1,720,966 research outputs found
Attaccamento, trauma, mentalizzazione e personalità nell'Intimate Partner Violence: un'indagine preliminare.
No full textViolence against women and girls is both a human rights and a public health issue. It is a global phenomenon, which adversely affects individuals who experience it and carries social and financial costs for the societies in which it occurs. The World Health Organisation (WHO) recently estimated that more than 35% of women worldwide have experienced either intimate partner violence or non-partner sexual violence in their lifetime. Violence against women is both a cause and a consequence of gender inequality in society. Intimate partner violence (IPV) is one of the most common forms of violence against women and includes physical, sexual, and emotional abuse and controlling behaviours by an intimate partner (WHO, 2013). It has been examined from a range of theoretical perspectives, one of those being attachment theory, identified as a way to assess several psychosocial risk factors for violence (Mahalik et al., 2005). In the previous literature, the child’s exposure to violence in the family resulted as a major predictor of subsequent exposure to IPV victimization (Widom, et al., 2008). Research on abused and traumatized samples has shown high frequencies of unresolved/disorganized attachment in adults. Attachment disorganization is associated with major problems of affect regulation and mentalizing deficits. An extensive body of research highlighted that mentalization was elaborated in terms of polarities (Fonagy et al., 2012).
Moreover research findings strengthen existing evidence that partner violence contributes to women's poor mental health. Women assaulted by an intimate partner experience significant health consequences including injury, chronic pain, gastrointestinal problems, sexually transmitted infections, depression, suicidality, post-traumatic stress disorder, and death. Despite the increasingly well-documented literature on this association there has been relatively less empirical focus on the interactions between IPV and personality disorders.
This research has different aims: to analyze the relationship between childhood trauma and victimization in adulthood; to investigate attachment and mentalization ability in order to identify specific mentalizing and attachment profiles of women IPV victims; to investigate the associations between personality features and IPV; to identify therapist countertransference in relation to IPV.
A sample of 31 women, recruited through anti-violence centers, were administered the Adult Attachment Interview (AAI, George et al., 1984) and completed the Reflective Functioning Questionnaire (RFQ, Fonagy et al., 2016). The Complex Trauma Questionnaire (ComplexTQ, Vergano et al., 2015), and the Reflective Functioning Scale (RFS, Fonagy et al., 1998) were applied to AAI transcripts. The interviews were audiotaped and transcribed verbatim. Coding was conducted by two trained coders, and certified as reliable in the use of the AAI. The protocols were double coded for RFQ, ComplexTQ and RFS. The clinicians completed Shedler-Westen Assessment Procedure–200 (Shedler et al., 2014), Modes of Mentalization Scale (MMS; Colli & Gagliardini, submitted; Gagliardini et al., 2017; Colli et al., 2016); Mentalization Imbalances Scale (MIS; Gagliardini et al., 2018; Gagliardini & Colli, 2017; Colli & Gagliardini, 2015) and Therapist Response (Countertransference) Questionnaire (TRQ, Betan, et al. 2005; Tanzilli et al., 2015):.
Data have shown a higher percentage of women with disorganized attachment and a reflective function decrease. Results will be discussed in terms of clinical and theoretical implications. Efforts to understand the etiology of intimate partner violence are critical to reduce this public health threat
Referential process and intimate partner violence: a preliminary investigation
No full textSeveral studies (Henderson, et al., 2005; Levendosky et al., 2011), found a prevalence of unresolved/disorganized attachment in people with a history of traumatic loss or abuses, and a strong intergenerational transmission of attachment representations and styles. In accordance with Multiple Code Theory (Bucci, 1997), we suppose that the Intimate Partner Violence (IPV) victims are more involved in the narration of the attachment experiences rather than control group. The traumatic events lead to impose an activation of their referential process. The opportunity to tell their experience should start to reflect of themselves. We suppose also that IPV victims are more open to reflect on their experiences, less defended speaking more fluently approaching to interview protocol because they are starting a self-protecting process in anti-violence centers. We hypothesize to highlight different linguistic patterns in the sample of IPV victims.
