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1.
Clin Psychol Psychother ; 31(3): e3016, 2024.
Article in English | MEDLINE | ID: mdl-38859691

ABSTRACT

OBJECTIVE: This study examined therapists' dispositional empathy profiles and how they differ based on professional and personal characteristics. METHOD: A total of 376 clinicians was recruited for this study. Dispositional empathy was assessed with the Interpersonal Reactivity Index (IRI). Profiles were generated using latent profile analysis. Predictors of profiles were assessed with multiple self-report questionnaires measuring demographic and professional characteristics, romantic attachment styles, five-factor personality traits and vulnerable narcissism. RESULTS: A four-profile solution was retained with the following proportions: rational empathic (20%), disengaged/detached (10%), empathic immersion (35%) and insecure/self-absorbed (35%). Overall, few relationships were found regarding demographic and professional characteristics. In contrast, significant relationships were found between profile membership and personal characteristics, including avoidant and anxious attachment, agreeableness, conscientiousness, neuroticism, intellect/imagination and vulnerable narcissism. CONCLUSION: The findings show that differences in therapists' empathic dispositions are linked to personality dimensions. Implications for psychotherapy research, practice and training are discussed.


Subject(s)
Empathy , Psychotherapists , Humans , Male , Female , Adult , Psychotherapists/psychology , Psychotherapists/statistics & numerical data , Middle Aged , Personality , Surveys and Questionnaires , Professional-Patient Relations , Narcissism
2.
J Ment Health ; 32(1): 24-32, 2023 Feb.
Article in English | MEDLINE | ID: mdl-33084445

ABSTRACT

BACKGROUND: Theorized to stem from experiences of childhood emotional neglect, narcissistic vulnerability has been identified as contributing to expressions of psychiatric distress such as depressive and anxiety symptoms, particularly due to shame-proneness. AIMS: To investigate narcissistic vulnerability and shame as mediators between perceived childhood emotional neglect and depressive and generalized anxiety symptoms among psychiatric outpatients. METHODS: Adults (N = 137) attending community mental health services completed self-report measures at intake. Mediation analyses tested the indirect effect of perceived emotional neglect on depressive and generalized anxiety symptom severity through narcissistic vulnerability; shame was added to subsequent models to examine narcissistic vulnerability and shame as sequential mediators. RESULTS: Perceived emotional neglect was significantly associated with narcissistic vulnerability, which in turn was linked with depressive and generalized anxiety symptoms as separate dependent variables. Indirect effects were significant in each model, indicating narcissistic vulnerability as a significant mediator. With the inclusion of shame, narcissistic vulnerability and shame were significant as sequential mediators. CONCLUSION: Narcissistic vulnerability and shame may operate as mechanisms in conferring affective symptom severity from perceived childhood emotional neglect. Narcissistic vulnerability and susceptibility to shame may thus be important treatment targets when addressing psychological distress in the context of childhood adversity.


Subject(s)
Mental Health , Outpatients , Adult , Humans , Shame , Anxiety , Narcissism
3.
J Clin Psychol ; 77(1): 329-339, 2021 01.
Article in English | MEDLINE | ID: mdl-32738186

ABSTRACT

OBJECTIVE(S): Interpersonal problems are one of the most persistent difficulties facing those with personality disorders (PDs) and are linked with dysfunction across numerous social domains. Using an interpersonal model of PDs, we examined the indirect effects of Avoidant PD (AvPD) symptoms and social dysfunction through interpersonal problems, as well as Borderline PD (BPD) symptoms and social dysfunction. METHODS: Participants were 226 adults taking part in an outpatient treatment program. RESULTS: Using cross-sectional data from self-reported measures, we found that cold (b = 0.10, 95% confidence interval (CI) [0.038, 0.176]) and overly nurturant (b = 0.04, 95% CI [0.001, 0.090]) interpersonal problems showed an indirect association between AvPD symptoms and social dysfunction. The only significant indirect association between BPD symptoms and social dysfunction was overly nurturant (b = 0.05, 95% CI [0.001, 0.120]). CONCLUSIONS: Results may aid in the development of more individualized treatments for AvPD and BPD symptoms.


