Short-Term Inpatient DBT Combined with Metacognitive Interventions for Personality Disorders: A Pilot Acceptability and Effectiveness Study

This study aims at evaluating the effectiveness of an intensive 1-month residential treatment course in an Italian psychiatric unit for patients meeting criteria for personality disorders (PD). This study involved 189 patients consecutively admitted to the unit and assessed at admission and discharge. The inpatient program was based on Dialectical Behavior Therapy (DBT) combined with Metacognitive interventions. Primary outcome was a reduction of general symptom severity (as measured by SCL-90-R). Secondary outcomes were reduction in depression (BDI), interpersonal problems (IIP-47). Other outcomes were impulsivity (BIS-11), aggressiveness (AQ), and dissociation (DES). We found a significant reduction in symptom severity, as well as in depression, interpersonal problems, dissociation, impulsivity and aggressiveness. The size of this benefit was predicted mostly by number of criteria met at SCID-II and intake scores mostly for impulsiveness and dissociation. In conclusion, intensive 1-month residential DBT combined with metacognitive interventions can be effective in treating patients with any PD presenting with severe global suffering, prominent self-harm and suicidal risk.

     

Plotinus on the Inner Sense

Recently, there has been a growing interest in ancient views on consciousness and particularly in their influence on medieval and early modern philosophers. Here I suggest a new interpretation of Plotinus’s account of consciousness which, if correct, may help us to reconsider his role in the history of the notion of the inner sense. I argue that, while explaining how our divided soul can be a unitary subject of the states and activities of its parts, Plotinus develops an original account of consciousness that appeals to an inner sense. In contrast to ‘the outer senses’, which perceive sensible things out there in the world, this sense, for him, perceives the activities of the parts of our soul, thus enabling us to be conscious of them as a single subject. I suggest that Plotinus devises his account of this psychic power in the light of Alexander of Aphrodisias’s interpretation of the Aristotelian ‘common sense’. Since in Alexander the ‘common sense’ enables us to be conscious as a single subject of sensations from different modalities, Plotinus uses it as a model to explain how we can be the conscious subject of all the states and activities of our soul.