[Incidence and predictors of peri-traumatic reactions in an Algerian population faced with COVID-19]. / Incidence et prédicteurs des réactions péri-traumatiques dans une population algérienne face à la COVID-19.

Objectives: This study explored two related questions: (1) the incidence of peri-traumatic distress and dissociation in a general Algerian population during the initial stages of the COVID-19 epidemic; (2) sociodemographic predictors of peri-traumatic reaction. The objective is to better understand the peri-traumatic experience in order to identify vulnerable people to whom psychological care could be offered. Materials and methods: An online descriptive survey containing three questionnaires, a demographic questionnaire, the questionnaire for peri-traumatic distress and the questionnaire for peri-traumatic dissociation experiences, was conducted using the snowball sampling technique to select 1374 Algerians. Results: The results of this survey indicate that 32.7 % of the participants present a peri-traumatic distress and 61.8 % of the participants present a significant level of peri-traumatic dissociation during the initial phases of the COVID-19 pandemic. In addition to confinement, stress, female gender, the origin of a particularly affected department, the average economic situation and a history of psychological problems are predictors of peri-traumatic distress. Conclusion: This study provides the first empirical data on the incidence of peri-traumatic reactions (distress and dissociation), as well as their predictors in an Algerian population during the initial phases of the COVID-19 epidemic. The Algerian population has experienced levels of distress in the low range of what has been described in the literature, while the dissociation shows that the majority of the population is affected. This result demonstrates the importance of measuring the peri-traumatic reactions according to the two dimensions of distress and dissociation, and offering psychological care for the most vulnerable people, in order to prevent the risk of their possible chronicisation, and developing post-traumatic stress disorder in later periods.

Lessening of the pervasiveness of interpersonal patterns in borderline personality disorder explains symptom decrease after treatment: A process analysis.

BACKGROUND: Problematic interpersonal patterns, as defined by the core conflictual relationship theme (CCRT) method, are part of the clinical presentation of clients with borderline personality disorder (BPD). So far, we do not know whether the pervasiveness of interpersonal patterns changes and if this change explains therapy outcome. METHODS: In a secondary analysis of a randomized controlled trial on a brief version of psychiatric treatment for BPD, a treatment with a psychodynamic focus, the present study included N = 39 clients. One early session and one late session of the treatment were transcribed and analyzed using the CCRT method. RESULTS: It appeared that pervasiveness of the predominant CCRT decreased over the course of the brief treatment; this effect was robust across treatment conditions. Change in pervasiveness in any CCRT component explained a small portion of variance of the decrease in borderline symptoms observed at the end of treatment. DISCUSSION: Lessening of pervasiveness of problematic in-session interpersonal patterns may be hypothesized as potential mechanism of effective treatment for BPD which should be tested in controlled designs.

Defense Mechanisms and Treatment Response in Depressed Inpatients.

The study investigated the extent to which defensive functioning and defense mechanisms predict clinically meaningful symptomatic improvement within brief psychodynamic psychotherapy for recurrent and chronic depression in an inpatient setting. Treatment response was defined as a reduction in symptom severity of 46% or higher from the baseline score on the Montgomery-Asberg Depression Rating Scale (MADRS). A subsample of 41 patients (19 responders and 22 non-responders) from an RCT was included. For each case, two sessions (the second and the penultimate) of brief inpatient psychodynamic psychotherapy (a manualized 12-session therapy program developed in Lausanne) were transcribed and then coded using the Defense Mechanism Rating Scales (DMRS) and the Psychotic Defense Mechanism Rating Scales (P-DMRS), an additional scale developed to study psychotic defenses. Results showed that defensive functioning and mature and immature defense changed during psychotherapy and predicted treatment response. Patient's defenses observed throughout therapy also predicted treatment response at 12-month follow-up. The addition of psychotic defenses allows a better prediction of the treatment response. Overall, these results are in line with previous research and provide further validation of defensive functioning as a predictor of outcomes and a mechanism of change in psychotherapy.