The Application of Attachment Theory and Mentalization in Complex Tertiary Structural Dissociation: A Case Study

The concept of structural dissociation can provide useful information for increasingly complex applications of mentalizing in therapeutic settings; however, little integration of the two approaches has emerged. Grounded in the intricate case of a woman diagnosed with dissociative identity disorder, this case study integrates and applies the concepts of structural dissociation and mentalizing from an attachment perspective. Client history includes pervasive spiritual and sexual abuse, as well as extreme neglect throughout her development. The presenting problems, relevant history (including the profound impact of neglect), and the therapeutic models that guided treatment are described. Also presented are the specific therapeutic interventions that have facilitated and strengthened therapeutic alliances, levels of integration, and mentalizing capacity in this challenging but rewarding study of human resiliency.     

Salutary effect of daily coping self-efficacy: impact on day-by-day coping to mood effects within dyads following hematopoietic stem cell transplantation

ABSTRACT

Background and Objectives: Little is known how coping self-efficacy (CSE) interacts with coping in dyad everyday life. The present study examined the moderating role of daily CSE in the relationship between coping and the next-day positive (PA) or negative (NA) affect in patient-caregiver dyads, following hematopoietic stem cell transplantation.

Design: This intensive longitudinal study was conducted during the first 28 days after post-transplant discharge.

Methods: Patients and their caregivers (N?=?200) maintained daily diaries on CSE, coping strategies, and affect.

Results: Daily CSE moderated daily coping–affect relationship: Positive emotion-focused coping increased PA in patients with higher than usual emotion-related CSE, whereas a buffering effect was found at lower than usual emotion-related CSE. A positive association between negative emotion-focused coping and NA in both patients and caregivers was stronger among those with lower than usual levels of emotion-related CSE. Higher than usual instrumental coping reduced NA in patients whose caregivers had higher than usual problem-related CSE, but increased NA for those whose caregivers had lower than usual instrumental CSE.

Conclusion: The findings show that daily CSE contributes to the effectiveness of daily coping within dyad, confirming its significance in effective adaptation and the role in the dyadic coping process.     

Figure-Ground Phenomena in the Perception of Physical and Social Stimuli

An instrument, the Grasha-Riechmann Student Learning Style Scales (GRSLSS), was developed to assess six student learning styles. These styles are Independent, Dependent, Avoidant, Participant, Collaborative, and Competitive. A “rational approach” was used to develop the GRSLSS and evaluate its construct validity. The process included professional and student inputs in special procedures for selecting scale items and designing criterion items. The utility of this approach is considered and problems critiqued. The rational approach yielded relatively high temporal reliability coefficients (range across scales r = .76 to r = .83; N = 269) and numerous meaningful correlations between criterion items and scale scores.     

Assessing the Relationship Between Differentiation and Infidelity

SUMMARY

Differentiation and infidelity have been theoretically related. However, few studies have tested whether the concepts in differentiation are statistically related to infidelity. One hundred nineteen participants in the present study completed two inventories assessing their level of differentiation and engaging in infidelity. Two-step structural equation modeling is used to determine the degree to which differentiation relates to infidelity. Results indicated that, though differentiation may be part of a plausible model of infidelity behavior, there are potentially other models that may be relevant in engaging in infidelity. The findings and implications are discussed.     

Structural Evaluation of the Contemporary Psychological Models of Chronic Pain: Does Fear of Pain Work for All?

The aim of the present study was to test Turk and Okifuji's (2002) model of chronic pain and in particular the moderating role of self-efficacy. We assessed 207 consecutive chronic pain patients (53.1% female) on a range of relevant measures and tested the model using structured equation modelling. The model was supported. These results support Turk and Okifuji's model of chronic pain and suggest that it can account for the relationships between variables in chronic pain patients. In particular, the results support the central role of fear-based avoidance and self-efficacy in chronic pain. Future research should be aimed at testing the alternative contemporary models of chronic pain at different stages of the development and maintenance of chronic pain and over time.     