The Adult Attachment Interview (AAI, George et al., 1984) was administered to 15 Italian female victims of IPV, recruited in some anti-violence centers, and to 15 Italian women with no history of IPV. On the AAI transcripts we applied the Italian version of the linguistic measures (Mariani, et al., 2013) to detect the referential process between subsymbolic and symbolic systems.
Compared with control group, the IPV group presents different linguistic styles, in particular greater levels of emotional activation and higher referential process (WRAD, t = 4,913, p < .01; DF t = -4,7168, p < .01) and more capacity to reorganization of the narrative (WRRL, t = 3,410, p < .05).
The results show IPV victims are more connected to their attachment experience than the control group and more capability to be involved in their specific experience even though is strongly traumatic. They use the AAI protocol as an opportunity to tell to someone their experience
Therapist’s interventions and ruptures and resolutions of therapeutic alliance in patients with and without personality disorders
No full textThis study explores the relationship between therapist’s interventions and ruptures and resolutions processes of the therapeutic alliance in patient with and without personality disorders. We also present the revised version of the Collaborative Interactions Scale Revised (CIS-R; Colli, Gentile, Condino, & Lingiardi, 2017), an observer-rated measure for the assessment of therapeuticalliance ruptures and resolutions. Our aim is to investigate the predictive effect of the therapist’s techniques on the patient’s collaborative processes in relation to session’s depth and patient’s insight. Specifically, we hypothesize that the effect of expressive interventions (focus on the affects, on the relational patterns, on the “here and now” of the relationship) on the patient’s collaboration is influenced by the level of depth and insight. Method: three raters conducted a blind evaluation of a sample of 130 sessions (390 segments; 7,214 narrative units) with 65 patients (33 had a PD diagnosis and 32 had a DSM–5 clinical syndrome diagnosis without a PD). Measures: CIS-R (Colli, et al., 2014, 2017) to evaluate the ruptures and collaborative processes in the session; CPPS (Hilsenroth et al., 2005; Gentile & Tanzilli, 2015) to assess therapist’s interventions; SEQ-D (Stiles & Snow, 1984a) to describe the session’s depth of elaboration. Results: The linear regression evidenced that the expressive interventions are predictive of alliance ruptures in patients with PDs in presence of low level of insight and session’s depth. The expressive interventions are predictive of collaborative processes in patients without PDs in presence of good level of insight and session’s depth. Conclusions: The application of the scale seems to confirm that — as evidenced by the former version (Colli & Lingiardi, 2009) — also the CIS-R is a reliable rating system that is useful for both empirical research and clinical assessments. Clinical implications of these results will be discussed
Assessing ruptures and resolutions of therapeutic alliance in patients with and without personality disorders
No full textThis study presents the revised version of the Collaborative Interactions Scale (CISR; Colli, Gentile, Condino, & Lingiardi, 2017), an observer-rated measure for the assessment of therapeutic-alliance ruptures and resolutions. Aim: Our aim is to assess differences in the presence of alliance ruptures and resolutions in relation to patient’s diagnosis. Specifically, we hypothesize that the focus on the affects is different in the sessions of patients with and without personality disorders (PDs). Method: three raters conducted a blind evaluation of a sample of 130 sessions (390 segments; 7,214 narrative units) with 65 patients (33 had a PD diagnosis and 32 had a DSM–5 clinical syndrome diagnosis without a PD). Results: The ANOVA evidenced that the patients with PDs showed a greater number of alliance ruptures and a smaller number of collaborative processes than patients without PDs. Moreover, the non-PD patients are characterized by: (a) a major frequency of the patient’s communications focused on the affects (F = 4.002; sig. = .048) and (b) a higher number of therapists’ interventions on the affects (F = 4.116; sig. = .045) than PD patients. Conclusions: The application of the scale seems to confirm thatas evidenced by the former version (CIS; Colli & Lingiardi, 2009) also the CISR is a reliable rating system that is useful for both empirical research and clinical assessments
Attachment and mentalization in Intimate Partner Violence
