323,026 research outputs found
Patient personality and therapist emotional responses in the psychotherapy with adolescents: An empirical investigation
No full textIntroduction: Therapist’s emotional responses to the patient (or
countertransference) are more and more considered as an important
component of the patient-therapist relationship that are able to play
a critical role in the psychotherapy process and outcome across
different treatment approaches (Hayes, Gelso, & Hummel, 2011;
Hayes, Nelson, & Fauth, 2015; Norcross, 2011). The classical
psychoanalytic concept of countertransference—originally defined as
the analyst’s transference to the patient’s transference, and
considered a disruptive obstacle to the therapeutic process (Freud,
1910, 1912)— has evolved considerably becoming a valuable
source of information about patient’s intrapsychic and interpersonal
dynamics (Heimann, 1950). According to this totalistic perspective
(Kernberg, 1965), all the clinician’s reactions to the patient can be
helpful to make accurate diagnostic formulations and provide
effective therapeutic interventions, especially in the treatment of
personality pathology (Bateman & Fonagy, 2016; Beck, Davis, &
Freeman, 2004; Dahl et al., 2014; Gabbard, 2014; Lingiardi &
McWilliams, 2017; Yeomans, Clarkin, & Kernberg, 2015). To date,
empirical investigations have examined the relationships between
patient’s personality styles/syndromes and therapists’ responses
showing that they are not arbitrary. Countertransference patterns were
related to personality disorders and dimensions in clinically coherent
and systematically predictable ways (e.g., Betan, Heim, Zittel Conklin,
& Westen, 2005; Colli, Tanzilli, Dimaggio, & Lingiardi, 2014; Tanzilli,
Lingiardi, & Hilsenroth, 2018; Tanzilli, Muzi, Ronningstam, & Lingiardi,
2017). However, these studies were mostly based on clinicians’
subjective experience to adult personality-disordered patients. Only
a few studies have explored the associations between
countertransference and specific styles/syndromes of personality in
the psychotherapy with adolescents (e.g., Knaus et al., 2016; Satir,
Thompson-Brenner, Boisseau, & Crisafulli, 2009; Tishby & Vered,
2011). The aims of this study were to: 1) examine the stability of the
factor structure and psychometric properties of the Therapist
Response Questionnaire – Adolescent Version (TRQ-A; Satir et al.,
2009); 2) investigate the relationship between therapists’ emotional
responses and specific emerging personality patterns of their
adolescent patients. Methods: A national sample of psychiatrists and
clinical psychologists (N=140) completed the TRQ-A to identify
patterns of therapist response, as well as the Shedler–Westen
Assessment Procedure–II-A (SWAP-II-A; Westen et al., 2014) to
assess personality styles/syndromes regarding an adolescent patient
currently in their care. An exploratory factor analysis (EFA) was carried
out to identify the factor structure of the TRQ-A. Reliability of the TRQA’s
scales was calculated using the Cronbach’s alpha coefficients.
Bivariate correlations between the TRQ-A’s scales and personality
styles/syndromes were conducted to assess the criterion validity of
the TRQ-A and examine the associations of countertransference
dimensions with patients’ personality pathology. Results: EFA
revealed six distinct countertransference scales that were
conceptually coherent and psychometrically robust: (a)
hostile/devaluated, (b) positive, (c) bored/failing, (d)
overwhelmed/scared, (e) overinvolved, and (f) sexualized. This factor
solution accounted for about 51% of the variance, and the six scales
were well marked by at least five items each, suggesting a stable
factor structure unlikely to be substantially affected by sample size
(Fabrigar, Wegener, MacCallum, & Strahan, 1999). The scales of the
TRQ-A’s current version showed excellent reliability and validity. Their
internal consistencies were: hostile/devaluated (α=.87), positive
(α=.93), bored/failing (α=.84), overwhelmed/scared (α=.90),
overinvolved (α=.85), and sexualized (α=.89). They were significantly
associated with distinct personality styles/syndromes. Notably, more
severe level of personality functioning was related to the bored/failing
and overwhelmed/scared countertransference. Narcissistic and
antisocial/psychopathic personality styles/syndromes were
associated with the hostile/devaluated and overwhelmed/scared
therapist responses, and borderline style/syndrome was related to
the overwhelmed/scared and overinvolved countertransference.
Schizoid personality style/syndrome was associated with the
bored/failing countertransference, while impulsive/histrionic
style/syndrome was related to the sexualized therapist response.
