Therapist Adherence to Good Psychiatric Practice in a Short-Term Treatment for Borderline Personality Disorder
Stéphane Kolly, MD, Jean-Nicolas Despland, MD, Yves de Roten, PhD, Pierre Marquet, PhD, Ueli Kramer, PhD
We examined the relationship between therapist adherence and symptom change in the context of a short-term treatment with respect good psychiatric management (GPM) principles. Based on a parent trial, borderline personality disorder patients (N = 40) benefited from a 10-session intervention. The psychometric properties of the GPMAS were excellent, and the adherence to GPM explained 16% of the general symptom improvement and 23% of the borderline symptom improvement. GPMAS is a valuable measure early on in psychiatric practice as part of an initial step to longer-term treatment.
Childhood Precursors of Adult Borderline Personality Disorders Features: A Longitudinal Study
Phebe Cramer, PhD
In a longitudinal study, childhood personality traits were assessed at age 11 (N = 100) using the California Child Q-set. A number of these Q-items were found to be significantly correlated (p < 0.001) with a prototype-based measure of Borderline Personality Disorder (BPD) features at age 23. Factor analysis of these Q-items suggested that they could be characterized by two underlying personality dimensions: Impulsivity and Nonconformity/Aggression. The findings thus provide evidence that childhood personality traits predict adult BPD features.
Effects of Intensive Short-Term Dynamic Psychotherapy
Bita Ajilchi, PhD, Vahid Nejati, PhD, Joel M. Town, DClinPsy, Ryan Wilson, PhD, Allan Abbass, MD, FRCPC
We examined pretest, posttest, and follow-up depression scores, as well as pretest–posttest executive functioning scores, between 16 participants receiving intensive short-term dynamic psychotherapy (ISTDP) and 16 allocated to wait-list control. Participants in each group were matched according to age, sex, and educational level. Depressed patients receiving ISTDP show a sustained reduction in depression severity after treatment and after 12-month follow-up, and in improvements in executive functioning after treatment as compared with a wait-list control.
Sick Leave and Disability Across Three Decades After a Major Disaster
Katrine Høyer Holgersen, PhD, Christian A. Klöckner, PhD, Hans Jakob Bøe, PhD, Are Holen, MD, PhD
This longitudinal, case–control study applied growth mixture modeling to predict trajectories of functional impairment in oil rig workers, survivors (n = 68) and a matched comparison group (n = 84), over 27 years after the 1980 North Sea oil rig disaster. In the initial 12 years post-disaster, survivors displayed higher rates of functional impairment than the comparison group. A minor group of survivors (n = 8, 11.8%) demonstrated persistent functional impairment and remained unable to work. Long-term sick leave and disability were related to perceived peritraumatic death threat and a propensity towards social withdrawal; most survivors (n = 60) revealed no major functional impairment.
Interpersonal Subtypes of Anxiety Disorder Patients: Relationship to Assessment and Treatment Variables
Seth R. Pitman, MA, and Mark J. Hilsenroth, PhD
We attempted to replicate earlier findings of interpersonal subtypes in patients with anxiety disorder and examine whether these subtypes are characterized by different types of pathology and respond differently to treatment. Results demonstrated the existence of 4 interpersonal subtypes. The subtypes did not differ in severity of anxiety and global levels of symptoms at pretreatment or in Reliable Change Index of anxiety symptoms. However, they were significantly different in terms of overall interpersonal problems. Half of the patients in the nonassertive cluster discontinued treatment prematurely. The number of psychotherapy sessions attended was significantly different across the 4 clusters (p = 0.04), with socially avoidant patients attending significantly greater number of sessions.
Effects of 3,4-Methylenedioxymethamphetamine on Patient Utterances in a Psychotherapeutic Setting
Vicka Rael Corey, PhD, Vincent D. Pisano, BS, John H. Halpern, MD
3,4-Methylenedioxymethamphetamine (MDMA) administered as an adjunct to talk therapy influences patient speech content and increases improvement in treatment-resistant posttraumatic stress disorder (PTSD). Condition-blind scorers listened to therapy recordings and scored utterances where patients initiated topics that were empathic, entactic, or ensuic. Patients who received MDMA produced high levels of all three utterances. The relationship between the number of scored utterances and the CAPS scores measuring PTSD severity after the treatment was significant, and reanalysis grouped bimodally into "many" or "few" such utterances remained significant.
Association of Spirituality With Mental Health Conditions in Ohio National Guard Soldiers
Stephen J. Ganocy, PhD, Toyomi Goto, MA, Philip K. Chan, MS, Gregory H. Cohen, MSW, Laura Sampson, BA, Sandro Galea, MD, DrPH, Israel Liberzon, MD, PhD, Thomas Fine, MA, Edwin Shirley, PhD, James Sizemore, MDiv, Joseph R. Calabrese, MD, Marijo B. Tamburrino, MD
This study used the Spiritual Well-Being Scale to examine the association of spiritual well-being with suicidal ideation/behavior, posttraumatic stress disorder (PTSD), and depression and alcohol use disorders. The participants were 418 soldiers, with nearly three-quarters indicating that they had been deployed at least once. Higher spirituality was associated with significantly less lifetime PTSD, depression, and alcohol use disorders, and with less suicidal ideation. Future research in this area may benefit from a longitudinal design that can assess spirituality and mental health behaviors.
