A person-centered, transdiagnostic schema and mode profile approach to predict outcome in time-limited schema group therapy.

Objective: This study employs a person-centered transdiagnostic approach to examine how schema and mode profiles predict symptom severity reduction in schema group therapy for patients with personality disorders and enduring clinical syndromes.

Method: We analyzed symptom reduction in 248 patients across three formats of manualized, time-limited schema group therapy. Latent profile analysis and mixed multilevel modeling were used to determine the extent to which schema/mode classes predict symptom reduction, and whether the inclusion of individual schemas and modes enhances these predictions.

God Representation Types Are Associated With Levels of Personality Organization and Christian Religious Orthodox Culture.

This exploratory study shows that God representation types are associated with levels of personality organization. Among two Dutch samples of psychiatric patients (n = 136) and nonpatients (n = 161), we found associations between the psychotic, borderline, and neurotic personality organizations, and passive-unemotional, negative-authoritarian, and positive-authoritative God representation types, respectively. Both patients and nonpatients reported positive God representations, but only nonpatients and higher-level functioning patients reported an integrated God-object relation.

Mixed results of a pilot RCT of time-limited schema mindfulness-based cognitive therapy and competitive memory therapy plus treatment as usual for personality disorders.

Waiting lists for psychotherapy for patients with personality disorders are increasing; there is an imbalance between the number of patients seeking help and the amount of therapy available. Thus, there is a need for time-limited treatments that are effective for specific patients and their specific problems. This pilot randomized controlled trial aimed to investigate the effectiveness of two 8-week group modules + treatment as usual (TAU): schema mindfulness-based cognitive therapy (SMBCT) and competitive memory therapy (COMET) with special attention to predictors and mediators of change.

The relationship between childhood abuse and severity of psychosis is mediated by loneliness: an experience sampling study.

Background: This study tested the hypotheses that (i) the relationship between a history of childhood abuse and severity of psychosis is mediated by loneliness; (ii) the relationship between loneliness and psychosis is mediated by within-person fluctuations in depressive and anxious feelings.

Methods: Fifty-nine individuals with non-affective psychotic disorder rated the intensity of loneliness, positive symptoms, and depressive and anxious feelings during repeated moments in daily life (Experience Sampling Method). Childhood abuse was assessed retrospectively using the 'Childhood Experience of Care and Abuse' interview.

Reported Childhood Abuse and Stress Reactivity in Psychosis: A Conceptual Replication and Exploration of Statistical Approaches.

A previous study observed that reported childhood abuse moderated psychotic and emotional reactivity to stress among patients with non-affective psychotic disorder. However, that study used a type of analysis unsuited for skewed data. This study aimed (1) to replicate the study and (2) to examine whether we would obtain similar results using a statistical approach better suited to skewed data.

Mentalizing impairment as a mediator between reported childhood abuse and outcome in nonaffective psychotic disorder.

Reported childhood abuse has been linked to the severity of clinical symptoms and social dysfunction in non-affective psychotic disorder. Impaired mentalizing ability may be one of the mechanisms accounting for this effect. This study examined whether impaired mentalizing mediates the effect of reported childhood abuse on positive symptoms, negative symptoms, and social dysfunction.

Mentalization-based treatment for psychotic disorder: protocol of a randomized controlled trial.

Background: Many patients with a non-affective psychotic disorder suffer from impairments in social functioning and social cognition. To target these impairments, mentalization-based treatment for psychotic disorder, a psychodynamic treatment rooted in attachment theory, has been developed. It is expected to improve social cognition, and thereby to improve social functioning.

Insecure attachment strategies are associated with cognitive alexithymia in patients with severe somatoform disorder.

Objective: In light of interpersonal difficulties and their relation to alexithymia in patients with somatoform disorder, the primary aim of this study was to explore the association between two insecure attachment strategies (deactivation and hyperactivation strategies), and affective and cognitive alexithymia in a sample of 128 patients with severe somatoform disorder, over and above the levels of negative affectivity and personality pathology.

Method: In a cross-sectional study among patients with somatoform disorder, self-report data were obtained using measures for alexithymia (Bermond-Vorst Alexithymia Questionnaire), attachment (Experiences in Close Relationships Questionnaire), personality pathology (Inventory of Personality Organization), and negative affectivity (Dutch Short Form of the MMPI). We used hierarchical regression analyses to test main effects of attachment deactivation and hyperactivation strategies in the prediction of both cognitive and affective alexithymia, while controlling for the levels of negative affectivity and personality pathology.