No full textIntimate partner violence (IPV) is one of the most common forms of violence against women (WHO, 2012). IPV has been examined from a range of theoretical perspectives, one of those being attachment theory, identified as a way to assess several psychosocial risk factors for violence (Mahalik et al., 2005). In the previous literature, the child`s exposure to violence in the family resulted as a major predictor of subsequent exposure to IPV victimization (Widom, et al., 2008). Research on abused and traumatized samples has shown high frequencies of unresolved/disorganized attachment in adults. Attachment disorganization is associated with major problems of affect regulation and mentalizing deficits (Lyons Ruth & Jacobvitz, 2016). This study has two aims: To analyze the relationship between childhood trauma and victimization in adulthood; To investigate attachment and mentalization ability in order to identify specific mentalizing and attachment profiles of women IPV victims. A sample of forty women, recruited through anti-violence centers, were administered the Adult Attachment Interview (AAI, George et al., 1984) and completed the Reflective Functioning Questionnaire (RFQ, Fonagy et al., 2016). The hostile/helpless coding system (Lyons-Ruth & Melnick, 2004), the Complex Trauma Questionnaire (ComplexTQ, Vergano et al., 2015), and the Reflective Functioning Scale (RFS, Fonagy et al., 1998) were applied to AAI transcripts. The interviews were audiotaped and transcribed verbatim. Coding was conducted by two trained coders, and certified as reliable in the use of the AAI. The protocols were double coded for RFQ, ComplexTQ and RFS. Results will be discussed in terms of clinical and theoretical implications
Pattern di negoziazione intersoggettiva in pazienti anaclitici e introiettivi
No full textLo studio si propone di individuare dei predittori di risposta del paziente agli interventi del terapeuta focalizzati sull’alleanza. Obiettivo è descrivere le variabili di pazienti, clinici e processo terapeutico associati con a) la riparazione delle rotture e ripristino di buoni livelli di collaborazione e b) il fallimento della gestione delle rotture che si verificano nella seduta. I risultati sono discussi alla luce delle implicazioni cliniche per la pratica quotidiana
Therapist interventions and ruptures and resolutions of therapeutic alliance in anaclitic and introjective patients
No full textThis study explores the relationship between therapist’s interventions and ruptures and resolutions processes of therapeutic alliance in anaclitic and introjective patients. We also present the revised version of the Collaborative Interactions Scale Revised (CIS-R; Colli, Gentile, Condino, & Lingiardi, 2017), an observerrated measure for the assessment of therapeutic-alliance ruptures and resolutions. Our aim is to investigate the impact of the therapist’s techniques on the (a) ruptures markers and (b) collaborative processes in two groups of patients. Specifically, we hypothesize the effects of these therapist’s interventions: (a) The focus on the relationship and/or affects are predictive of the collaborative processes in anaclitic patients and of the indirect rupture markers in the introjective patients; (b) the intervention on insight and/or defenses and/or recurrent patterns are predictive of the collaborations in the introjective patients and on the direct rupture markers in the anaclitic patients. Method: three raters conducted a blind evaluation of a sample of 130 sessions (390 segments; 7,214 narrative units) with 65 patients (33 had an anaclitic orientation and 32 had a introjective orientation). Measures: Collaborative Interactions Scale Revised (CIS-R; Colli, et al., 2014, 2017) to evaluate the ruptures and collaborative processes in the session; Comparative Psychotherapy Process Scale (CPPS; Hilsenroth et al., 2005; Gentile & Tanzilli, 2015) to assess therapist’s interventions; Prototype Matching of Anaclitic–Introjective Personality Configuration (PMAI; Werbart & Levander, 2014, 2016) for the assessment of the anaclitic and introjective; Psychodynamic Functioning Scale (PFS; Høglend et al., 2000, 2006, 2008) for the evaluation of the patient’s level of functioning. Results: The linear regression evidenced that the focus on affects interventions are predictive of collaborative process in anaclitic patients only in presence of high level of functioning (b=.683, sig.=.001). The focus on the relationship are predictive of collaborative processes both in anaclitic (b=.472, sig.=.000) and introjective patients (b=.389, sig.=.05) in presence of low level of functioning. The interventions focused on insight (b=.541, sig.=.000) and defenses (b=.767, sig.=.005) are predictive of collaborative process in introjective patients with a high level of functioning. Conclusions: The application of the scale seems to confirm that3⁄4as evidenced by the former version (Colli & Lingiardi, 2009)3⁄4 also the CIS-R is a reliable rating system that is useful for both empirical research and clinical assessments. The data seem suggesting the differential impact of therapist techniques according patient’s characteristic and focusing the importance of the tailoring in order to promote patient’s collaboration in session. Clinical implications of these results will be discussed
