A Preliminary Study of the Interactive Effect of Avoidant Personality Disorder Symptoms and Expressive Suppression on the Outcome of a Psychodynamically Oriented Day Treatment Program.

Patients with avoidant personality disorder (AvPD) pathology tend to have poor prognosis in psychotherapy, yet there has been little research conducted to better understand why their outcomes are limited, making it difficult to improve treatments for them. Expressive suppression is a dysfunctional emotion regulation strategy that may exacerbate avoidant tendencies, further complicating the therapeutic process. Using data from a naturalistic study ( = 34) of a group-based day treatment program, we examined whether there was an interactive effect of AvPD symptoms and expressive suppression on treatment outcome.

The Relationship Between Patients' Personality Traits, the Alliance, and Change in Interpersonal Distress in Intensive Group Treatment for Personality Dysfunction.

This study examined patients' personality traits as operationalized by the five-factor model in relation to early alliance and reduction of interpersonal distress through an intensive group treatment program for personality dysfunction. A sample of 79 consecutively admitted psychiatric outpatients with personality dysfunction who attended an 18-week intensive group treatment program completed the NEO Five-Factor Inventory at pretreatment, the Inventory of Interpersonal Problems at pre- and posttreatment, and the Edmonton Therapeutic Alliance Scale, a measure of the therapeutic alliance with the program therapist, at Session 5. Results indicated that patients who were relatively extraverted tended to rate the alliance with their program therapist higher and subsequently reported more improvement of interpersonal distress.

A randomized controlled trial evaluating the effect of an internet-based cognitive-behavioral program on anxiety symptoms in a community-based sample of adolescents.

Adolescents' use of online resources to self-manage anxiety is growing. The objective of the current trial was to assess the effectiveness of an online, primarily self-led cognitive behavioral therapy (CBT) program in reducing anxiety symptoms compared to an active comparator, access to anxiety resources on a static website. A total of 563 adolescents (13-19 years) with self-identified anxiety concerns were enrolled.

Different fixation constructs and the risk of non-union following first metatarsophalangeal joint arthrodesis.

Background: The aim of this study was to determine if a single or separate construct with interfragmentary screw was associated with higher rates non-union following first metatarsophalangeal joint (MTPJ) arthrodesis.

Methods: A retrospective analysis of patients undergoing first MTPJ arthrodesis between April 2010 and June 2017 was performed. Patients who received either a single (Stryker Anchorage 1 MTP Cross Plate) or separate (Stryker Anchorage 1 MTP locking plate with one Asnis partially threaded compression screw) construct locking plate and interfragmentary compression screw were reviewed.

Interpersonal problems and social dysfunction: Examining patients with avoidant and borderline personality disorder symptoms.

Objective(s): Interpersonal problems are one of the most persistent difficulties facing those with personality disorders (PDs) and are linked with dysfunction across numerous social domains. Using an interpersonal model of PDs, we examined the indirect effects of Avoidant PD (AvPD) symptoms and social dysfunction through interpersonal problems, as well as Borderline PD (BPD) symptoms and social dysfunction.

Methods: Participants were 226 adults taking part in an outpatient treatment program.

An Internet-Based Cognitive Behavioral Program for Adolescents With Anxiety: Pilot Randomized Controlled Trial.

Background: Internet-based cognitive behavioral therapy (ICBT) is a treatment approach recently developed and studied to provide frontline treatment to adolescents with anxiety disorders.

Objective: This study aimed to pilot procedures and obtain data on methodological processes and intervention satisfaction to determine the feasibility of a definitive randomized controlled trial (RCT) to test the effectiveness of a self-managed ICBT program, Breathe (Being Real, Easing Anxiety: Tools Helping Electronically), for adolescents with anxiety concerns.

Methods: This study employed a two-arm, multisite, pilot RCT.

Depression symptoms' impact on personality disorder treatment: Depression symptoms amplifying the interpersonal benefits of negative-affect expression.

Background: While there is some evidence that patients with elevated depression symptoms experience greater benefits from negative-affect expression, this amplifying effect has not been investigated within a psychotherapeutic context. This is particularly notable considering the substantial evidence linking affect expression with desired outcomes across psychotherapeutic approaches. The primary purpose of the present study was to investigate if depression symptoms amplified (i.