Association between level of personality organization as assessed with theory-driven profiles of the Dutch Short Form of the MMPI and outcome of inpatient treatment for personality disorder.

The association between level of personality organization as assessed by theory-driven profile interpretation of the MMPI (Hathaway & McKinley, 1943) Dutch Short Form and treatment outcome was investigated in a naturalistic follow-up study among 121 psychotherapy inpatients who had been treated for their severe personality pathology. Treatment outcome was measured with the Brief Symptom Inventory (De Beurs & Zitman, 2006). Personality organization was associated with severity of psychopathology at baseline, the end of treatment, and 36 months after baseline.

Effectiveness of psychotherapy for severe somatoform disorder: meta-analysis.

Background: Patients with severe somatoform disorder (in secondary and tertiary care) typically experience functional impairment associated with physical symptoms and mental distress. Although psychotherapy is the preferred treatment, its effectiveness remains to be demonstrated.

Aims: To examine the effectiveness of psychotherapy for severe somatoform disorder in secondary and tertiary care compared with treatment as usual (TAU) but not waiting-list conditions.

Changes in symptom severity, schemas and modes in heterogeneous psychiatric patient groups following short-term schema cognitive-behavioural group therapy: a naturalistic pre-treatment and post-treatment design in an outpatient clinic.

Unlabelled: Schema therapy has proven to be an effective treatment for patients with borderline personality disorder. However, little is known of its merits in other psychiatric (personality) disorders.

Objective: This study investigated whether schema therapy in a group setting (group schema cognitive-behavioural therapy [SCBT-g]) was associated with changes in symptom and schema and mode severity.

Differential treatment response of subtypes of patients with borderline personality organization, as assessed with theory-driven profiles of the Dutch short form of the MMPI: a naturalistic follow-up study.

We investigated the validity of different subtypes of borderline personality organization (BPO) as assessed by theory-driven profiles of the Minnesota Multiphasic Personality Disorder (MMPI; Hathaway & McKinley, 1943 ) Dutch Short Form (DSFM; Eurelings-Bontekoe, Onnink, Williams, & Snellen, 2008 ) in a naturalistic follow-up study among 2,062 psychiatric outpatients who received 6 months of ambulatory treatment. Patients were assessed at intake (T1) and 6 months later (T2). At T2, both patients and therapists rated the level of improvement, using the Global Assessment of Improvement.

The relationship between personality organization as assessed by theory-driven profiles of the Dutch Short Form of the MMPI and self-reported features of personality organization.

In this study, we investigated the relationships between features of personality organization (PO) as assessed by theory driven profiles of the Dutch Short Form of the MMPI (DSFM; Luteijn & Kok, 1985) and 2 self-report measures of personality pathology, that is, the Dutch Inventory of Personality Organization (Berghuis, Kamphuis, Boedijn, & Verheul, 2009) and the Dutch Schizotypy Personality Questionnaire-Revised (Vollema & Hoijtink, 2000), in a sample of 190 outpatient psychiatric patients. Results showed that the single scales of all 3 measures segregated into 2 theoretically expected and meaningful dimensions, that is, a dimension assessing severity of personality pathology and an introversion/extraversion dimension. Theory-driven combinations of single DSFM subscales as a measure of level of PO distinguished characteristics of patients at various levels of PO in theoretically predicted ways.

Structural personality organization as assessed with theory driven profile interpretation of the dutch short form of the MMPI predicts dropout and treatment response in brief cognitive behavioral group therapy for axis I disorders.

We investigated the validity of theory driven profile interpretation of the MMPI (Hathaway & McKinley, 1943) Dutch Short Form (DSFM; Eurelings-Bontekoe, Onnink, Williams, & Snellen, 2008) as a measure of personality organization (PO) in a naturalistic follow-up study among 576 psychiatric outpatients receiving brief cognitive behavioral group therapy. Results showed that this assessment method was useful in predicting dropout as well as treatment response. Patients with a latent psychotic PO profile and a manifest low-level borderline organization profile were 3 times more likely to drop out than patients with other PO profiles.

Validation of a theory-driven profile interpretation of the Dutch short form of the MMPI using the TAT Social Cognitions and Object Relations Scale (SCORS).

In this study, we investigated the construct validity of the theory-driven profile interpretation of the Dutch Short Form of the MMPI (DSFM; Luteijn & Kok, 1985), an interpretation method aimed at assessing structural features of personality based on Kernberg and Caligor's (2005) views concerning personality organization. We utilized the four dimensions of the Social Cognition and Object Relations Scale (SCORS; Westen, Lohr, Silk, Gold, & Kerber, 1990) as external criteria. Results showed that, congruent with theoretical expectations, the DSFM profiles predicted structural features of personality functioning, especially identity diffusion as measured by the SCORS, after adjustment for the effect of the single scales used to construct the profiles.

