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Studi clinici e ricerche empiriche sulla psicopatologia
No full textIn questo capitolo presenteremo alcuni studi clinici e ricerche empiriche che possono aiutarci a comprendere la psicopatologia alla luce della Control Mastery Theory. I risultati di questi studi devono essere verificati o replicati da ulteriori ricerche empiriche, ma abbiamo deciso di presentarli al lettore in modo che possa farsi un’idea del tipo di ricerche condotte finora alla luce di questo modello e delle loro implicazioni teoriche e cliniche
La centralità dell'adattamento. emozioni primarie, funzionamento motivazionale e moralità tra neuroscienze, psicologia evoluzionistica e control- mastery theory
No full textLa Control-Mastery Theory (CMT) è una teoria psicodinamica-cognitiva di matrice relazionale del funzionamento mentale, della psicopatologia e della psicoterapia sviluppata da Joseph Weiss (1993) e studiata empiricamente dal San Francisco Psychotherapy Research Group (Weiss, Sampson, & The Mount Zion Psychotherapy Research Group, 1986). Tra le ipotesi centrali della CMT vi sono la centralità della motivazione all'adattamento alla realtà, l’idea che siamo in grado di compiere inconsciamente operazioni mentali superiori e il ruolo di rilievo attribuito alle motivazioni prosociali e ai sensi di colpa interpersonali nel funzionamento normale e patologico. Scopo di questo lavoro è fornire una rassegna di alcuni dei principali studi neuroscientifici, di psicologia evoluzionista e di matrice cognitivista a sostegno di queste ipotesi. Gli studi considerati mostrano come l’evoluzione della specie abbia prodotto una serie di sistemi comportamentali evolutivamente fondati, ma “ambientalmente labili”, che nel loro complesso promuovono la sopravvivenza e la riproduzione dell’individuo e dei gruppi. Per adattarsi al proprio gruppo primario, ognuno di noi costruisce una serie di credenze affidabili sul proprio mondo circostante e sulle norme “morali” che regolano le interazioni. La psicopatologia può essere letta come l’espressione di credenze che hanno favorito l’adattamento del bambino ad ambienti traumatici ma si sono rivelate disadattive al mutare delle circostanzeControl-Mastery Theory (CMT) is a cognitive-psychodynamic-relational theory of mental functioning, psychopathology and psychotherapy developed by Joseph Weiss (1993) and empirically studied by the San Francisco Psychotherapy Research Group (Weiss, Sampson, & The Mount Zion Psychotherapy Research Group, 1986). The central hypotheses of CMT are: the humans being's motivation to adapt to reality, their unconscious ability to execute higher mental functions and the importance of pro-social motivations and interpersonal guilt in normal and pathological mental functioning. The aim of this paper is to provide a review of the most important neuroscientific studies, along with both evolutionary and cognitive psychology researches that support these hypotheses. These studies showed how the evolution of species have been producing a series of behavioral systems, evolutionary based but “environmentally labile” which, overall, have promoted individuals and groups' survival and reproduction. To adapt to our own primary group, each of us builds a reliable set of beliefs about our surrounding world and about “moral rules” that govern relationships. Psychopathology can be seen as the expression of beliefs that had facilitated the adaptation of the child to a traumatic environment but have then revealed to be maladaptive because of the changing circumstances
Primary emotional systems and interpersonal guilt: an empirical study