Positive countertransference was related to the obsessional
personality style. Conclusions: The TRQ-A is a very useful instrument
to evaluate countertransference reactions in clinically sensitive and
psychometrically robust ways. Moreover, adolescents’ emerging
personality styles/syndromes were consistently associated with
specific emotional responses, which suggests that clinicians can
make diagnostic and therapeutic use of their responses to patients.
This study supports the potential strengths of the TRQ-A’s use in both
clinical and empirical contexts. It could be employed by therapists
or supervisors of different theoretical orientations for making accurate
case formulations and planning effective therapeutic interventions
at the beginning of treatment, or for monitoring possible changes in
the personality and the ways of interacting of adolescent patients
during the psychotherapy process. In empirical terms, its applicability
is equally relevant to examine countertransference across different
clinical populations, or in the field of process-outcome research.
References
Knaus, S., Grassl, R., Seidman, C., Seitz, T., Karwautz, A., & Löffler-Stastka, H.
(2016). Psychiatrists’ emotional reactions: Useful for precise diagnosis in
adolescence?. Bulletin of the Menninger Clinic, 80(4), 316-325.
doi:10.1521/bumc.2016.80.4.316.
Satir, D. A., Thompson-Brenner, H., Boisseau, C. L., & Crisafulli, M. A. (2009).
Countertransference reactions to adolescents with eating disorders:
relationships to clinician and patient factors. The International Journal Of
Eating Disorders, 42(6), 511-521. doi:10.1002/eat.20650.
Tanzilli, A., Colli, A., Del Corno, F., & Lingiardi, V. (2016). Factor structure,
reliability, and validity of the Therapist Response Questionnaire. Personality
Disorders: Theory, Research, and Treatment, 7(2), 147–158. doi:10.1037/
per0000146.
Tanzilli, A., Muzi, L., Ronningstam, E., & Lingiardi, V. (2017). Countertransference
when working with narcissistic personality disorder: An empirical
investigation. Psychotherapy, 54(2), 184-194. doi:10.1037/pst0000111.
Tishby, O., & Vered, M. (2011). Countertransference in the treatment of
adolescents and its manifestation in the therapist-patient relationship.
Psychotherapy Research, 21(6), 621-630. doi:10.1080/10503307.
2011.598579
Personality, Defenses, Mentalization, and Epistemic Trust Related to COVID-19 Containment Strategies: A Psychodynamic Perspective
No full textIntroduction: The COVID-19 pandemic has considerably influenced all the domains of people’s lives
worldwide, determining a high increase in overall psychological distress and several clinical conditions.
The study attempted to shed light on the relationship between strategies adopted to manage the
pandemic, vaccine hesitancy, and distinct features of personality and mental functioning.
Methods: The sample consisted of 367 Italian individuals (68.1% women, 31.9% men; M age = 37,
SD = 12.79) who completed an online survey including an instrument assessing four response styles to
the pandemic and lockdown(s) (RSPL; Tanzilli et al., 2021), the Personality Inventory for DSM-5-Brief
Form (PID-BF; Krueger et al., 2013), the Defense Mechanisms Rating Scales-Self-Report-30 (DMRSSR-
30; Di Giuseppe et al., 2020, 2014), the Reflective Functioning Questionnaire (RFQ; Fonagy et al.,
2016), and the Epistemic Trust, Mistrust, Credulity Questionnaire (ETMCQ; Campbell et al., 2021).
Results: Maladaptive response patterns to pandemic restrictions were related to dysfunctional
personality traits, immature defense mechanisms, poor mentalization, and epistemic mistrust or
credulity. Moreover, more severe levels of personality pathology was predictive of an extravertedmaladaptive
response style to health emergency through the full mediation of low overall defensive
functioning, poor certainty of others’ mental states, and high epistemic credulity.