[Personality disorders in an institution for ambulatory mental health care. Prevalence, type and severity, treatment indication and drop out].

Background: Personality disorders occur frequently. The presence of one or more personality disorders can influence the severity of the symptoms and can affect coping, treatment indication and drop out.

Aim: To study the prevalence of personality disorders in an ambulatory health care centre and to investigate the influence of both the severity and the nature of personality disorders on the following: symptomatology, interpersonal behaviour, coping and defence mechanisms, personality traits, treatment indication and drop out.

Validation of the multiple language versions of the Hopkins Symptom Checklist-37 for refugee adolescents.

The objective of this study is to provide preliminary psychometric properties of the Hopkins Symptom Checklist-37 (HSCL-37A) for refugee adolescents. The HSCL-37A is a modification of the well-known HSCL-25 and assesses symptoms of internalizing and externalizing problems that have been associated with reactions to trauma. Four independent heterogeneous samples (N=3890) of unaccompanied refugee minors, immigrants, and native Dutch and Belgian adolescents were assessed at school.

Comparing psychological distress, traumatic stress reactions, and experiences of unaccompanied refugee minors with experiences of adolescents accompanied by parents.

The objective of this study is to make comparisons of the severity of the psychological distress, behavioral problems and traumatic stress reactions, and experiences of unaccompanied refugee minors (URMs) with immigrant/refugee (I/R) and Dutch (native) adolescents with parental caregivers (N = 3273). Self-report questionnaires were administered. Most assessments took place at school.

Course and predictors of mental health of unaccompanied refugee minors in the Netherlands: one year follow-up.

This epidemiological investigation addresses the prevalence, course, and predictors of the psychological distress and behavioral problems of unaccompanied refugee minors living in the Netherlands. The legal guardians, teachers and minors themselves all reported on the mental health of the refugee minors (n=582) at baseline and follow-up approximately 12 months later. The self-reported psychological distress of refugee minors was found to be severe (50%) and of a chronic nature (stable for one year) which was confirmed by reports from the guardians (33%) and teachers (36%).

Factors associated with mental health service need and utilization among unaccompanied refugee adolescents.

This study is the first to address the need for mental health Care (MHC) and the patterns of utilization of MHC services among Unaccompanied Refugee Minors (URM). Information concerning the well being, mental health need, and utilization of services of URM was collected from three informants, the minors themselves (n = 920), their legal guardians (n = 557), and their teachers (n = 496). The well-being, need and utilization of MHC services of URM was compared with those of a representative Dutch adolescent sample (n = 1059).

Validation of the multiple language versions of the Reactions of Adolescents to Traumatic Stress questionnaire.

The objective of this study was to assess the preliminary psychometric properties of the Reaction of Adolescents to Traumatic Stress questionnaire (RATS) for refugee adolescents. Four independent heterogeneous adolescent population samples (N = 3,535) of unaccompanied refugee minors, immigrants, and native Dutch and Belgian adolescents were assessed at school. The confirmatory factor analyses, per language version, support the three-factor structure of intrusion, avoidance/numbing, and hyperarsoual.

Associations among homesickness, anger, anxiety, and depression.

The study investigated the association of homesickness with the related concepts of anxiety, depression, and anger. Two conceptualizations of homesickness were used, one considering homesickness as a state, characterized by severe symptoms of a depressive episode, and the other one as a self-reported tendency to experience homesickness in times of separation from the familiar environment. The latter conceptualization can rather be considered as an enduring trait and does not specifically refer to actual feelings of depression.

Anxiety sensitivity profile: dimensional structure and relationship with temperament and character.

Background: Anxiety sensitivity (AS), the belief that bodily sensations have harmful consequences, is a reliable predictor of panic attacks in both clinical and nonclinical populations. Recently, a new measure of AS has been proposed. The AS profile (ASP) was designed to be a more comprehensive measure of AS, and to be more suitable for the measurement of different AS dimensions.

An exploratory investigation into types of adult homesickness.

Background: It is not clear yet whether or not homesickness is a singular syndrome. Some authors have proposed different subtypes or forms of homesickness. Since there may be great differences between various subtypes of homesickness regarding etiology, causes, manifestations and consequences, a distinction of subtypes may have far-reaching implications for research and therapy.