Experiential avoidance in adolescents with borderline personality disorder: comparison with a non-BPD psychiatric group and healthy controls

ABSTRACT

Previous research has identified experiential avoidance (EA) as related to a host of adolescent internalizing and externalizing problems, as well as borderline personality disorder, suggesting that it is a crosscutting factor for adolescent psychopathology. It remains unclear whether EA differs among adolescents with BPD compared to adolescents with other psychiatric disorders and healthy adolescents. The aims of this study were to 1) examine EA in adolescents with BPD compared to non-BPD inpatient adolescents and healthy adolescents, and 2) to evaluate whether EA has a unique relationship to borderline pathology over and above internalizing and externalizing. Self-report measures of BPD features, EA, and psychopathology were completed by 692 adolescents (64.5% female, M_age= 15.20). This sample included a group of psychiatric inpatient youth (n = 197 BPD; n = 403 non-BPD) and a group of healthy adolescents (n = 92). Results revealed that EA differed significantly across all three groups, with the highest level of EA evidenced in adolescents who had BPD. Furthermore, there was a significant, unique association between BPD symptoms and EA over afnd above internalizing and externalizing pathology. These findings pinpoint EA as an important risk marker and possible target of prevention or intervention for adolescent BPD.     

依恋焦虑对大学生囤积行为的影响:无法忍受不确定性与经验性回避的序列中介作用

为探讨依恋焦虑、无法忍受不确定性、经验性回避与大学生囤积行为的关系，本研究构建了一个序列中介模型。采用问卷法对黑龙江等地高校的610名大学生进行调查研究。结果发现：（1）无法忍受不确定性和经验性回避在依恋焦虑与大学生囤积行为之间均起部分中介作用；（2）无法忍受不确定性和经验性回避在依恋焦虑和大学生囤积行为之间构成序列中介，即依恋焦虑个体通过增强无法忍受不确定性，从而提高经验性回避倾向，进而增加大学生的囤积行为。研究进一步从认知和应对手段角度来考察依恋焦虑对大学生囤积行为的作用机制，对囤积行为的预防和干预具有启示意义。     

Another way to think about psychological change: experiential vs. incremental

The traditional pre-post treatment difference reflects an incremental notion of change, where a quantity of some psychological function is added to (or subtracted from) a pretreatment quantity. This study presents a complementary, experiential notion of change. Rather than a difference, change is a feeling or experience of having changed, a feeling that one is different than before. Based on a post-treatment interview the Change after Psychotherapy (CHAP) is a method to quantify/rate such ‘differentness’ in terms of how extensively or radically the patient feels having changed. A pre-post quasi-experimental study (N = 49) comparing the CHAP with ratings on the Global Assessment of Functioning, the Karolinska Psychodynamic Profile and the Comprehensive Psychopathological Rating Scale-Self-Affective is reported. The results showed the CHAP to be a reliable, valid and sensitive way to assess an experiential kind of CHAP.     

Using Relational Cultural Theory as a Pedagogical Approach for Counselor Education

ABSTRACT

In the article the authors will discuss core concepts of RCT in greater detail while relating these concepts to the counselor education classroom setting. There are many aspects of the counseling process that are open-ended due to the necessity of counselors needing to be responsive to the client’s needs in the moment. It is the assertion of the authors that using RCT in the classroom as a pedagogical framework may be beneficial to the growth of CITs. Through creating and maintaining an environment that supports growth fostering relationships, mutual empathy, authenticity, recognition and healing of disconnection, identification of central relational paradoxes, and processing relational images can all lead to developing relational competence in the CITs who will become the next generation of counselors. Additionally, the authors provide examples of the core concepts in action that are grounded in their experiences, blending RCT into their instructional delivery in their course.     

Warriors,authors and baseball coaches: the meaning of metaphor in theories of family therapy

This article examines the metaphors family therapists use in their theories to reveal aspects of the theories which are not explicitly stated, using Whitaker's symbolic experiential therapy, Minuchin's structural therapy and White's narrative therapy as examples. Such examination, drawing on social constructivist understandings of metaphor and meaning making, reveals that Minuchin's metaphors of family as organism and therapist as artist and warrior emphasize the family as relatively holistic and the therapist as relatively interventionist. In contrast, Whitaker's metaphor of family as ecological system or team and therapist as coach emphasizes the interdependence and context sensitivity of the family and relative powerlessness of the therapist to impose change. Finally, White, reflecting his explicitly post‐structural commitment, uses the metaphor of therapy as a journey undertaken with a map and as therapy as an act of re‐narrating a story.     