Conclusions: Recognizing and understanding dysfunctional psychological pathways associated with
individuals’ difficulties in dealing with the pandemic are crucial for developing tailored mental health
interventions and promoting best practices in healthcare services
In reply to “The novel whole-organ high-definition CT scanner: A promising diagnostic method for coronary stented patients with unfavorable HR”
No full textSexism and Attitudes Toward Same-Sex Parenting in a Sample of Heterosexuals and Sexual Minorities: the Mediation Effect of Sexual Stigma
No full textThe present study aimed to: (a) investigate the relationship between attitudes toward same-sex parenting and sexism both in heterosexuals and sexual minorities; (b) verify whether sexism predicted negative attitudes toward same-sex parenting via the mediating role of sexual stigma (sexual prejudice in heterosexual people and internalized sexual stigma [ISS] in lesbians and gay men [LG]). An Italian sample of 477 participants (65.6% heterosexual people and 34.4% LG people) was used to verify three hypotheses: (a) heterosexual men showed higher levels of sexism than heterosexual women and LG people; (b) heterosexual men reported more negative attitudes toward same-sex parenting than those of heterosexual women and LG people; and (c) sexual prejudice in heterosexual people and ISS in LG people mediated the relationship between sexism and attitudes toward same-sex parenting. Overall, men and heterosexual people showed stronger sexist tendencies and more negative attitudes toward same-sex parenting. Moreover, sexism affected attitudes toward same-sex parenting via sexual prejudice in heterosexual people and ISS in LG people. These results suggest that negative attitudes toward same-sex parenting reflect sociocultural inequalities based on the traditional gender belief system and points to the necessity of social policies to reduce prejudice toward sexual minority groups
Impact of Sex and Gender on the Efficacy of Antiplatelet Therapy: The Female Perspective
No full textDiffusive author(s), cohesive author: Analysis of S/N (1994)
No full textThis study indicates the ways in which various aspects of the author(s) are brought forth in Dumb type’s performance art, the S/N production. Previous research has suggested a non-hierarchical organization of Dumb type and the absence of a “privileged author” in Dumb type’s collaborative work, S/N. However, the results that I have investigated from member’s interviews on the creative process of S/N along with my analysis of the recorded images of S/N, indicate a different aspect of the author(s). First, S/N was created through, so to speak, the collective ideas of the members of Dumb type. Further, S/N has at least nine quotations from previous performances, installations, and printed writings, besides the work-in-progress technique. Explicating one of the “author functions” as given by Michel Foucault, each text has plural subjects of the author. However, it has been revealed from members’ interviews that Teiji Furuhashi had a decision-making role in selecting the members’ ideas within the performance. Since then, S/N has had plural subjects of creation; however, Furuhashi is one of the subjects of creation along with the “privileged author.” S/N has plural authors (diffusive authors) yet at the same time, it has a “privileged author,” Teiji Furuhashi (cohesive author)
Going Beyond Counting First Authors in Author Co-citation Analysis
No full textThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Unraveling Pathophysiology of Takotsubo Syndrome: The Emerging Role of the Oxidative Stress’s Systemic Status
No full textTakotsubo Syndrome (TTS) is usually triggered by emotional or physical stressors, thus suggesting that an increased sympathetic activity, leading to myocardial perfusion abnormalities and ventricular dysfunction, plays a major pathogenetic role. However, it remains to be elucidated why severe emotional and physical stress might trigger TTS in certain individuals but not others. Clinical research has been focused mainly on mechanisms underlying the activation of the sympathetic nervous system and the occurrence of myocardial ischemia in TTS. However, scientific evidence shows that additional factors might play a pathophysiologic role in the condition’s occurrence. In this regard, a significant contribution arrived from metabolomics studies that followed the systemic response to TTS. Specifically, preliminary data clearly show that there is an interplay between inflammation, genetics, and oxidative status which might explain susceptibility to the condition. This review aims to sum up the established pathogenetic factors underlying TTS and to appraise emerging mechanisms, with particular emphasis on oxidative status, which might better explain susceptibility to the condition
Evaluation of hand circulation with cardiowaves photoplethysmograph device during allen test in healthy volunteers
No full textOBJECTIVE:Radial artery occlusion is a potential complication of transradial procedures and its occurrence ranges from 0.8 to 30%. It is virtually always asymptomatic but the functional and sensorial consequences of a long acting hand hypoperfusion could go underestimated. CardioWaves is a novel photoplethysmograh device that allows us to detect the pulse wave amplitude of the blood flowing to the hand. Our objective was to assess in normal subjects the hand blood flow supplied by radial arteries and ulnopalmar arches, respectively, by using CardioWaves device during modified Allen's test (MAT).
PATIENTS AND METHODS: MAT was performed on both hands of 60 normal subjects, age ranging 21 to 66 years, without any cardiovascular factor risk.
RESULTS: Photoplethysmograh and MAT showed a high positive linear correlation (r=0.93). Despite that, MAT tends to give a higher reading by between 1.05 and 1.6 sec. 11 of 120 readings (9%) by CardioWaves showed values of radial/ulnar pulse amplitude ratio more than mean + 1 SD, suggesting a significant decrease in ulnopalmar arterial circulation when radial blood flow supply would ceased.
CONCLUSIONS: The CardioWaves device allows us an accurate reading of the flow because of its independency from respiratory changes. Furthemore, the evaluation of radial and ulnar pulse wave amplitude and the ratio between them would reveal an insufficient blood flow supply by the ulnar artery irrespective of the MAT results. We suggest that their assessment before performing coronary angiography and interventions may reduce potential complication of transradial access
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