No full textGuilt is a complex and distressing emotion that can be experienced in different situations. The majority of psychoanalytic authors focused on the intrapsychic origins of guilt, connecting it with perverse desires and unconscious wishes to hurt others. On the contrary, according to Control-Mastery Theory (CMT), guilt is interpersonal in its origin, its aim is pro-social and its function is adaptive. Guilt, however, can be pathogenic when it derives from pathogenic beliefs, is generalized and leads to distress and symptoms (O'Connor et al. 1997). Both evolutionary and moral psychology researches support the hypothesis of the pro-social origin of guilt and its adaptive function for individual and group evolution (Wilson, Wilson, 2008; Haidt, 2012; Tomasello 2016). The aim of this study is to investigate 1) the relation between guilt, assessed with the Interpersonal Guilt Questionnaire-67 (IGQ-67; O'Connor et al. 1997) and the Interpersonal Guilt Rating Scale 15 self (IGRS-15-s; Gazzillo et al. 2017) and motivational systems assessed with the Affective Neuroscience Personality Scale (ANPS; Davis, Panksepp, 2003) and 2) the relation between guilt and well-being assessed with Psychological General Well-Being Index (PGWBI; Grossi et al. 2002) in a sample of 600 subjects. The first step of the study is the Italian validation of IGQ-67 and IGRS-15-s, where the factor structure differentiates interpersonal guilt (survivor, separation and omnipotent) from self-hate guilt. The second step investigates the relation between guilt and the motivational systems. The third step investigates the relation between guilt and well-being. Preliminary analysis show a positive and significant relation between interpersonal guilt and care and attachment system, as well as between self-hate guilt and panic-grief system and a negative and significant relation between guilt and well-being. These results confirm the hypothesis that guilt, as interpersonal emotion, is primarily related to pro-social motivations
Psychopathology and adaptation to environment: Fonagy model compared to Weiss model
No full textIn the recent transition of Fonagy and collaborators’ thinking, psychopathology results from a lack of resilience which, in turn, results from a lack of epistemic trust, which is an adaptive consequence of the early social learning environment and leads to limitations in the capacity to mentalize and properly evaluate interpersonal situations. The possibility to read psychopathology as the adaptation of the child to traumatic environment is indeed the core of the Control-Mastery Theory (CMT). According to CMT, the child is “wired” from birth to adapt to his reality; to this aim, starting from what he learns from the caregivers, he constructs, by inference from experience, a system of beliefs, more or less reliable, on himself, others, and his social world. Some of these beliefs are pathogenic when they associate an internal (feeling of shame or guilt) or external (departure or loss of the caregiver) danger to the achievement of a healthy and realistic goal. Once again, psychopathology results from an adaptation to traumatic experiences in childhood, but, in this case, the adaptation is mediated by a system of beliefs and, so, by the extreme trust that the child has in his caregiver
The Interpersonal Guilt Rating Scale-15: The First Validation Data About A New Clinician Report Tool For The Assessment Of Interpersonal Guilt
No full textAccording to Control-Mastery Theory (CMT) guilt's origin is interpersonal, its aim is prosocial and
its function is adaptive. However, guilt can be also unconscious, irrational and pathogenic,
especially when generalized and repeatedly linked to shame and when it derives from pathogenic
beliefs (O'Connor et al. 1997; Locke et al., 2013). Our aim is to introduce a brief clinician-report
tool for the assessment of interpersonal guilt, the Interpersonal Guilt Rating Scale-15 (IGRS-15
Gazzillo, Bush, Faccini, De Luca, Mellone, 2015), and its psychometric proprieties. The item set
derived from literature and from our clinical experience. We asked to 28 clinicians to assess 154
patients with: the IGRS-15; the Interpersonal Guilt Questionnaire-67 (IGQ-67; O'Connor et al.
1997); the Clinical Data Form (CDF; Westen, Shedler, 1999). An EFA on a random half of our
sample (N=70) and a CFA on the other half (N=84) were performed. The extracted factors on the
basis of both the scree plot procedure (point of inflexion of the curve) and factors with eigenvalue >
1 criterion are survivor guilt, separation/disloyalty guilt, omnipotent responsibility guilt and selfhate
guilt. All the subscales have good internal consistency, with Alpha's values from .80 to .87.