Subject(s)
Borderline Personality Disorder , Adult , Borderline Personality Disorder/epidemiology , Cross-Sectional Studies , Humans , Interpersonal Relations , Personality Disorders , Self Report , Social Behavior
4.
J Nerv Ment Dis ; 208(2): 161-164, 2020 02.
Article in English | MEDLINE | ID: mdl-31977828

ABSTRACT

Research is scarce regarding the mechanisms by which pathological narcissism--consisting of narcissistic grandiosity and vulnerability--is linked with depression. The present study examined whether impaired emotional processing would mediate relations between pathological narcissism domains and depressive symptoms in a sample of 99 psychiatric outpatients. A significant indirect effect was found for narcissistic vulnerability on depressive symptoms, through unprocessed emotion as a mediator. Findings suggest that narcissistic vulnerability contributes to persistent and intrusive negative feelings, which in turn contribute to depressive symptom severity.


Subject(s)
Depressive Disorder, Major/psychology , Emotions , Personality Disorders/psychology , Adult , Depressive Disorder, Major/etiology , Female , Humans , Male , Outpatients/psychology , Personality Disorders/complications , Personality Inventory , Psychiatric Status Rating Scales , Severity of Illness Index , Surveys and Questionnaires
5.
J Nerv Ment Dis ; 207(10): 820-825, 2019 Oct.
Article in English | MEDLINE | ID: mdl-31503178

ABSTRACT

With a controversial history, passive-aggressive personality disorder (PAPD) was eventually removed from the latest edition of the Diagnostic and Statistical Manual for Mental Disorders. Despite its demise from diagnostic nomenclature, clinicians continue to regard it as a clinically relevant construct, and some researchers argue for its resurrection. Toward this end, it is important to empirically demonstrate the relevance of the passive-aggressive personality construct, including demonstrating its association with impaired functioning. Consistent with contemporary emphasis on interpersonal functioning in personality pathology, the current study aims to explore interpersonal problems that are associated with PAPD in a large clinical sample. Before beginning treatment, 240 patients completed assessments of personality psychopathology and interpersonal functioning. Results showed that higher levels of PAPD were significantly associated with greater level of interpersonal distress, especially regarding interpersonal problems of a vindictive nature. The findings are consistent with clinical descriptions of the core conflictual relational issues of patients with PAPD and lend some support to further considering PAPD as a valid diagnostic construct.


Subject(s)
Interpersonal Relations , Passive-Aggressive Personality Disorder/psychology , Passive-Aggressive Personality Disorder/therapy , Psychotherapy, Group/methods , Self Report , Adult , Female , Humans , Male , Middle Aged , Passive-Aggressive Personality Disorder/diagnosis , Personality Assessment/standards , Self Report/standards
6.
J Nerv Ment Dis ; 207(2): 49-52, 2019 02.
Article in English | MEDLINE | ID: mdl-30672878

ABSTRACT

Psychotherapists can experience emotional drain as a result of their work with distressed and traumatized patients. It has been suggested that psychotherapists' empathy, which is central to clinical work, may be an important risk factor in the development of burnout or secondary traumatic stress. This apparent contradiction is thought provoking, especially given the complexity of empathic response. The current study aimed to explore the relationship of empathy to compassion satisfaction, burnout, and secondary traumatic stress, while also considering the influence of important work conditions. To do so, 240 psychotherapists described their current practice and reported their levels of empathy and their professional quality of life. Results revealed various relationships between dimensions of empathy and professional quality of life, and the moderating role of empathy regarding the impact of work conditions on professional quality of life. Results highlight the importance of a multidimensional assessment of empathy and the importance of different training and supervision strategies that could help psychotherapists to be more resilient in their work.


Subject(s)
Burnout, Professional/psychology , Compassion Fatigue/psychology , Empathy , Health Personnel/psychology , Job Satisfaction , Professional-Patient Relations , Psychotherapy , Adult , Female , Humans , Male , Middle Aged , Quality of Life
8.
J Clin Psychol ; 75(3): 546-561, 2019 03.
Article in English | MEDLINE | ID: mdl-30368817

ABSTRACT

OBJECTIVE: Attachment theory is of great relevance to psychotherapy process and outcome. The labor-intensive and time-consuming nature of attachment codification impedes its widespread use in clinical practice. The Attachment Questionnaire (AQ), a clinician-rated instrument, was developed to address these limitations. However, the status of validation of the AQ remains preliminary. The objective of this study is to further validate the AQ by evaluating its factor structure and convergent validity. METHODS: To this end, 389 psychotherapists completed the AQ and assessed patients' personality disorders and level of functioning. RESULTS: Factor analyses revealed that a five-factor solution provided a better fit than the original four-factor solution. The additional factor, inhibited exploration, captured difficulties in open, nondefensive, exploration of memories and their effects. Correlations between AQ factors and criterion variables support the convergent validity of the AQ. CONCLUSIONS: These results are discussed in light of patients' characteristics and recent advances in attachment research.


