Mistrust is a significant problem for people with psychosis and can interfere with their capacity to engage in psychosocial treatment. In this article, the developmental trajectory of mistrust is outlined, including the impact that attachment disruption, childhood trauma, attributional biases, internalized stigma, and discrimination can have on the person's capacity to form trusting bonds with others. After this review, three elements are described that may allow for the restoration of trust: the therapist's openness to understanding the patient's experience and agenda for therapy, the therapist's effort to honestly disclose their thoughts to encourage dialogue and mutual reflection, and therapist's attempt to promote metacognition through helping the patient develop more complex representations of the minds of others.
View Article and Find Full Text PDFWhile recovery from psychosis is possible, recovery is a multidimensional construct driven by various factors. One relevant factor to recovery from psychosis that has often been overlooked in the psychotherapy literature is the importance of facing loss and processing grief in relation to psychosis. A review of the existing empirical literature on grief associated with psychosis was conducted.
View Article and Find Full Text PDFResearch confirms that although patients experiencing psychosis want to speak about their symptoms with psychiatrists, psychiatrists are often hesitant to engage them directly in such conversations because of their fear of colluding, promoting defensiveness, or rupturing the therapeutic alliance. As a result, patients are often left to contend with confusing psychotic experiences, such as hallucinations and delusions, that they cannot make sense of on their own. In this article, the common barriers that prevent engagement in conversations about psychosis are described, and the conventional wisdom about the futility of talking with patients about delusions is challenged.
View Article and Find Full Text PDFWhile understanding how internalized representations of others (i.e., object relations) change over the course of treatment is essential for treatment planning and evaluation of progress, few studies have examined the nature of these changes through repeated psychological assessments.
View Article and Find Full Text PDFHow a person recovers after a psychotic episode is known to be a key predictor of treatment response, impacting a person's sense of self and interpersonal relationships. An integrating recovery style, characterized by more curiosity about the psychotic episode and its potential meaning, has been shown to produce better outcomes. A novel therapeutic treatment, mentalization-based therapy for psychosis, targets the potential mechanisms (i.
View Article and Find Full Text PDFThe two polarities model (TPM) of personality organizes psychological assessment and psychotherapy and connects to personality disorder diagnosis using the Alternative Model for Personality Disorders (AMPD). The authors developed scales assessing the TPM from an existing self-report measure for level of personality functioning (LPF), a core component of the AMPD. Iterative content analyses of the LPF measure yielded scales for Autonomy and Communion corresponding to dimensions of the TPM.
View Article and Find Full Text PDFIn recent years, there has been growing interest in examining the stimulus pull effects on respondent narratives to the Thematic Apperception Test (Murray, 1943) using standardized coding methods such as the Social Cognition and Object Relations Scale-Global Rating Method (SCORS-G; Stein, Hilsenroth, Slavin-Mulford, & Pinsker, 2011; Westen, 1995). The present study expands on prior work by examining sources of variance in SCORS-G dimensions and card pull effect patterns in an adult clinical sample characterized by high psychiatric comorbidity and clinical severity. A sample of 158 adult psychiatric patients in long-term residential treatment provided narratives to 10 TAT cards (five of which have not previously been studied for pull effects).
View Article and Find Full Text PDFPassive-aggressive (PA) personality traits have received increasing attention in the research literature and are known to interfere with treatment engagement and recovery. Theoretical disagreements about PA, combined with its omission from the DSM-5, have left open many questions regarding its dynamic structure and temporal stability. Our goal in the present case study was to use a multimethod, experience sampling assessment framework for a single research subject enrolled in long-term residential treatment who exhibited significant PA traits to provide a complex portrait of daily interpersonal behaviors and experiences across a range of contexts.
View Article and Find Full Text PDFNickel-catalyzed reductive addition of phosphonodienes to aldehydes (the Mori-Tamaru reaction) gives hydroxy vinyl phosphonates in good yields with excellent control of the relative stereochemistry. Base-induced cyclization of the vinyl phosphonates yields phosphonomethyl-substituted tetrahydrofurans. Inversion of the hydroxyl stereochemistry by Mitsunobu reaction and then cyclization yields a different set of phosphonomethyl-substituted tetrahydrofuran diastereoisomers.
View Article and Find Full Text PDFContent validity analyses of eight self-report instruments for assessing severity of personality disorder (PD), also known as Level of Personality Functioning (LPF), were conducted using the conceptual scheme of the Alternative Model for Personality Disorders (AMPD; APA, 2013). The item contents of these eight inventories were characterized for the LPF constructs of Identity (ID), Self-Direction (SD), Empathy (EM), and Intimacy (IN) along with the pathological personality trait domains of Negative Affectivity, Detachment, Antagonism, Disinhibition, and Psychoticism. Severity of pathology (SV) reflected in item content was also rated.
View Article and Find Full Text PDFPsychoanalysis has produced important theories that help explain the radical alterations in self-experience central for persons experiencing psychosis. These concepts have led to important clinical developments, case studies, and some research on the efficacy of psychodynamic psychotherapy for psychosis (Gottdiener, 2006). However, psychodynamic psychotherapy has struggled to produce operationalized constructs to measure how it enhances self-development and the therapeutic mechanisms of action that facilitate these changes.
View Article and Find Full Text PDFBorderline Personal Disord Emot Dysregul
December 2019
Background: Conceptualizations of personality disorders (PD) are increasingly moving towards dimensional approaches. The definition and assessment of borderline personality disorder (BPD) in regard to changes in nosology are of great importance to theory and practice as well as consumers. We studied empirical connections between the traditional DSM-5 diagnostic criteria for BPD and Criteria A and B of the Alternative Model for Personality Disorders (AMPD).
View Article and Find Full Text PDFTwelve new Cyclophostin and Cyclipostins analogues () were synthesized, thus extending our series to 38 . Their antibacterial activities were evaluated against four pathogenic mycobacteria (, , BCG, and ) and two Gram negative bacteria. The displayed very low toxicity toward host cells and were only active against mycobacteria.
View Article and Find Full Text PDFThe utilization of multimethod assessment approaches can provide comprehensive information regarding daily interpersonal and personality functioning, increasing opportunities to guide treatment planning in a more personalized, evidence-based manner. The routine implementation of multimethod assessment within clinical settings, however, remains rare, and there are few studies that have reviewed the clinical utility of multimethod assessment. Our goal in this study was to analyze multimethod data collected from a single research subject enrolled in residential treatment in order to illustrate the process of integrating data across both single-occasion (e.
View Article and Find Full Text PDFRecent developments in the research and clinical literatures have highlighted the importance of focusing on higher-order cognitive processes in the treatment of psychotic disorders. A particular emphasis has been placed on how impairments in self-monitoring and the ability to form mental representations of others uniquely manifest in psychosis. At the same time, the recovery movement has influenced clinical innovations by emphasizing the importance of subjective domains of recovery that privilege the individual's phenomenological experience.
View Article and Find Full Text PDFTheoretical perspectives on personality and the development of psychopathology have shifted markedly over the last 7 decades. However, it remains unclear how those changes affect mental health practice. Comprehensive and conscientiously recorded reports of psychological testing provide a clear window on this process because they comprise distinctive records of how patients are assessed and understood.
View Article and Find Full Text PDFDimethyl (β-substituted) vinylphosphonates do not readily undergo cross metathesis reactions with Grubbs catalyst and terminal alkenes. However, the corresponding mono- or diallyl vinylphosphonate esters undergo facile cross metathesis reactions. The improved reactivity is attributed to a relay step in the cross metathesis reaction mechanism.
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