284 research outputs found
Diagnostics in personality disorders
No full textDiagnosing and classifying personality disorders is complex and difficult from both the scientific and clinical perspectives. Dimensional and categorical models and assessment instruments of personality disorders, and different (behavioral and psychodynamic orientated) clinical procedures are described. Furthermore, an integrative view on clinical practice is presented
Word and Work Session 07
No full textIn the first half of Word and Work: An Intersection, Concordia Seminary, St. Louis President Dr. Dale A. Meyer talks with Seminary alum Rev. Ted Doering (’14) about his background, church planting and ways in which the church can reach younger generations. Doering is author of Myth of the Millennial: Connecting Generations in the Church from Concordia Publishing House. In the second half of the program, Professor Charles Arand interviews Professor Emeritus Bruce Hartung about nurturing and developing church environments that are psychologically and spiritually healthy as well has his books, Holding Up the Prophet’s Hands and Building Up the Body of Christ.https://scholar.csl.edu/wordandwork/1008/thumbnail.jp
Exact two-dimensionalization of low-magnetic-Reynolds-number flows subject to a strong magnetic field
No full textWe investigate the behavior of flows, including turbulent flows, driven by a horizontal body-force and subject to a vertical magnetic field, with the following question in mind: for very strong applied magnetic field, is the flow mostly two-dimensional, with remaining weak three-dimensional fluctuations, or does it become exactly 2D, with no dependence along the vertical? We restrict attention to low-magnetic-Reynolds number (Rm) flow. Because liquid metals have low magnetic Prandtl number, such low- flows can have a kinetic Reynolds number as large as one million and therefore be strongly turbulent. We first focus on the quasi-static approximation, i.e. the asymptotic limit of vanishing magnetic Reynolds number Rm << 1: we prove that the flow becomes exactly 2D asymptotically in time, regardless of the initial condition and provided the interaction parameter N is larger than a threshold value. We call this property absolute two-dimensionalization: the attractor of the system is necessarily a (possibly turbulent) 2D flow. We then consider the full-magnetohydrodynamic equations and we prove that, for low enough Rm and large enough N, the flow becomes exactly two-dimensional in the long-time limit provided the initial vertically-dependent perturbations are infinitesimal. We call this phenomenon linear two-dimensionalization: the (possibly turbulent) 2D flow is an attractor of the dynamics, but it is not necessarily the only attractor of the system. Some 3D attractors may also exist and be attained for strong enough initial 3D perturbations. These results shed some light on the existence of a dissipative anomaly for magnetohydrodynamic flows subject to a strong external magnetic field
Dimensions of personality - Relationship between DSM-IV personality disorder symptoms, the five-factor model, and the biosocial model of personality
No full textDimensional approaches regard personality disorders as extreme or maladaptive variants of traits that are commonly used to describe normal personality. Previous clinical and nonclinical studies identified four factors interpreted as Antisocial, Asocial, Asthenic, and Anankastic. To investigate the validity of this four-factor structure in healthy volunteers, 97 male and 98 female students completed versions of the NEO-PI-R and TPQ. Symptoms of personality disorders were assessed using the ADP-IV questionnaire. A factor analysis of the personality and symptom scales revealed a four-factor solution accounting for 71.55% of the total variance. These factors resembling the "four A's" were labelled Asthenic, Sociable vs. Asocial, Antisocial, and Disorderly vs. An- ankastic. The results of this study support the presence of four factors in the description of adaptive as well as maladaptive personality traits
A new approach to cultural scripts of trauma sequelae assessment: The sample case of Switzerland
No full textBackground
The novel concept of cultural scripts of trauma sequelae captures culture-specific expressions of posttraumatic distress (e.g., cognitive, emotional, interpersonal, psychosomatic changes) and their temporal associations. Cultural scripts of trauma sequelae complement pan-cultural (etic) diagnoses, such as posttraumatic stress disorder (PTSD) and Complex PTSD, as well as the cultural syndromes concept.
