Beliefs in personality disorders: a test with the personality disorder belief questionnaire

The hypothesis that each personality disorder (PD) is characterized by a specific set of beliefs was tested in a sample of 643 subjects, including non-patient controls, axis-I and axis-II patients, diagnosed with SCID-I and -II interviews. Beliefs of six PDs (avoidant, dependent, obsessive-compulsive, paranoid, histrionic, borderline) were assessed with the Personality Disorder Belief Questionnaire (PDBQ). Factor analyses supported the existence of six hypothesized sets of beliefs. Structural equation modeling (SEM) supported the hypothesis that each PD is characterized by a specific set of beliefs. Path coefficients were however in the medium range, suggesting that PDs are not solely determined by beliefs. Nevertheless, empirically derived cutoff scores of the six belief subscales were reasonably successful in classifying subjects, percentages ranging form 51% to 83%. It appeared that there was a monotonical increase in scores on each belief subscale from non-patient controls, to patients without any PD, to patients with PDs (other than the pertinent PD), to patients with the pertinent PD. This suggests that PD-related beliefs are at least partly associated with (personality) psychopathology in general. Another explanation is that many patients' position on the underlying dimensions is not high enough to lead to a DSM PD diagnosis, but high enough to lead to an elevated belief score.     

An especial skill: Support for a learned parameters hypothesis

We tested the ‘learned parameters’ hypothesis as an explanation of the ‘especial skill effect’. Outcome attainment and movement kinematics were recorded for 10 expert and 10 novice players performing basketball free-throw shots at five distances (11-19 ft) with a regular and heavy weight basketball. As predicted, experts performed better than expected relative to the regression equation at the 15 ft, free-throw line with the regular basketball, supporting the ‘especial skill effect’. This effect was not present for the experts when shooting with the heavy ball. Novices did not show an advantage at the free-throw line when performing with either ball. Although the outcome attainment scores support the ‘learned parameters’ hypotheses, kinematic analysis failed to identify differences in the movement pattern for the especial skill, suggesting that these skills (i.e., shooting at different distances) are not governed by separate motor programs.     

Bartlett's schema theory: The unreplicated “portrait d'homme” series from 1932

In 1932, Frederic Bartlett laid the foundation for the later schema theory. His key assumption of previous knowledge affecting the processing of new stimuli was illustrated in the famous “portrait d'homme” series. Sequenced reproductions of ambiguous stimuli showed progressive object-likeness. As Bartlett pointed out, activation of specific schemata, for instance “the face schema”, biases memory retrieval towards such schemata. In five experiments (Experiment 1, n?=?53; Experiment 2, n?=?177; Experiment 3, n?=?36; Experiment 4, n?=?6; Experiment 5, n?=?2), we tested several factors potentially influencing retrieval biases—for example, by varying the general procedure of reproduction (repeated vs. serial) and by omitting versus providing visual or semantic cues for activating face schemata. Participants inspected face-like stimuli with the caption “portrait of the human” and reproduced them repeatedly under specific conditions. None of the experiments revealed a systematic tendency towards Bartlett's described case, even when the participants were explicitly instructed to draw “a face” like the previously inspected one. In one of the “serial reproduction” experiments, we even obtained contrary effects with decreasing face-likeness over the reproduction generations. A close analysis of the original findings raises questions about the replicability of Bartlett's findings, qualifying the “portrait d'homme” series more or less as an illustrative example of the main idea of reconstructive memory.     

Rule-based schema matching for ontology-based mediators

Mediating heterogeneous data sources heavily relies on explicit domain knowledge expressed, for example, as ontologies and mapping rules. We discuss the use of logic representations for mapping schema elements onto concepts expressed in a simplified ontology for cultural assets. Starting with a logic representation of the ontology, criteria for a rule-based schema matching are exemplified. Special requirements are the handling of uncertain information and the processing of hierarchical XML structures representing instances.     

A new look at the schema therapy model: organization and role of early maladaptive schemas

This study reexamined the organization of Young’s 18 early maladaptive schemas and their hypothesized associations with experiences of need-thwarting parental experiences in childhood and the “vulnerable child” mode of emotional distress in adulthood. A large Danish sample (N = 1054) of 658 clinical- and 391 nonclinical adults completed measures of early maladaptive schemas, parenting styles, and the vulnerable child mode. We identified four higher-order schema domains as most appropriate in terms of interpretability and empirical indices (“Disconnection & Rejection”, “Impaired Autonomy & Performance”, “Excessive Responsibility & Standards”, and “Impaired Limits”). All four schema domains were differentially associated with conceptually relevant need-thwarting parental experiences. Apart from “Impaired Limits”, the schema domains meaningfully accounted for the association between need-thwarting parental experiences in childhood and emotional states of feeling like a “vulnerable child” in adulthood. We conclude that four domains of early maladaptive schemas are empirically and conceptually consistent with Young’s schema therapy model of personality pathology and longstanding emotional disorders. Findings warrant replication using different populations and if possible a prospective multi-method design. A scoring key for computing the four schema domains is provided.     