Subject(s)
Object Attachment , Personality Disorders/diagnosis , Psychiatric Status Rating Scales/standards , Psychometrics/standards , Adult , Factor Analysis, Statistical , Female , Humans , Male , Middle Aged , Psychometrics/instrumentation , Psychotherapy , Reproducibility of Results
9.
J Nerv Ment Dis ; 206(6): 455-460, 2018 06.
Article in English | MEDLINE | ID: mdl-29781893

ABSTRACT

Countertransference (CT) is usually conceptualized as emerging in the course of psychotherapy. This study explores whether CT manifests itself in the context of assessment and if the modality of exposure to participants (interviewer and observer) affects the intensity and nature of CT. Evaluators either led (direct exposure) or observed (indirect exposure) a 6-hour interview with a subject focusing on attachment and personality. Interviewers and evaluators then completed a measure of CT, the Therapist Response Questionnaire for a total of 43 subjects. Results show significant CT reactions for both interviewers and observers that were globally as intense in both conditions, although lower positive/satisfying and helpless/inadequate CTs were reported by observers. Moreover, intraclass correlations suggest that interviewers' and observers' CT reactions toward the same interviewee show an important degree of similarity. These results highlight the presence of CT in assessment contexts and support the existence of an objective part to CT reactions.


Subject(s)
Countertransference , Mental Disorders/diagnosis , Adolescent , Adult , Female , Humans , Interview, Psychological , Male , Mental Disorders/psychology , Mental Disorders/therapy , Middle Aged , Object Attachment , Professional-Patient Relations , Psychotherapy , Surveys and Questionnaires , Young Adult
10.
Bull Menninger Clin ; 76(4): 329-64, 2012.
Article in English | MEDLINE | ID: mdl-23244526

ABSTRACT

The aim of this study was to develop a typology of adolescent sex offenders based on object relations theory and Otto F. Kernberg's model of personality organizations (PO). A secondary objective was to compare the identified subtypes on offense characteristics as well as some psychological variables of adolescent sex offenders. Clinical files from 40 male adolescent sex offenders in treatment were examined. Cluster analysis based on PO and object relations variables identified six subtypes of offenders, in line with Kernberg's PO model. These subtypes differed from one another on various variables pertaining to characteristics of sex offenses, general delinquency, relational/sexual history, and trauma history.


Subject(s)
Criminals/classification , Juvenile Delinquency/classification , Object Attachment , Personality Disorders/psychology , Psychological Theory , Sex Offenses/psychology , Adolescent , Adult , Aggression/psychology , Analysis of Variance , Canada , Child , Child Abuse, Sexual/psychology , Child Abuse, Sexual/statistics & numerical data , Cluster Analysis , Crime Victims/psychology , Criminals/psychology , Humans , Interpersonal Relations , Juvenile Delinquency/psychology , Male , Models, Psychological , Personality Assessment/statistics & numerical data , Personality Development , Personality Disorders/classification , Personality Inventory , Psychometrics , Sex Offenses/classification , Sexual Behavior/psychology
11.
Psychother Res ; 22(4): 402-16, 2012.
Article in English | MEDLINE | ID: mdl-22417116

ABSTRACT

The aim of this study was to report on the development and the initial validation of the Object Relations Rating Scale (ORRS), which is a measure of in-session enactments of object relations that draws on a psychodynamic conceptualization of personality organization. Forty participants were included in the study, distributed among neurotic, borderline and psychotic personality organizations (PO). Results showed that the interrater reliability of this new measure is good. Two tests of criterion validity support the validity of the measure: the ORRS discriminates well between the three PO groups and it correlates in expected ways with five PO dimensions. Finally, ORRS scales that pertain to the degree of in-session object relation enactments correlated with a measure of transference intensity (convergent validity), and correlations with therapists experience were low as expected (discriminant validity).