The Effect of Hopelessness and Perceived Group Compatibility on Treatment Outcome for Patients With Personality Dysfunction.

Improvement in life satisfaction is hard to achieve for any patient with personality psychopathology, and possibly even moreso for those who feel hopeless at the start of treatment. The present research investigated the potential influence of hopelessness in the treatment of patients with personality dysfunction, using data from patients who completed an intensive group therapy program designed to reduce symptom distress and support optimal psychosocial functioning (N = 80). In the present study, we sought to examine whether hopelessness would moderate (i.

Narcissism and Quality of Life: The Mediating Role of Relationship Patterns.

Pathological narcissism is associated with decreased quality of life, even when accounting for psychiatric comorbidity, but the processes behind this association are unclear. Here, we evaluate whether disturbed relatedness accounts for the negative association between narcissistic pathology and quality of life. Patients in day hospital treatment for personality pathology (N = 218, 70% female; mean age, 37.

Transmetatarsal amputation: A 12 year retrospective case review of outcomes.

Background: Diabetic foot pathology has rapidly increased, presenting a vast economic burden with severe implications for patients. Establishing effective limb salvage techniques such as transmetatarsal amputation is essential to offer viable alternatives to major limb amputation in severe foot infection, where outcomes are variable and mortality rates high.

Methods: A retrospective review of outcomes was performed on patients who underwent TMA at a single United Kingdom hospital between 2005-2017.

Improving social functioning and life satisfaction among patients with personality dysfunction: Connectedness and engagement in integrative group treatment.

Reduced social impairment and improved life satisfaction are important objectives in group treatment for patients with personality dysfunction. Knowledge regarding patient characteristics and group treatment processes that contribute to these outcomes, however, remains limited. Dispositional connectedness, the valuing of interpersonal connections, may be an important patient factor that influences patients' experience of group treatment in ways that facilitate therapeutic benefits.

The efficacy of the Strength, Hope and Resourcefulness Program for people with Parkinson's disease (SHARP-PWP): A mixed methods study.

Introduction: Treatment of PD focuses on improving symptoms and quality of life, yet research has not examined interventions aimed at promoting hope in patients. This study examined the effects of a Strength, Hope, and Resources Program for People with PD (SHARP-PWP), based on the principles of positive psychology.

Methods: A mixed method design examined the effects of a randomized, waitlist-controlled trial of SHARP-PWP.

Improving self-esteem through integrative group therapy for personality dysfunction: Investigating the role of the therapeutic alliance and quality of object relations.

Objective: We aimed to investigate change in self-esteem through intensive group treatment for personality dysfunction, by exploring: (a) the relationship between patients' experience of therapeutic alliance and improvement in self-esteem during treatment, including patients' quality of object-relations (QOR) as a possible moderator; and (b) the association between improvement in self-esteem during treatment, and depressive symptoms 9 months later.

Method: Eighty patients with personality dysfunction, consecutively enrolled in a group-oriented treatment program, were assessed at pretreatment, posttreatment, and 9 months follow-up.

Results: Especially for patients with lower QOR, alliance predicted self-esteem change during treatment.

Where does it hurt? Location of pain, psychological distress, and alexithymia among outpatients seeking psychotherapy.

Physical pain is prevalent among psychiatric outpatients, yet there has been little research regarding the types of pain reported. The purpose of this study was to survey outpatients seeking psychotherapy regarding pain locations and to examine associations between number of pain locations and psychiatric distress and alexithymia. Two hundred and seventeen patients were recruited from three Canadian hospitals that offer outpatient psychiatry services and short-term therapies.

The attenuating effect of depression symptoms on negative-affect expression: Individual and group effects in group psychotherapy for personality disorders.

Across a breadth of psychotherapeutic approaches, feeling affect intensely and then talking about those feelings is a common means for increasing insight and other desired outcomes. While several naturalistic and laboratory studies have found that depression symptoms attenuate (i.e.

Individual goal achievement in group psychotherapy: The roles of psychological mindedness and group process in interpretive and supportive therapy for complicated grief.

The ability to infer psychological meaning in behaviour-referred to as psychological mindedness-has been posited as a patient characteristic that contributes to the therapy process and consequently to therapeutic success. The present study was developed to examine the relationship between patients' psychological mindedness and improvement in patients' personal treatment goals in interpretive and supportive group therapies for complicated grief, along with patients' importance to group process. The study was conducted with a clinical sample of 109 patients (79% female; average 45 years old) receiving treatment for complicated grief.

