Changes in natural language use as an indicator of psychotherapeutic change in personality disorders

Word use has been shown to reflect various psychological processes and psychological change. This study examines the self-view in personality disorders (PDs) and its change over the course of therapy using the Linguistic Inquiry and Word Count analysis procedure. A sample of 299 participants with PDs and 108 community control participants wrote short essays about their lives. Patients repeated the assignment three times over two years and completed assessments of PD-pathology, general psychopathology, PD-beliefs, and quality of life. Results show that as hypothesized the use of words in the 1st Person Singular Pronouns, Negative Emotion, Causation, Past and Future Tense Verbs categories significantly declines over the course of treatment, while the use of Present Tense Verbs and Positive Emotion increases. These categories tend to distinguish patients from non-patients prior to treatment. We also found 12 additional word categories changing over time, including Word Count and Negations. Change in word use statistically predicts better treatment outcome on all outcome measures (p < .001). Reductions in the use of Negative Emotion Words and Negations are the strongest predictors of outcome. The non-hypothesized role of Negations was explored and seemed to reflect that PD-patients miss a lot in their lives. Reduction of what they miss seems central to recovery. This issue seems relatively neglected in theoretical and treatment models of PDs. An increased focus on what patients miss in their lives might improve our understanding and treatment of PDs. In sum, Negative Emotion and Negation word categories appear to reflect key treatment targets.     

Word use of outpatients with a personality disorder and concurrent or previous major depressive disorder

In a recent study, Rude, Gortner, and Pennebaker (2004) found word use to be related to depression and vulnerability to depression in the essays of college students. We sought to replicate and extend these findings in a clinical sample. Written essays of 304 psychiatric outpatients with a personality disorder and a mixed psychiatric profile on DSM-IV axis-I and 108 healthy controls were examined with word count software. Data on the tendency to be discrepant about the current self compared to a more ideal self were also gathered. We found that psychiatric outpatients in general used more words referring to the self and negative emotion words and fewer positive emotion words, compared to healthy controls. However, word-use proved unrelated to depression specifically. Actual-ideal self discrepancies were related to patient status and to current depression. Contrary to our hypothesis, these discrepancies did not correlate with the use of words referring to the self. We conclude that the negative content and self-focus of written essays and high levels of discrepancy reflect a negative thinking style that is common to a range of psychiatric disorders rather than being specific to depression.     

Professional responsibility: The role of the engineer in society

We argue that the practice of engineering does not exist outside the domain of societal interests. That is, the practice of engineering has an inherent (and unavoidable) impact on society. Engineering is based upon that relationship with society (inter alia). An engineer’s conduct (as captured in professional codes of conduct) toward other engineers, toward employers, toward clients, and toward the public is an essential part of the life of a professional engineer, yet the education process and professional societies pay inadequate attention to the area. If one adopts Skooglund’s definition of professional ethics^I (how we agree to relate to one another), then the codes of professional conduct lay out a road map for professional relationships. As professionals, engineers need to internalize their codes and to realize that they have a personal stake in the application of codes as well as the process of developing the codes. Yet, most engineers view professional codes as static statements developed by “others” with little (or no) input from the individual engineer. Complicating the problem, questions of professionalism (such as ethics) are frequently viewed as topics outside the normal realm of engineering analysis and design. In reality, professional responsibility is an integral part of the engineering process.     

Divorce,single parenthood and stepfamilies: Structural implications of these transactions

This article focuses on change in the family structure during the divorce as well as in the sequential stages of single parenthood and the reconstituted family. Special characteristics of these families and the tasks to be undertaken to enable the new unit to function are discussed conceptually and through case illustrations. Family therapy is seen as particularly helpful during the crisis stage when either a parent leaves or a new unit is added to an established one. The necessity of being aware of and working with all parts of the system, both the split-off and the newly-added, is stressed.     

The need of courage

A brave man leaveth not the battle, He who flieth from it is no true warrior, In the field of this body a great war is toward Against Passion, Hunger, Pride and Greed, It is for the Kingdom of Truth, of Contentment and of Purity that this battle is raging: And the sword that ringeth most loudly is the sword Of His name.

—KABIR, Hindu Poet