Subject(s)
Object Attachment , Personality Assessment/statistics & numerical data , Personality Disorders/therapy , Personality , Psychoanalytic Therapy/methods , Adult , Female , Humans , Male , Middle Aged , Professional-Patient Relations , Psychometrics/instrumentation , Reproducibility of Results , Surveys and Questionnaires , Transference, Psychology
12.
Clin Psychol Rev ; 31(4): 554-62, 2011 Jun.
Article in English | MEDLINE | ID: mdl-21239099

ABSTRACT

Research indicates that sexual offenders who do not complete their treatment are more likely to reoffend than are those who do complete it (Hanson et al., 2002; Losël & Schmucker, 2005). Several investigators have attempted to identify the characteristics of those individuals who do not complete treatment, most likely with the aim of preventing recidivism and the disastrous consequences that offenders' behavior has for their victims and for society at large. The objective of the present article is to review studies of treatment noncompletion among sexual offenders. We found that between 15% and 86% of sexual offenders do not complete treatment. In addition, results of the 18 studies reviewed diverge to the point where it is difficult to draw unequivocal conclusions about the variables related to the phenomenon. Only antisocial personality disorder and certain features of antisocial personality disorder appear to be related consistently and significantly to the discontinuation of treatment. These features are conceptualized under the three principles of effective treatment for general offenders. We present an analysis of the methodological limitations common to all of the studies reviewed in order to explain why confusion seems to reign supreme in the literature in this area at the present time, and we offer recommendations for future research in light of these limitations.


Subject(s)
Antisocial Personality Disorder/therapy , Criminals/psychology , Psychotherapy , Sex Offenses/psychology , Antisocial Personality Disorder/psychology , Humans , Risk , Treatment Outcome
13.
Bull Menninger Clin ; 74(1): 1-28, 2010.
Article in English | MEDLINE | ID: mdl-20235621

ABSTRACT

The goal of this study was to examine whether psychological dimensions of antisocial personality disorder (ASPD), as conceptualized by Kernberg (1992), could predict psychotherapy noncompletion (PNC) among 50 men found guilty of sexual abuse of children. All participants began a 65-week, court-mandated course of cognitive-behavioral psychotherapy, which 20 (40%) of them did not complete. Pretherapy personality was assessed with the Structured Clinical Interview for DSM Axis II Disorders (First, Spitzer, Gibbon, Williams, & Benjamin, 1997), the Personality Organization Diagnostic Form (Diguer, Normandin, & Hébert, 2001), and Blatt and colleagues' (Blatt, Bers, & Schaffer, 1993; Blatt, Chevron, Quinlan, Schaffer, & Wein, 1988) scales of mental representations, as well as the State-Trait Anger Expression Inventory (Spielberger, 1988). A discriminant function analysis, which explained 46% of the total variance, showed that descriptive (antisocial and narcissistic personality disorders), psychological (primitive defense mechanisms, identity diffusion and self-representations), and demographic (work status and income) variables predicted PNC. The classification analysis correctly classified 78% of the participants. These findings support the hypothesis that psychological dimensions of ASPD help explain PNC among sexual offenders. The authors discuss the theoretical and clinical implications of these results.


Subject(s)
Antisocial Personality Disorder , Cognitive Behavioral Therapy/methods , Patient Compliance/statistics & numerical data , Sex Offenses/psychology , Adult , Anger , Antisocial Personality Disorder/epidemiology , Antisocial Personality Disorder/psychology , Antisocial Personality Disorder/therapy , Defense Mechanisms , Humans , Male , Predictive Value of Tests , Sex Offenses/statistics & numerical data , Young Adult
14.
Psychotherapy (Chic) ; 47(4): 454-68, 2010 Dec.
Article in English | MEDLINE | ID: mdl-21198235

ABSTRACT

This study examined the relation of client attachment to the therapist to diverse facets of the therapeutic alliance, client personality, and psychopathological symptoms, as well as the relative importance of therapeutic attachments, personality, and symptomatology in predicting the alliance. Eighty clients in ongoing therapy completed measures of client attachment to therapist (CATS), personality (6FPQ), psychopathological symptoms (BSI), and therapeutic alliance (WAI-Short, CALPAS, HAQ). Secure and Avoidant-Fearful attachment to the therapist correlated positively and negatively, respectively, with total and subscale alliance scores. Preoccupied-Merger therapeutic attachment was unrelated to the alliance. Exploratory analyses suggested however that the relationship between Preoccupied-Merger attachment and the alliance was moderated by the extent to which clients were distressed. Clients' therapeutic attachments were unrelated to basic personality dimensions. Preoccupied-Merger attachment to the therapist correlated significantly with several symptom dimensions. Clients' therapeutic attachments emerged as superior and more consistent predictors, relative to client personality and symptomatology, of the therapeutic alliance.