The ICC calculated on an item-per-item basis was .67, while the ICC of the scores of the four
different IGRS-15 factors was .86. The test-retest reliability was acceptable with Pearson's r from
.52 to .69. The assessment of guilt with the IGRS-15 show a good concordant validity with guilt
assessed with IGQ-67 and we collected first data about the construct validity of our tool. This scale
represent a first step in the direction of supporting the clinical judgement about interpersonal guilt
with an empirically sound, easy to use, tool
Through flow and swirls: modifying implicit relational knowledge and disconfirming pathogenic beliefs within the therapeutic process
No full textThe aim of this paper is to describe and discuss the models of the process of change in psychotherapy
developed by the Boston Change Process Study Group (2010), and by the San Francisco Psychotherapy
Research Group (Gazzillo, 2016; Silberschatz, 2005; Weiss, 1993; Weiss, Sampson, & the Mount Zion
Psychotherapy Research Group, 1986). The first model is centered on change in implicit relational
knowledge and describes the process of change as being composed of “moving along” phases interspersed
by “now moments” that can become “moments of meeting” if the clinician is able to give
authentic and specifically fitted responses. A moment of meeting opens up space for a change in the
implicit relational knowledge of the patient. The second model is centered on the idea that patients come
to therapy with an unconscious plan to master traumas, pursue healthy and adaptive goals, and disprove
their pathogenic beliefs, and points to how patients test their pathogenic beliefs in the relationship with
the therapist, coaching the therapist about what they need. Passing patients’ tests means helping them
disconfirm or undermine pathogenic beliefs that hopefully will lead to disproving them. This second
model focuses on the subjective meaning of the therapeutic process as seen from the perspective of the
patient. We will also try to show, using clinical examples, how these two models can be integrated and
how their integration may give us a more comprehensive, tridimensional vision of the therapeutic
process
The plan formulation method for adolescents (PFM A): personalizing psychotherapy for adolescents
No full textThe aim of this paper is to show how the Plan Formulation Method, an
empirically validated and clinically useful assessment procedure, can be
adapted to the therapy of adolescents.
According to Control-Mastery Theory, patients come to therapy with an
unconscious plan to achieve their goals, disconfirm their pathogenic beliefs,
and master their traumas. PFM is a procedure aimed at formulating the
unconscious plan of a patient with high levels of reliability and it articulates
this plan in five components: the goals that the patient wants to achieve, the
obstructions to these goals, the traumas which have given rise to these
obstructions, the way the patient will try to overcome these obstructions
during the therapy (tests), and the insights that the patient needs to achieve
in order to get better. To apply this method to adolescent therapy, we added
two components: the vicious relational circles between adolescents and their
relevant others which support the patient’s problems and that the patient
wants to break, and the experience the adolescent needs in order to get better.
Each component will be explained with the help of a clinical case. The
possible applications of the PFM to adolescents both in clinical and research
contexts will be discussed
L’IGRS-15: UN CLINICIAN-REPORT PER LA VALUTAZIONE DEL SENSO DI COLPA INTERPERSONALE
No full textIntroduzione. Secondo la Control-Mastery Theory (CMT) l’origine del senso di colpa è
interpersonale, il suo scopo è prosociale e la sua funzione è adattiva. Il senso di colpa può
essere però anche inconscio, irrazionale e patogeno, in particolare quando generalizzato e
ripetutamente associato a vergogna e quando deriva da credenze patogene.
In questo contributo presenteremo un breve strumento clinician-report per una valutazione di
screening dei sensi di colpa interpersonali, l’Interpersonal Guilt Rating Scale-15 (IGRS-15
Gazzillo, Bush, Faccini, De Luca, Mellone, 2015), e le sue proprietà psicometriche.
Metodo. Il set di item dell’IGRS-15 è stato ricavato dalla letteratura CMT e dall’esperienza
clinica. Abbiamo poi chiesto a 28 clinici di valutare 154 pazienti con: l’IGRS-15; l’Interpersonal
Guilt Questionnaire-67 (IGQ-67; O'Connor et al. 1997); il Clinical Data Form (CDF; Westen,
Shedler, 1999).
Risultati. Sono state condotte una EFA sui dati raccolti da una metà casuale del campione
(N=70) e una CFA sull’altra metà (N=84). I fattori estratti sulla base dello scree plot (punto di
flesso della curva) e del criterio di Kaiser (eigenvalue > 1) sono: il senso di colpa del
sopravvissuto, il senso di colpa da separazione/slealtà, il senso di colpa da onnipotenza e
quello da odio del sé. Questi fattori spiegano il 65.9% della varianza. La CFA mostra una gfi
=.98 e una RMSEA = .0. Tutte le sotto-scale hanno una buona coerenza interna con un valore
di alpha compreso tra .80 e .87. L’ICC calcolato item per item è .67, mentre l’ICC del
punteggio dei quattro differenti fattori dell’IGRS-15 è .86. L’affidabilità test-retest risulta
accettabile con r di Pearson che oscillano tra .52 a .69.
Conclusioni. La valutazione del senso di colpa con l’IGRS-15 mostra una buona validità
concordante con le valutazioni degli stessi sensi di colpa condotte con l’IGQ-67 e i primi dati
circa la sua validità di costrutto sono promettenti
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