探索性结构方程建模(ESEM):EFA和CFA的整合

探索性结构方程建模(ESEM)是在测量模型部分使用了类似于EFA模型的SEM.作为一种高级统计方法,ESEM整合了EFA和CFA两种因子分析方法的功能和优点.通过ESEM,研究者既可以灵活地探索因子结构,又可以系统地验证因子模型,为潜变量的关系分析提供更适宜的测量模型.ESEM已经在某些社科领域的研究中得到应用,是一种值得推介的因子分析方法.ESEM的具体应用问题,例如因子旋转方法的选用、测验信度评价等,仍有待探讨.     

The effect of personal and group discrimination on the subjective well-being of people with mental illness: the role of internalized stigma and collective action intention

The goal of this study is to test a model in which personal discrimination predicts internalized stigma, while group discrimination predicts a greater willingness to engage in collective action. Internalized stigma and collective action, in turn, are associated to positive and negative affect. A cross-sectional study with 213 people with mental illness was conducted. The model was tested using path analysis. Although the data supported the model, its fit was not sufficiently good. A respecified model, in which a direct path from collective action to internalized stigma was added, showed a good fit. Personal and group discrimination appear to impact subjective well-being through two different paths: the internalization of stigma and collective action intentions, respectively. These two paths, however, are not completely independent, as collective action predicts a lower internalization of stigma. Thus, collective action appears as an important tool to reduce internalized stigma and improve subjective well-being. Future interventions to reduce the impact of stigma should fight the internalization of stigma and promote collective action are suggested.     

Psychoanalytic inpatient psychotherapy of depression – Two naturalistic samples throughout the course of a decade

Background: While the general effectiveness of psychodynamic inpatient psychotherapy has been established, very few studies have specifically investigated the effectiveness of psychodynamic inpatient treatment of depression, though depressed patients represent the largest group of inpatients.

Method : This study investigated two naturalistic samples of depressed patients regarding treatment outcome as well as clinical and treatment characteristics. Patients were treated in a psychoanalytical psychosomatic hospital unit. Data was collected from 2000 to 2002 (N=234) and from 2008 to 2010 (N=514). Data was acquired at admission and discharge.

Results: The findings reveal high pre-post effect sizes for symptom reduction (SCL-90-R), general functioning (GAF) and medium changes of interpersonal problems (IIP). The improvement on the IIP was significantly higher for patients with comorbid personality disorder. Based on therapist ratings, the sample treated from 2008-2010 showed higher levels of impairment on several levels: chronic, complex, functional (GAF) and structural (OPD).

Conclusion: Findings indicate that patients show substantial short-term benefit following psychoanalytic inpatient psychotherapy, as practiced under naturalistic conditions. Open questions remain regarding the long-term nature of these benefits and the possible influence of placebo-effects.     

Exploring the validity of scores from the Rosenberg Self-Esteem Scale (RSES) in Burundi: A multi-strategy approach

The present study aimed to validate the Rosenberg Self-Esteem Scale (RSES) in Burundi, through a multi-strategy approach used in cross-cultural studies. Respondents were 906 health workers (men = 56%; caregivers 60%). They responded to a bilingual version of RSES. We utilised Confirmatory Factorial Analysis (CFA) with structural equation modelling and a back translation test to explore the structure of the RSES and the reliability of scores from the scale. Data from an independent sample were analysed for the reliability of scores assessment. CFA results suggested that the global RSES factor was likely contaminated by a method-effect; mainly associated with negatively worded items. Internal consistencies and a back-translation test demonstrated that the negatively worded items were unsuitable in this context. The independent sample study confirmed poor reliability and internal consistency of scores for both alternative language versions of the RSES. Our data suggested that an overall cultural effect, rather than a merely specific language effect, may undermine the cross-cultural transportability of the Western scale.