An Investigation Into the Relationship Between Long-term Posttraumatic Stress Disorder Symptoms and Coping in Australian Volunteer Firefighters
Rebekah M. Doley, PhD, MSci (Inv Psy), MPsych (Clin), Ryan Bell, MPsych (Clin), BA Arts (Psych), Bruce D. Watt, PhD, MPsych
A total of 277 firefighters completed 4 questionnaires to assess patterns of psychiatric morbidity. Firefighters evidencing distress were more likely to use both problem- and emotion-focused methods of coping. Based on previous research, it was hypothesized that problem-focused coping strategies would be used after 84 months. The use of both problem- and emotion-focused coping may be due to the length of time following this disaster or unique characteristics of firefighters. These data suggest that present coping theories are not sufficient to account for the onset and pattern of psychiatric morbidity within a firefighter sample.
Prevalence and Recognition of Depressive Disorder in Three Medical Outpatient Departments of General Hospitals in Beijing, China
Chang Liu, PhD, Meiyan Liu, PhD, Ronghuan Jiang, PhD, Hong Ma, PhD, Xiamin Wu, PhD, Shuxin Luan, PhD, Yanling He, PhD, Jing Wei, PhD, Wenpei Bai, PhD
Patients screened with a Hospital Anxiety and Depression Scale score of 8 or higher were interviewed by psychiatrists. Prevalence of depressive disorders within the cohort was determined, sociodemographic data were analyzed for correlations to a depression diagnosis, and comparisons between the surveys and the clinical diagnosis were done to assess recognition of depressive disorders. 12.8% were diagnosed with depressive disorders by MINI, with major depressive disorder, depression due to general medical conditions, and dysthymia having prevalence values of 10.8%, 1.4%, and 0.6%, respectively. As compared with MINI, physicians only recognized 27.6% of any of the depressive disorders.
Perceived Discrimination in Patients with Psychiatric Disorder and Turkish Migration Background in Germany
Matthias J. Müller, MD, and Eckhardt Koch, MD
Perceived discrimination (PD) has a negative impact on psychiatric disorders. We have investigated PD in inpatients with affective or anxiety disorder and Turkish migration background (TP) or native Germans (GP). Migration-related, clinical, and sociodemographic data of n = 62 TP and n = 62 GP, matched for age, sex, and psychiatric diagnoses were analyzed. PD was assessed as one of 10 questions related to migration and acculturation. PD prevalence rates were compared between TP and GP; relationships of PD with other variables were analyzed using bivariate correlations and multiple regression analyses. Within the TP sample, asylum-seeking status and migration-related distress were significantly predictive of PD.
Comparing Self-Stigma Between People with Different Mental Disorders in Taiwan
Chih-Cheng Chang, MD, MS, Tsung-Hsien Wu, MD, Chih-Yin Chen, MS, Chung-Ying Lin, MS, PhD
We hypothesized that people with different psychiatric diagnoses have different levels of self-stigma. Through convenience sampling, we used the Internalized Stigma of Mental Illness Scale to compare people diagnosed with schizophrenia (n = 161), depressive disorder (n = 98), bipolar disorder (n = 43), and anxiety disorder (n = 45) in southern Taiwan. We found that people with schizophrenia (mean, 2.09–2.30) and those with bipolar disorder (mean, 2.16–2.38) had significantly higher levels of self-stigma, except for the Stigma Resistance, than did those with anxiety disorder (mean, 1.74–1.87). Our results suggest that clinicians should use different interventions to reduce self-stigma for populations with different psychiatric diagnoses.
Prevalence and Characteristics of Body Dysmorphic Disorder Among Patients in a Partial Hospital Program
Andri Bjornsson, PhD, Soffia Magnusdottir, CandPsych, Inga Wessman, MSc, Courtney Beard, PhD, Josephine Lee, BA, Bridget A. Hearon, PhD, Throstur Bjorgvinsson, PhD
The current study is the first to assess prevalence of body dysmorphic disorder (BDD) among patients in a partial hospital program, and compare patients with and without BDD on demographic and clinical variables. Participants were 207 patients with a variety of Axis I diagnoses. Prevalence of current BDD was 7.2%, and a diagnosis of BDD did not predict worse treatment outcome in the program. Patients with current BDD were more likely to be female and younger, and have more comorbid diagnoses than patients without current BDD. No other significant differences were found at baseline between patients with and without current BDD.
LETTER TO THE EDITOR
"Gender dysphoria and psychiatric symptoms" by Professor Henk Nijman Joost á Campo, PhD, and Henk Nijman, PhD
Mindfulness-Based Substance Abuse Treatment for Adolescents. Sam Himelstein and Stephen Saul (2016) New York, NY: Routledge, Taylor & Francis. 223 pp.
Reviewed by Drs. Anna T. LaRose and John A. Renner, Jr.