Is avoidance of illness uncertainty associated with distress during oncology treatment? A daily diary study

Objective: The aim of this study was to explore the daily relationship between illness uncertainty, avoidance of uncertainty, well-being and treatment-related distress among patients with cancer receiving treatment with curative intent. It was hypothesised that daily illness uncertainty, daily avoidance of uncertainty and daily treatment-related distress would be negatively associated with daily well-being. It was also hypothesised that daily illness uncertainty and daily avoidance of uncertainty would be positively associated with daily treatment-related distress.

Design: Thirty-one patients receiving oncology treatment with curative intent completed a daily diary for seven consecutive days. Data were analysed using multilevel modelling.

Main outcome measures: Daily illness uncertainty, avoidance of illness uncertainty, treatment-related distress and well-being.

Results: As hypothesised, on days when patients with cancer reported heightened treatment-related distress they experienced diminished well-being. And on days when patients reported more experiential avoidance of illness uncertainty, they also experienced heightened levels of treatment-related distress. No other daily associations were significant.

Conclusion: These findings indicate that patients with cancer experience day-to-day fluctuations in distress and well-being throughout oncology treatment. Avoidance of illness uncertainty-related thoughts and/or emotions are associated with daily distress, but not daily well-being.     

First‐hand sensory experience plays a limited role in children's early understanding of seeing and hearing as sources of knowledge: Evidence from typically hearing and deaf children

One early‐developing component of theory of mind is an understanding of the link between sensory perception and knowledge formation. We know little about the extent to which children's first‐hand sensory experiences drive the development of this understanding, as most tasks capturing this early understanding target vision, with less attention paid to the other senses. In this study, 64 typically hearing children (M_age = 4.0 years) and 21 orally educated deaf children (M_age = 5.44 years) were asked to identify which of two informants knew the identity of a toy animal when each had differing perceptual access to the animal. In the ‘seeing’ condition, one informant saw the animal and the other did not; in the ‘hearing’ condition, one informant heard the animal and the other did not. For both hearing and deaf children, there was no difference between performance on hearing and seeing trials, but deaf children were delayed in both conditions. Further, within both the hearing and deaf groups, older children outperformed younger children on these tasks, indicating that there is a developmental progression. Taken together, the pattern of results suggests that experiences other than first‐hand sensory experiences drive children's developing understanding that sensory perception is associated with knowledge.     

Effects of Analytical and Experiential Self-focus on Rumination After a Stress Induction in Patients with Social Anxiety Disorder: A Pilot Study

According to cognitive models, negative post-event processing rumination is a key maintaining factor in social anxiety disorder (SAD). Analogue research has supported the differentiation of self-focus into different modes of self-focused attention with distinct effects on rumination in depression and social anxiety. The purpose of this study was to replicate these effects with a sample of clients with SAD (N = 12) using (a) an experimental, cross-over design and (b) an evaluation situation (impromptu speech) prior to manipulation. Processing an identical list of symptoms, half of a sample was asked to successively adopt an analytic (abstract, evaluative) and an experiential (concrete, process-focused) self-focus; the other half employed the modes in the reversed order. Effects were assessed with a thought-listing (TL) procedure. As predicted, the two modes of self-focused attention affected cognitions differently; participants in the experiential condition showed a tendency for a decreased proportion of negative thoughts, whereas those in the analytical condition reported a decreased proportion of neutral thoughts. No difference was shown on positive cognitions. Furthermore, the participants' self-evaluation following the speech predicted their degree of subsequent negative thinking. After self-focus inductions, however, this effect was only seen in those participants who started by receiving the analytical self-focus induction. The results support previous findings that the analytical and the experiential self-focus modes affect cognitions differently, and that experiential processing may have beneficial effects on rumination in SAD. However, results need to be replicated in a larger sample.