Assessing alliance ruptures and resolutions: Reliability and validity of the Collaborative Interactions Scale-revised version
Full text linkObjective: This study presents the revised version of the Collaborative Interactions Scale (CIS) [Colli, A., & Lingiardi, V. (2009). The Collaborative Interactions Scale: A new transcript-based method for the assessment of therapeutic alliance ruptures and resolutions in psychotherapy. Psychotherapy Research, 19(6), 718–734.], an observer-rated measure for the assessment of therapeutic-alliance ruptures and resolutions. Intensive use of the previous scale resulted in three criticisms:
(i) excessive time required to perform evaluations, (ii) the low occurrence of some items, and (iii) the scale’s low capacity to capture some patient–therapist interactions in fine detail. In this study, we aimed to describe the scale revision process and evaluate interrater reliability and scale validity by comparing sessions of patients with and without personality disorders (PDs). Method: Three raters conducted a blind evaluation of a sample of 60 sessions (180 segments; 3607 narrative units) with 30 patients (15 had a PD diagnosis and 15 had a DSM-5 clinical syndrome diagnosis without a PD). Results: Interrater reliability results ranged from acceptable to excellent and were comparable to those of the former version. Patients with PDs showed a greater number of alliance ruptures and a smaller number of collaborative processes than patients without PDs. Moreover, therapists presented more negative interventions with the PD sample than with the non-PD sample. Conclusions: The results indicate that the revised CIS is a reliable rating system that is useful for both empirical research and clinical assessments
Therapeutic interventions in intimate partner violence: an overview
Full text linkIntimate partner violence (IPV) is associated with significant morbidity and mortality, and its prevention is a global public health
priority. There is strong scientific evidence that suggests IPV and symptoms such as anxiety, depression, post-traumatic stress disorder,
substance abuse, chronic pain, etc. are linked. Despite recommendations and various interventions for the treatment of IPV that have
been tried in these last 20 years, the rates of recurrence are still too high. Furthermore, there is a lack of research evidence for the effectiveness
of the most common treatments provided for victims and perpetrators of IPVs. The purpose of this paper is to present most
used, at a global level, therapeutic interventions for women experiencing IPV (as well as treatments for perpetrators). The possibility
of building a preliminary theoretical and clinical model is discussed
Attachment, trauma, and mentalization in intimate partner violence: a preliminary investigation
Full text linkIntimate partner violence (IPV) has been examined from a range of theoretical perspectives, including attachment theory, with the aim of assessing psychosocial risk factors. Previous research has shown that a child’s exposure to violence in the family is a major predictor of IPV victimization later in life. Furthermore, research on abused and traumatized adult samples has shown high frequencies of unresolved/disorganized attachment styles. In particular, disorganized attachment is associated with major problems of affect regulation and deficits in mentalizing ability. The present research had three aims: (a) to assess the childhood traumatic experiences of female victims of IPV; (b) to investigate and identify the attachment patterns of female victims of IPV; and (c) to examine reflective functioning and prementalistic modes in female victims of IPV, in relation to attachment and trauma. A sample of 31 women, recruited through anti-violence centers, were administered the Adult Attachment Interview (AAI) and the Reflective Functioning Questionnaire. The Complex Trauma Questionnaire and the Reflective Functioning Scale (RFS) were also applied to the AAI transcripts. Interviews were audio recorded and transcribed verbatim. Coding was conducted by two trained coders and certified as reliable for the AAI and RFS. Clinicians completed the Modes of Mentalization Scale (MMS) to assess participants’ mentalization style. The data showed a high percentage of women with insecure attachment and lower reflective functioning. The results are discussed in terms of their clinical and theoretical implications— particularly their application to psycho-forensics, through the development of preventive programs and interventions for IPV. Efforts to understand the etiology of IPV and to intervene to prevent recidivism are fundamental in reducing this public health threat
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