su explicación. En el presente artículo se trata de ofrecer algunos de los resultados de esta labor. Estos resultados se concretan en un enfoque metodológico desde el enfoque de Modelos del Mundo (MDM), consistente en predecir actuaciones a partir del modelo de sujeto y su mundo que, operativizados en forma de conducta, se contrasten con la realidad.     

Androginia psicológica y flexibilidad comportamental

RESUMEN

Los autores investigan la hipótesis de que los sujetos andróginos son más flexibles en su implicación y bienestar ante tareas que se tipifican culturalmente como pertenecientes al “otro” sexo. Comienzan repasando la literatura psicológica acerca de androginia psicológica y flexibilidad comportamental y seguidamente concretan sus hipótesis: comprobar que los individuos andróginos a) mostrarán una mayor implicación en tareas tanto masculinas como femeninas, b) preferirán en menor medida actividades apropiadas a su sexo y c) experimentarán un mayor bienestar psicológico al desarrollar este tipo de actividades que cualquier otro grupo de rol sexual. Tras describir el método y los resultados del trabajo, los autores ofrecen una discusión final de éstos, en la que destacan que su investigación parece confirmar los resultados de Bem: parece que es el rol sexual andrógino el que siente un mayor grado de bienestar al realizar conductas que son sancionadas socialmente como inapropiadas a su sexo y el que escoge un mayor número de este tipo de comportamientos. Los autores finalizan afirmando que también parece haber quedado respaldada la validez predictiva del Bem Sex Role Inventory.     

The I Ching as a Potential Jungian Application: History and Practice

Swiss psychiatrist Carl Jung had a lifelong interest in the I Ching after discovering it in 1919. Jung’s interest in the I Ching is arguably more practical than purely theoretical or intellectual, and references to I Ching divination appear frequently in his various publications, seminars, letters and clinical practice records. After a few observations on the history of the study of the I Ching in China, the author categorizes Jung’s three uses of the I Ching as physical use (to preview future potentials of outer reality), psychological use (to reveal one’s psychological state), and psychical approach (to engage with the divine through “神”[“shen”, spiritual agencies]). Finally, the author discusses the current Jungian engagement by demonstrating clinical cases in contemporary times. Some Jungian analysts practise I Ching divination to obtain insights into the physical and psychological state of therapeutic relationships and for personal development. This paper is a historical and critical engagement of the Jungian practice of I Ching divination.     

We‐Language and Sustained Reductions in Drinking in Couple‐Based Treatment for Alcohol Use Disorders

Couple‐based treatments for alcohol use disorders (AUDs) produce higher rates of abstinence than individual‐based treatments and posit that active involvement of both identified patients (IPs) and significant others (SOs) is partly responsible for these improvements. Separate research on couples’ communication has suggested that pronoun usage can indicate a communal approach to coping with health‐related problems. The present study tested whether communal coping, indicated by use of more first‐person plural pronouns (“we” language), fewer second‐person pronouns (“you” language), and fewer first‐person singular pronouns (“I” language), predicted improvements in abstinence in couple‐based AUD treatment. Pronoun use was measured in first‐ and mid‐treatment sessions for 188 heterosexual couples in four clinical trials of alcohol behavioral couple therapy (ABCT). Percentages of days abstinent were assessed during treatment and over a 6‐month follow‐up period. Greater IP and SO “we” language during both sessions was correlated with greater improvement in abstinent days during treatment. Greater SO “we” language during first‐ and mid‐treatment sessions was correlated with greater improvement in abstinence at follow‐up. Greater use of IP and SO “you” and “I” language had mixed correlations with abstinence, typically being unrelated to or predicting less improvement in abstinence. When all pronoun variables were entered into regression models, only greater IP “we” langue and lower IP “you” language predicted improvements in abstinence during treatment, and only SO “we” language predicted improvements during follow‐up. Most pronoun categories had little or no association with baseline relationship distress. Results suggest that communal coping predicts better abstinence outcomes in couple‐based AUD treatment.