Objective
This study aimed to develop the cultural scripts of trauma inventory (CSTI) for German-speaking Switzerland and to explore temporal associations of script elements.
Method
Five semi-structured focus groups were conducted with psychotraumatologists (n = 8) and Swiss trauma survivors (n = 7). The interview schedule included open questions about different domains of potential posttraumatic changes (emotions, cognitions, worldviews, interpersonal relationships, body-related experiences, behavior, and growth). Data were analyzed using qualitative content analysis.
Results
The Swiss CSTI includes 57 emic elements that represent salient trauma sequelae (30 conformed with a theoretically derived item pool, 27 were newly phrased). Temporal script associations were visualized in a network, whereby self-deprecation, the urge to function and overcompensate, and the urge to hide and endure suffering had the highest number of connections.
Conclusion
While many posttraumatic changes identified in the present work seem to mirror pan-cultural phenomena represented in the Complex PTSD concept (e.g., self-deprecation), others (e.g., urge to function and perform, urge to hide and endure suffering) may be prominently related to Swiss culture with its value orientations. Knowledge about cultural scripts of trauma sequelae may provide a culture-specific framework that can help to understand individual experiences of distress and enable mental health practitioners to administer culturally sensitive interventions. Pending further validation, the Swiss CSTI bears the potential to advance culture-sensitive assessment of trauma sequelae
Empirical Developments in Transference-Focused Psychotherapy
No full textObjective: Transference-focused psychotherapy (TFP) is an empirically supported individualized psychotherapy for pa-tients with borderline personality disorder. This review highlights its development and current status.Methods: A review of the theoretical background under-pinning TFP and empirical advances in the development of TFP provide perspective.Results: Otto Kernberg's object relations model of person-ality and its implications for assessment and diagnosis of personality disorders are described. The authors review the programmatic research that has been developed and has demonstrated the efficacy of TFP. In view of the empiri-cal studies that have demonstrated the successful out-comes and processes of TFP for patients with borderline personality disorder, compared with other approaches, TFP has been applied to a broader range of difficulties related to patients' self-functioning and interpersonal functioning across the range of severities in personality pathology, consistent with the Alternative DSM-5 Model for Personality Disorders. The authors discuss borderline personality organization in the context of interpersonal, neurocognitive, and self-regulatory dysfunction, including preliminary findings.Conclusions: The theoretical and empirical advances in TFP lead to future directions for research evaluating personality disorder and its treatment
Withdrawal ruptures in adolescents with borderline personality disorder psychotherapy are marked by increased speech pauses-can minimal responses be automatically detected?
No full textAlliance ruptures of the withdrawal type are prevalent in adolescents with borderline personality disorder (BPD). Longer speech pauses are negatively perceived by these patients. Safran and Muran's rupture model is promising but its application is very work intensive. This workload makes research costly and limits clinical usage. We hypothesised that pauses can be used to automatically detect one of the markers of the rupture model i.e. the minimal response marker. Additionally, the association of withdrawal ruptures with pauses was investigated. A total of 516 ruptures occurring in 242 psychotherapy sessions collected in 22 psychotherapies of adolescent patients with BPD and subthreshold BPD were investigated. Trained observers detected ruptures based on video and audio recordings. In contrast, pauses were automatically marked in the audio-recordings of the psychotherapy sessions and automatic speaker diarisation was used to determine the speaker-switching patterns in which the pauses occur. A random forest classifier detected time frames in which ruptures with the minimal response marker occurred based on the quantity of pauses. Performance was very good with an area under the ROC curve of 0.89. Pauses which were both preceded and followed by therapist speech were the most important predictors for minimal response ruptures. Research costs can be reduced by using machine learning techniques instead of manual rating for rupture detection. In combination with other video and audio derived features like movement analysis or automatic facial emotion detection, more complete rupture detection might be possible in the future. These innovative machine learning techniques help to narrow down the mechanisms of change of psychotherapy, here specifically of the therapeutic alliance. They might also be used to technologically augment psychotherapy training and supervision
Stephan Doering: What is true?