Alexithymia and Early Maladaptive Schemas in chronic pain patients

Psychological factors have an impact on subjective pain experience. The aim of this study was to explore the occurrence of alexithymia and Early Maladaptive Schemas in a sample of 271 first visit chronic pain patients of six pain clinics. The patients completed the study questionnaire consisting of the Toronto Alexithymia Scale‐20, the Finnish version of the Young Schema Questionnaire short form‐extended, the Beck Depression Inventory‐II, and pain variables. Alexithymic patients scored higher on Early Maladaptive Schemas and had more pain intensity, pain disability and depression than nonalexithymic patients. Both alexithymia and depression correlated significantly with most Early Maladaptive Schemas. The co‐occurrence of alexithymia, Early Maladaptive Schemas and depression seems to worsen the pain experience. Screening of alexithymia, depression and Early Maladaptive Schemas may help to plan psychological treatment interventions for chronic pain patients.     

Emotional, cognitive and physiological correlates of abuse-related stress in borderline and antisocial personality disorder

Childhood abuse is an important precursor of borderline personality disorder (BPD) and antisocial personality disorder (ASPD). The current study compared the emotional reactivity to abuse-related stress of these patients on a direct and an indirect level. Changes in self-reported affect and schema modes, psychophysiology and reaction time based cognitive associations were assessed following confrontation with an abuse-related film fragment in patients with BPD (n = 45), ASPD (n = 21), Cluster C personality disorder (n = 46) and non-patient controls (n = 36). Results indicated a hyperresponsivity of BPD-patients on self-reported negative affect and schema modes, on some psychophysiological indices and on implicit cognitive associations. The ASPD-group was comparable to the BPD group on implicit cognitions but did not show self-reported and physiological hyper-reactivity. These findings suggest that BPD and ASPD-patients are alike in their implicit cognitive abuse-related stress reactivity, but can be differentiated in their self-reported and physiological response patterns.     

类比的图式驱动效应

本研究采用了两个实验探讨了类比的图式驱动效应即类比的映射不仅是一种外显的推理过程而且也是一种内隐的推理过程,这一内隐过程具有图式驱动效应.实验1要求被试者首先阅读基础课文和目标课文然后回答问题,结果表明在课文阅读过程中存在着内隐推理.实验2采用更加复杂的实验方法检验了影响内隐推理的图式驱动效应,结果发现被试者的类比内隐推理主要受图式驱动或者结构排列的影响而很少受到语义激活或者启动效应的影响.最后,在结构排列理论与图式理论的框架中讨论了本研究的结果.     

Implementation of outpatient schema therapy for borderline personality disorder with versus without crisis support by the therapist outside office hours: A randomized trial

Objective

This study aimed to evaluate the success of implementing outpatient schema focused therapy (ST) for borderline patients in regular mental healthcare and to determine the added value of therapist telephone availability outside office hours in case of crisis (TTA).

Methods

To enhance the implementation, the following adaptations regarding the original ST protocol were applied: a reduction in the frequency and duration of the therapy; training therapists of eight regular healthcare centers in ST with a structured and piloted program supported by a set of films (DVDs) with examples of ST techniques; training and supervision given by Dutch experts. Telephone availability outside office hours was randomly allocated to 50% of the therapists of each treatment center. Patient's outcome measures were assessed with a semi-structured interview and self-report measures on BPD, quality of life, general psychopathology and an ST questionnaire, before, during and after treatment.

Results

Data on 62 DSM-IV defined BPD patients were available. Intention-to-treat analyses showed that after 1.5 years of ST 42% of the patients had recovered from BPD.No added value of therapist telephone availability (TTA) was found on the BPDSI score nor on any other measure after 1.5 years of ST.

Conclusions

ST for BPD can be successfully implemented in regular mental healthcare. Treatment results and dropout were comparable to a previous clinical trail. No additional effect of extra crisis support with TTA outside office hours ST was found.