Subject(s)
Character , Cooperative Behavior , Mental Disorders/psychology , Mental Disorders/therapy , Object Attachment , Professional-Patient Relations , Psychotherapy , Adjustment Disorders/psychology , Adjustment Disorders/therapy , Adolescent , Adult , Aged , Anorexia Nervosa/psychology , Anorexia Nervosa/therapy , Anxiety Disorders/psychology , Anxiety Disorders/therapy , Female , Humans , Interpersonal Relations , Male , Middle Aged , Mood Disorders/psychology , Mood Disorders/therapy , Personality Disorders/psychology , Personality Disorders/therapy , Personality Inventory/statistics & numerical data , Psychometrics , Treatment Outcome , Young Adult
15.
J Nerv Ment Dis ; 197(11): 816-21, 2009 Nov.
Article in English | MEDLINE | ID: mdl-19996719

ABSTRACT

Clinical theories of borderline personality disorder (BPD) identify attachment insecurity as the basis of its characteristic disturbed interpersonal functioning. The purpose of this study was to compare attachment ratings in rigorously diagnosed BPD, depressed (MDD), and nonborderline comparison groups and their correlations to features of interpersonal disturbance. Subjects self-reported ratings on attachment styles using the relationship questionnaire. BPD subjects reported higher scores on both preoccupied and fearful attachment styles than both MDD and nonborderline comparison groups. A mixed model of preoccupied and fearful attachment was more prevalent in the BPD group and was associated with 3 to 20 times greater risk for diagnosis of BPD. Scores on preoccupied and fearful attachment styles were correlated with features of interpersonal disturbance in BPD. A combination of preoccupied and fearful self-reported attachment styles is more specific to BPD than either style alone or attachment insecurity in general.


Subject(s)
Borderline Personality Disorder/diagnosis , Borderline Personality Disorder/psychology , Interpersonal Relations , Object Attachment , Self Concept , Adolescent , Adult , Female , Humans , Interview, Psychological/methods , Young Adult
16.
J Nerv Ment Dis ; 197(5): 368-77, 2009 May.
Article in English | MEDLINE | ID: mdl-19440111

ABSTRACT

The purpose of this study is to examine the interrater reliability, validity, and internal consistency of a revised version of the Personality Organization Diagnostic Form (PODF; ), a measure that evaluates the major dimensions of Kernberg's model of Personality Organizations (PO). Results show that the revised PODF can be scored with an interrater reliability ranging from good to excellent for the personality dimensions and the global PO (GPO) score. Factor analysis shows that items tend to regroup according to Kernberg's model. The optimal solution includes 2 factors: a borderline-neurotic continuum and a psychotic factor. Internal consistency and convergence with clinical evaluations also indicate moderate to good validity. Convergent validity with mental health and psychiatric severity is good, and in accordance with Kernberg's model. The revised PODF therefore appears to possess sound psychometric properties, with numerous advantages over its predecessor. Its utility for clinical and research work is also discussed.


Subject(s)
Personality Disorders/diagnosis , Surveys and Questionnaires , Adolescent , Adult , Aged , Defense Mechanisms , Female , Humans , Male , Middle Aged , Object Attachment , Reproducibility of Results , Young Adult
17.
Sante Ment Que ; 33(1): 89-114, 2008.
Article in French | MEDLINE | ID: mdl-18795197

ABSTRACT

In this article, the authors address the concept of object relations and its place within psychodynamic theories regarding personality and, more specifically, in Kernberg's conceptualization of personality disorders and organization. The authors attempt to demonstrate the relevance of an empirical approach to object relations by presenting some of the instruments that are most considered. The Object Relations Rating Scale (ORRS ; Diguer, 2001), a new assessment instrument that is different from the others in that it assesses the therapeutic interaction as a whole, and that it is coherent with Kernberg's model of intervention and considers the overall relational manifestations. Finally, the authors present satisfying metrological ratings of this new instrument.


Subject(s)
Empirical Research , Object Attachment , Adult , Affect , Female , Humans , Male , