Anaesthesia or psychotherapy: Eradicating thoughts or working them through

The author presents two sessions from the analysis of a depressive narcissistic doctor, which are characterised by a mixture of co-operation and pseudo-co-operation. The dialogue is in parts intellectualised, complicated, lifeless and schizoid. Points at which the patient shows surprising insights are then partly denigrated by him, on the basis that change is not to be expected. Semi-lifeless contact assists the defensive claustrophobia that he experiences in meaningful contact. It becomes very clear that he is then afraid of entering into an openly aggressive conflict that entails the existential threat of object loss. However, this has so far been avoided. The secret pleasure in an anal-narcissistic, sadomasochistic addiction to doubt persists in the partial denigration. The patient's artificially maintained self-doubt and doubt of the object reinforce a genuine confusion that consists in never knowing exactly what lies behind the helpful and needed object.     

Clinical cut‐off point for the Distrust dimension of the Dimensional Clinical Personality Inventory 2 (IDCP‐2)

The Clinical Dimensional Personality Inventory 2 (IDCP ‐2) is a 206‐item self‐report tool developed for the assessment of 12 dimensions (divided into 47 factors) of personality pathology. One of the scales comprising the instrument, the Distrust scale, is intended to provide psychometric information on traits closely related to the Paranoid Personality Disorder (PPD ). In the present research, we used the Item Response Theory and the Receiver Operating Characteristic curve analysis to establish a clinical meaningful cutoff for the Distrust scale. Participants were 1,679 adults, among outpatients diagnosed with PPD , outpatients diagnosed with other PD s, and adults from the community. The Wright map revealed that outpatients were located at the very high levels on the latent continuum of the Distrust scale, with a very large effect size for the mean difference between patients and non‐patients. The ROC curve supported a cutoff at −1.00 score in theta standardization which yielded 0.87 of sensitivity and 0.54 of specificity. Findings from the present investigation suggest the IDCP ‐2 Distrust scale is useful as a screening tool of the core features of the PPD . We address potential clinical applications for the instrument and discuss limitations from the present study.     

Mindfulness tempers the impact of personality on suicidal ideation

The Five Factor Model (FFM) domains of neuroticism and extraversion have consistently been related to suicidal ideation, such that individuals high in neuroticism or low in extraversion are at greater risk for suicidal thinking. The relationship between mindfulness and suicidal thoughts has not been empirically investigated in relation to personality. However, mindfulness has been shown to moderate the relationship between neuroticism and depression (Barnhofer, Duggan, & Griffith, 2011). The current study examined the relationship of the FFM domains, mindfulness, and suicidal ideation, and tested whether mindfulness would moderate the relationship between FFM domains and suicidal thinking. Results indicated that mindfulness weakened the relationship between neuroticism and suicidal ideation. Additionally, a strong negative relationship between suicidal ideation and extraversion was present at low levels of mindfulness. The possible importance of incorporating mindfulness practices in the prevention of suicidal thinking is discussed.     

Moral transgression during the Vietnam War: a path analysis of the psychological impact of veterans’ involvement in wartime atrocities

Background and Objectives: Involvement in wartime combat often conveys a number of deleterious outcomes, including posttraumatic stress disorder (PTSD), depression, hostility, aggression, and suicidal ideation. Less studied is the effect of engagement in wartime atrocities, including witnessing and perpetrating abusive violence.

Design and Methods: This study employed path analysis to examine the direct effects of involvement in wartime atrocities on hostility, aggression, depression, and suicidal ideation independent of combat exposure, as well as the indirect effects via guilt and PTSD symptom severity among 603 help-seeking male Vietnam War veterans.

Results: Involvement in wartime atrocities was predictive of increased guilt, PTSD severity, hostility, aggression, depressive symptoms, and suicidal ideation after controlling for overall combat exposure. Combat-related guilt played a minor role in mediating the effect of atrocity involvement on depression and suicidal ideation. PTSD severity had a larger mediational effect. However, it still accounted for less than half of the total effect of involvement in wartime atrocities on hostility, aggression, and suicidal ideation.

Conclusions: These findings highlight the heightened risk conveyed by involvement in wartime atrocities and suggest that the psychological sequelae experienced following atrocity involvement may extend well beyond guilt and PTSD.     

Associations of Emotional Abuse Types With Suicide Ideation Among Dating Couples

Numerous studies have demonstrated that coercive control is more strongly associated with suicidal ideation than other forms of intimate partner violence. However, a majority of these studies focused on samples of help-seeking women. This study examined whether coercive control remains the form of intimate partner violence most strongly associated with suicidal ideation within a sample of nonclinical dating couples. This cross-sectional, survey study on 104 dating couples examined the associations of coercive control (i.e., dominance/intimidation and restrictive engulfment) with suicidal ideation, while controlling for other forms of emotional abuse (i.e., hostile withdrawal and denigration), physical assault, and depressive symptoms. As expected, dominance/intimidation and depressive symptoms, but not denigration and physical assault, were associated with suicidal ideation. Contrary to our hypothesis, hostile withdrawal, but not restrictive engulfment, was associated with suicidal ideation. This study suggests that dominance/intimidation and hostile withdrawal are forms of emotional abuse that are pertinent to suicidal ideation in nonclinical dating couples.     

Resilience and suicide ideation: Coping mediator-moderator effects among adolescent learners

The current study aimed to investigate the influence of coping on the relationship between resilience and adolescent suicide ideation among secondary learners in the Free State Province, South Africa (n = 495; female = 61.6%; black = 55%, white = 27%, other = 18%; mean age = 13.99 years; SD = 0.83 years). The learners completed the Suicide Ideation Questionnaire (SIQ), the Revised Coping Schema Inventory (RCSI), and the Resiliency Scale for Children and Adolescents (RSCA). Hierarchical multiple regression analyses were conducted to predict resilience-mediated suicide ideation from coping. Results suggested higher resilience scores on sense of mastery (SoM) and sense of relatedness (SoR) to predict lower suicide ideation risk among the teenagers. By contrast, higher scores on emotional reactivity (ER) predicted higher risk for suicide ideation. Religious coping (RC) moderated the relationship between resilience (sense of relatedness) and suicide ideation so that RC scores with SoM were associated with lower suicide ideation scores. Personal dispositions seem to explain risk for suicide ideation among adolescents.     

The Origins of Fears of Compassion: Shame and Lack of Safeness Memories,Fears of Compassion and Psychopathology

Empirical and clinical research suggests that some individuals find self-generating compassion and receiving compassion from others difficult and aversive. However, it is unclear how these fears of compassion are linked to early experiences and to psychopathological symptoms. This study explores the relationship between shame traumatic memories, centrality of shame memories, early memories of warmth and safeness, fears of compassion, and depression, anxiety and paranoid symptoms. Participants were 302 individuals from the general community population, who completed self-report measures of fears of compassion, shame memories, early affiliative memories, and psychopathology. Shame traumatic and central memories were positively associated with fears of compassion for self, for others and from others, whereas early memories of warmth and safeness were negatively related to such fears. Path analyses revealed that fears of compassion for self and of receiving compassion from others mediated the effects of shame traumatic memory, centrality of shame memory and early memories of warmth and safeness on depressive, anxious and paranoid symptoms. These findings have implications for therapeutic interventions as these fears, as well as the negative shame-based emotional memories fuelling them, may need to be addressed in therapy to assist patients in self-generating and receiving compassion.     

有自杀意念大学生的内隐态度探析

该文结合Greenwald开创的内隐联想测验,自编IAT程序,对有自杀意念大学生的内隐态度进行了相关研究。结果显示,有自杀意念大学生较无自杀意念大学生的内隐态度对自杀类词语敏感等。家庭所在地为农村对有自杀意念大学生的内隐态度有显著性影响。     

云南省大学生自杀行为及相关因素分析

采用SCL-90、青少年生活事件量表、应对方式量表、社会支持评定量表和自编的外显行为量表对云南省3313名大学生进行了测查,并探讨了包括自杀意念及自杀企图在内的自杀行为状况及其影响因素。结果表明:(1)427(13.2%)名大学生有自杀意念,卡方检验显示女生人数显著多于男生;154(4.7%)名大学生有过自杀企图,男女生人数没有显著差异;(2)自杀意念和自杀企图在人口统计学变量上有显著差异:在自杀意念上,女生、独生子女、文科生、来自城市的学生和不完整家庭的学生、月支出少于100元的学生得分显著高于与之对应的大学生;而在自杀企图上,只有来自城市的学生和不完整家庭的学生、月支出少于100元的学生得分显著高于与之对应的大学生;(3)大学生自杀意念和自杀企图与心理症状、生活事件、情感中心应对呈显著的正相关,与问题中心应对、社会支持呈显著的负相关;(4)在结构模型中,社会支持在心理症状和自杀行为中起到显著的调节作用,情感中心应对在生活事件、社会支持、社会支持对心理症状的调节作用中起显著的中介作用,而问题中心应对在生活事件、社会支持、社会支持对事件的调节作用中起显著的中介作用。     

Destructive and reparative transference in multiple levels of group psychotherapy

Group members are challenged to form psychologically meaningful relationships with therapists, other members, and the group as a whole. The way in which individuals perceive this challenge is based on their past experiences. Early relationships establish a perceptual frame in which fears of being hurt and concern about hurting others coexist. Balance between these two ways of generating meaning enables individuals to form relatively healthy relationships. Imbalance in this perceptual frame results in distorted perceptions and maladaptive patterns emerging as transference manifestations. Working through involves repeatedly addressing distortions as members relate to therapists, others and the group as a whole.