Narcissism and Interpersonal Problems Among Psychiatric Outpatients: What Is the Role of Defensive Style?

A growing body of evidence points to significant interpersonal problems associated with narcissism in clinical samples. Less well understood are the mechanisms by which narcissism negatively impacts one's interpersonal functioning. The present study investigated defensive style as a possible mediator of the relationship between narcissism and interpersonal problems.

The necessary conditions of engagement for the therapeutic relationship in physiotherapy: an interpretive description study.

Background: The therapeutic relationship between patient and physiotherapist is a central component of patient-centred care and has been positively associated with better physiotherapy clinical outcomes. Despite its influence, we do not know what conditions enable a physiotherapist and patient to establish and maintain a therapeutic relationship. This knowledge has implications for how clinicians approach their interactions with patients and for the development of an assessment tool that accurately reflects the nature of the therapeutic relationship.

What the patient wants: Addressing patients' treatment targets in an integrative group psychotherapy programme.

Objectives: Limited empirical attention has been devoted to individualized treatment objectives in intensive group therapy for personality dysfunction. This study investigated patients' ratings of distress associated with individual therapy goals - referred to as target object severity - in an intensive Evening Treatment Programme for patients with personality dysfunction.

Design: Change in target objective severity was examined in a sample of 81 patients who completed treatment in an intensive, integrative group therapy programme.

A framework for establishing connections in physiotherapy practice.

The therapeutic relationship between practitioner and patient is embedded in the clinical interaction. Research using self-report tools has illustrated that positively evaluated therapeutic relationships can have favorable impacts on patient satisfaction with services and clinical outcomes. However, little is known about how physiotherapists develop the connections, or positive attachments, that help establish the therapeutic relationship.

Body talk: Sex differences in the influence of alexithymia on physical complaints among psychiatric outpatients.

This study investigated the relationship between alexithymia and physical complaints among psychiatric outpatients, and whether sex moderated this relationship. Participants (N = 185) completed measures of physical complaints (bodily symptom burden, pain severity, pain interference), alexithymia, current symptom (depression, anxiety) distress, and somatosensory amplification (i.e.

Psychological Mindedness and Psychotherapy Process in Short-Term Group Therapy.

Psychological mindedness is regarded as an important patient characteristic that can influence the course of psychotherapy. The purpose of this study was to investigate the relationship between patients' capacity for psychological mindedness and aspects of the group psychotherapy process as experienced and rated by therapists and other group members. Participants were 110 patients who completed two forms of short-term group therapy for the treatment of complicated grief.

Intensive Evening Outpatient Treatment for Patients With Personality Dysfunction: Early Group Process, Change in Interpersonal Distress, and Longer-Term Social Functioning.

Objective: Entrenched interpersonal difficulties are a defining feature of those with personality dysfunction. Evening treatment-a comprehensive and intensive group-oriented outpatient therapy program-offers a unique approach to delivering mental health services to patients with chronic personality dysfunction. This study assessed change in interpersonal problems as a key outcome, the relevance of such change to future social functioning, and the influence of early group processes on this change.

Short-Term Group Therapy for Complicated Grief: The Relationship Between Patients' In-Session Reflection and Outcome.

Objective: The objective of the present study was to examine the nature of patients' work in two types of short-term group psychotherapy. The study sought to investigate the relationship between patients' psychodynamic work versus supportive work in group psychotherapy and treatment outcome at termination and at 6-month follow-up. Psychodynamic work refers to reflection regarding intrapsychic motivations, defenses, and relational patterns, and supportive work refers to practical problem solving.

Influence of the Labrum on Version and Diameter of the Glenoid: A Morphometric Study Using Magnetic Resonance Images.

Purpose: To use magnetic resonance imaging to determine the influence of the labrum on both the osseous version and effective diameter of the glenoid.

Methods: This was a retrospective, cross-sectional study of patients with shoulder pain who underwent MRI between February 2014 and February 2015. The morphology of the glenoid labrum and glenoid was scanned with a 3-T magnetic resonance imaging scanner, and variables were measured by use of IntelliSpace PACS Enterprise.