No full text
What science and arts have in common is the unavailability of truth. Natural sciences usually follow an empirical epistemology, i.e. experiments or evaluations are planned and conducted according to hypotheses, they use “objective measures”, and yield “valid” results. An artist creates a highly subjective image of reality, an idea, a fantasy, or a concept using his or her personal intuitive or heuristic epistemology. Both, if successful, create a picture of something that has been invisible before – be it covered, unconscious, implicit, not yet verbalized, or simply unknown. An artist makes something visible that contains an aspect of truth that can be experienced and intersubjectively shared by recipients, a scientist uncovers a formerly unknown existence, correlation, or causality of phenomena of any kind.</p
Long-term effectiveness of inpatient and day hospital treatment in departments of psychosomatic medicine and psychotherapy in Germany
No full textBackground There is a lack of reliable data concerning the long-term effectiveness of psychosomatic inpatient and day hospital treatment in a naturalistic setting. The Multicenter Effectiveness Study of Inpatient and Day Hospital Treatment in Departments of Psychosomatic Medicine and Psychotherapy in Germany aims to provide such data. The study itself and effectiveness from admission to discharge have already been reported in this journal (Doering et al., 2023). This brief report adds 12-month follow-up data. Methods The relevant outcome variables concerning somatoform, trauma-related, eating and personality disorders, as well as anxiety and depressive disorders were assessed by means of questionnaires on admission (T0), at discharge (T1) and after 12 months (T2). In order to make targeted statements about effectiveness regarding only clinically relevant symptoms, each symptom domain was stratified by severity at admission. Results From a total of 2,094 patients at admission, 60.6% still provided data at T2. Overall, the changes achieved at discharge (T1) already reported in Doering (2023) remained stable over the 12-month follow-up period (T2). There were hence significant improvements from T0 to T2 across all symptom domains with large effect sizes ranging from d=1.0 to 3.4. Conclusions The already reported effectiveness of inpatient and day hospital treatment in German university departments of Psychosomatic Medicine and Psychotherapy in a naturalistic setting is further strengthened by providing evidence for sustained treatment effects over the 12-month follow-up period. Importantly, the entire spectrum of disorders investigated showed this pattern. Clinical Trial Registration https://drks.de/search/de/trial/DRKS00016412 RKS00016412 , identifier DRKS00016412
Guideline adherence in the management of attention deficit hyperactivity disorder in children: An audit of selected medical records in three Australian states
No full textOBJECTIVE: To assess General Practitioner (GP) and pediatrician adherence to clinical practice guidelines (CPGs) for diagnosis, treatment and management of attention deficit hyperactivity disorder (ADHD). METHOD: Medical records for 306 children aged ≤15 years from 46 GP clinics and 20 pediatric practices in Australia were reviewed against 34 indicators derived from CPG recommendations. At indicator level, adherence was estimated as the percentage of indicators with 'Yes' or 'No' responses for adherence, which were scored 'Yes'. This was done separately for GPs, pediatricians and overall; and weighted to adjust for sampling processes. RESULTS: Adherence with guidelines was high at 83.6% (95% CI: 77.7-88.5) with pediatricians (90.1%; 95% CI: 73.0-98.1) higher than GPs (68.3%; 95% CI: 46.0-85.8; p = 0.02). Appropriate assessment for children presenting with signs or symptoms of ADHD was undertaken with 95.2% adherence (95% CI: 76.6-99.9), however ongoing reviews for children with ADHD prescribed stimulant medication was markedly lower for both pediatricians (51.1%; 95% CI: 9.6-91.4) and GPs (18.7%; 95% CI: 4.1-45.5). CONCLUSION: Adherence to CPGs for ADHD by pediatricians was generally high. Adherence by GPs was lower across most domains; timely recognition of medication side effects is a particular area for improvement
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