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).

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.

Implementation of outpatient schema therapy for borderline personality disorder: study design.

Background: Schema Therapy (ST) is an integrative psychotherapy based upon a cognitive schema model which aims at identifying and changing dysfunctional schemas and modes through cognitive, experiential and behavioral pathways. It is specifically developed for patients with personality disorders. Its effectiveness and efficiency have been demonstrated in a few randomized controlled trials, but ST has not been evaluated in regular mental healthcare settings.

Development and psychometric evaluation of a new assessment method for childhood maltreatment experiences: the interview for traumatic events in childhood (ITEC).

Objective: We conducted a comprehensive assessment of the reliability and validity of the Interview for Traumatic Events in Childhood (ITEC, Lobbestael, Arntz, Kremers, & Sieswerda, 2006), a retrospective, semi-structured interview for childhood maltreatment. The ITEC aims to yield dimensional scores for severity of experiences of different childhood maltreatment dimensions.

Methods: Initial psychometric properties were tested with the pilot version of the ITEC in 362 participants.

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.

A comparative study of patients and therapists' reports of schema modes.

The current study assesses whether patients and therapists report similar levels of schema modes, one of the central features in Schema-Focused Therapy. Patient's self-report and therapists' report on an abbreviated Schema Mode Inventory were compared in a sample of 92 patients with antisocial, borderline or cluster C personality disorder. Results indicate a markedly stronger self-therapist discrepancy in mode rating in antisocial patients than in borderline and cluster C patients.

Three preparatory studies for promoting implementation of outpatient schema therapy for borderline personality disorder in general mental health care.

Objective: Three studies were conducted to prepare for the implementation of Schema Therapy (ST) for Borderline Personality Disorder (BPD) in general mental healthcare settings. Two were surveys to detect promoting and hindering factors, one was a preliminary test of a training program in ST.

Methods: In 2004, a diagnostic analysis of factors promoting and hindering implementation of a new treatment for BPD was conducted among both managers (n = 23) and therapists (n = 49) of 29 Dutch mental healthcare institutes through a written survey (Study 1).

Reduced specificity of autobiographical memory in Cluster C personality disorders and the role of depression, worry, and experiential avoidance.

The study objective was to investigate whether, compared with nonclinical controls, participants with an avoidant, dependent, or obsessive-compulsive Cluster C personality disorder (PD) manifested reduced levels of memory specificity and whether the association of Cluster C PDs with memory specificity is mediated by repetitive negative thoughts and experiential avoidance. The Autobiographical Memory Test (R. J.

Mind the gap: Improving the dissemination of CBT.

Empirically supported psychological treatments have been developed for a range of psychiatric disorders but there is evidence that patients are not receiving them in routine clinical care. Furthermore, even when patients do receive these treatments there is evidence that they are often not well delivered. The aim of this paper is to identify the barriers to the dissemination of evidence-based psychological treatments and then propose ways of overcoming them, hence potentially bridging the gap between research findings and clinical practice.

How to deal with cost differences at baseline.

Background: To our knowledge, adjustment for baseline imbalances in costs has never been performed in trial-based cost-effectiveness analyses.

Methods: We used data from a clinical trial performed in the Netherlands comparing two outpatient psychotherapies: schema-focused therapy (SFT) versus transference-focused psychotherapy (TFP). Costs were assessed with a cost interview.

Clinical effectiveness of online computerised cognitive-behavioural therapy without support for depression in primary care: randomised trial.

Background: Computerised cognitive-behavioural therapy (CCBT) might offer a solution to the current undertreatment of depression.

Aims: To determine the clinical effectiveness of online, unsupported CCBT for depression in primary care.

Method: Three hundred and three people with depression were randomly allocated to one of three groups: Colour Your Life; treatment as usual (TAU) by a general practitioner; or Colour Your Life and TAU combined.

Performance measurement in mental health care: present situation and future possibilities.

This paper describes performance measurement and its indicators for mental health care services. Performance measurement can serve several goals such as accountability, quality improvement and performance management. For all three purposes structure, process and outcome indicators should be measured.

Effects of induced anger in patients with antisocial personality disorder.

Background: Anger is the main deregulated emotion in patients with antisocial personality disorder (ASPD). The aim of this study was to examine emotional, cognitive and physiological correlates of anger and compare these between ASPD patients with varying degree of psychopathy (PP) and control groups.

Method: Assessment of the effect of anger induction on self-reported emotions and schema modes, psychophysiology and implicit reaction-time tasks measuring self-anger and aggressor-swearword associations.

Use and acceptability of unsupported online computerized cognitive behavioral therapy for depression and associations with clinical outcome.

