A Pilot Study of Psychotherapist Trainees' Alpha-Amylase and Cortisol Levels During Treatment of Recently Suicidal Clients With Borderline Traits

Psychotherapists often experience stress while providing psychotherapy, in particular when working with difficult presentations such as suicidality. As part of a larger study on the treatment of recently suicidal college students with borderline traits, 6 therapists in training collected their own salivary samples for alpha-amylase (AA) and cortisol (C) analyses immediately before and after sessions with 2 selected clients. On average, samples were collected for the same therapist-patient dyad throughout the year-long study to ensure that data reflected therapist responses across stages of treatment. Therapists also completed a working alliance questionnaire and rated perceived session difficulty immediately after each selected session. Contrary to expectations, therapists demonstrated elevated levels of stress as measured by AA and C at presession relative to postsession levels. Greater session difficulty was related to more pronounced declines in AA, whereas a stronger working alliance was linked to more pronounced reductions in C. Results suggest that physiological stress responses while working with recently suicidal clients with borderline traits occur primarily in terms of session anticipatory anxiety, whereas AA and C changes may be affected differently by factors such as session difficulty and working alliance. This is a pilot study, limited by its sample size, but the design, findings, and inclusion of physiological measures present an initial step in an essential line of research.     

Educational risk factors for psychological truancy in Lesotho: a qualitative exploration

A qualitative case study design was used to explore educational risk factors that may contribute to psychological truancy in a Lesotho secondary school. Purposively sampled teachers (n = 4, females = 50%) and pupils (n = 4, females = 75%), who have experience of psychological truancy, took part in a focus group and individual interviews. Inductive content analysis was used to analyse data emanating from the interviews. The findings indicate that pupil–teacher relationships, the use of English as medium of instruction and a lack of resources may be educational risk factors contributing to psychological truancy. Positive pupil–teacher relationships and active classroom engagement are prerequisites for successful and active learning.     

Dialectical behavior therapy--family skills training

Over the past three decades, family interventions have become important components of treatment for a number of psychiatric disorders. To date, however, there has been no family treatment designed specifically for borderline personality disorder patients and their relatives. This article describes one short-term family intervention called Dialectical Behavior Therapy-Family Skills Training. Based on Linehan's Dialectical Behavior Therapy (DBT), borderline patients' behavioral patterns are thought to result from a lifelong transaction between emotional vulnerability and invalidating features of the social and familial environment. Individual DBT focuses on reducing individual emotion dysregulation and vulnerability and enhancing individual stability. The complementary family interventions proposed in this article aim to: 1) provide all family members an understanding of borderline behavioral patterns in a clear, nonjudgmental way; 2) enhance the contributions of all family members to a mutually validating environment; and 3) address all family members' emotion regulation and interpersonal skills deficits.     

Family connections: a program for relatives of persons with borderline personality disorder

This study assessed changes in family members who participated in Family Connections, a 12-week manualized education program for relatives of persons with borderline personality disorder (BPD). Family Connections, led by trained family members, is based on the strategies of standard Dialectical Behavior Therapy (DBT) and DBT for families. The program provides (a) current information and research on BPD, (b) coping skills, (c) family skills, and (d) opportunities to build a support network for family members. Forty-four participants representing 34 families completed the pre-, post-, and 6-month postbaseline self-report questionnaires. Analyses employing hierarchical linear modeling strategies showed significant reductions in grief and burden, and a significant increase in mastery from pre- to post-group assessment. Changes were maintained at 6 months post baseline.     

The Impact of Conflict Issues on Fixed-Pie Perceptions, Problem Solving, and Integrative Outcomes in Negotiation

It is argued that a negotiator's fixed-pie perception, cooperative motivation, problem-solving behavior, and integrative outcomes are influenced by the content of the negotiation—the conflict issue. Negotiation involves conflicting interests, conflicting ideas about intellective problems, or conflicting ideas about evaluative problems. Study 1 showed that individuals in a negotiation about interests have a stronger fixed-pie perception and have a lower cooperative motivation than individuals in an evaluative negotiation, with intellective negotiations taking an intermediate position. Study 2 showed that individuals in a negotiation about interests made more trade-offs and reached higher joint outcomes than individuals in an intellective or evaluative negotiation. Study 3 replicated this finding in a field study. The studies bridge insights from negotiation research and decision-making research and show that the conflict issue has important effects on the negotiation process.     

Family members' knowledge about borderline personality disorder: correspondence with their levels of depression, burden, distress, and expressed emotion

Borderline personality disorder (BPD) is a severe and generally chronic disorder that presents patients and their family members with multiple challenges. Little is currently known about how much family members of patients with BPD know about this disorder. Thirty-two family members of BPD patients were assessed for their level of knowledge about BPD. Knowledge level was then correlated with family members' burden, depression, distress, and expressed emotion. Contrary to expectation, greater knowledge about BPD was associated with higher levels of family members' burden, distress, depression, and greater hostility toward patients. These findings raise concerns about (a) the value of information family members receive about BPD and (b) the importance of the source and accuracy of the information they receive. Further research is warranted and may provide additional information to this understudied area.