Background: In a recent randomized trial, we were unable to confirm the previously reported high effectiveness of CCBT. Therefore, the aim of the current study was to have a closer look at usage and acceptability (i.e.

The EQ-5D: A useful quality of life measure in borderline personality disorder?

Introduction: Borderline Personality Disorder (BPD) is a severe psychiatric disorder and is associated with significant impairment in quality of life. The aim of the present study is to assess the internal and external responsiveness of the EuroQoL-5D (EQ-5D) in BPD patients.

Patients And Methods: Data from 49 patients included in a multi-center Dutch randomized trial were used.

Psychosocial predictors of chronic Post-Traumatic Stress Disorder in Sri Lankan tsunami survivors.

This study aimed to determine whether psychological factors associated with Post-Traumatic Stress Disorder (PTSD) identified in Western samples generalize to low Social-Economical-Status (SES) populations in an underdeveloped Asian country. The study included 113 survivors of the 2004-tsunami on the south coast of Sri Lanka, recruited from 4 preschools and 10 villages for displaced persons. With logistic regressions the relations between interview-based PTSD diagnosis and psychological factors were assessed, controlling for putative confounders.

Rumination and worrying as possible mediators in the relation between neuroticism and symptoms of depression and anxiety in clinically depressed individuals.

Rumination and worrying are considered possible mediating variables that may explain the relation between neuroticism and symptoms of depression and anxiety. The current study sought to examine the mediational effects of rumination and worry in the relationships between neuroticism and symptoms of depression and anxiety in a sample of clinically depressed individuals (N=198). All patients completed a battery of questionnaires including measures of neuroticism, rumination, worrying, depression, and anxiety.

All we need is a cue to remember: the effect of an extinction cue on renewal.

In the present study, it was investigated by employing a human fear conditioning paradigm whether an extinction retrieval cue can attenuate renewal of conditioned responding after an extinction treatment procedure, and if so, what the precise role of such an extinction cue comprises. It was hypothesized that such a cue can attenuate renewal and would function as a safety signal capable of directly inhibiting the expectancy of an aversive outcome and conditioned skin conductance responding to a conditioned stimulus. The results demonstrated that the extinguished expectancy of an aversive outcome was renewed when the CS was presented outside the extinction context and that an extinction cue attenuated this effect.

Clinical and cost-effectiveness of computerised cognitive behavioural therapy for depression in primary care: design of a randomised trial.

Background: Major depression is a common mental health problem in the general population, associated with a substantial impact on quality of life and societal costs. However, many depressed patients in primary care do not receive the care they need. Reason for this is that pharmacotherapy is only effective in severely depressed patients and psychological treatments in primary care are scarce and costly.

General practitioners' treatment orientations towards low back pain: influence on treatment behaviour and patient outcome.

Background: In low back pain (LBP) treatment and research attention has shifted from a biomedical towards a biopsychosocial approach. Patients' LBP beliefs and attitudes were found to predict long-term outcome, and recently it has been suggested that the health care providers' ideas about LBP are also important predictors of treatment behaviour and outcome.

Aims: In the present study we examined whether (1) differences in General Practitioners' (GP) LBP treatment orientation are associated with differences in actual treatment behaviour and (2) whether treatment orientation is related to LBP outcome in patients.

Out-patient psychotherapy for borderline personality disorder: cost-effectiveness of schema-focused therapy v. transference-focused psychotherapy.

Background: Schema-focused therapy (SFT) and transference-focused psychotherapy (TFP) for borderline personality disorder were recently compared in a randomised multicentre trial.

Aims: To assess the societal cost-effectiveness of SFT v. TFP in treating borderline personality disorder.

An empirical test of schema mode conceptualizations in personality disorders.

Although the use of schema modes in schema-focused therapy (SFT) has been very popular since its introduction, Young's schema mode concept remained largely empirically untested. In order to provide insight into the mode conceptualization of personality disorders (PDs), the current study assessed the relationships between 14 schema modes and all PDs. Relationships between dimensional PD scores and self-reported mode scores were tested in a mixed study group of 489 participants, consisting of axis I and axis II patients, and non-patients.

Psychometric properties of the Trauma Relevant Assumptions Scale.

This article describes the psychometric properties of a novel questionnaire, i.e. the Trauma Relevant Assumptions Scale (TRAS).

Can assessors and therapists predict the outcome of long-term psychotherapy in borderline personality disorder?

Surprisingly few studies have investigated the accuracy of prognostic assessments of therapy outcome by clinicians. The objective of the present study was to investigate the relationship between clinicians' prognostic assessments and patient characteristics and treatment outcome. Seventy-one patients with a borderline personality disorder randomly allocated to schema-focused therapy (SFT) or transference-focused psychotherapy (TFP) were assessed every 3 months for 3 years.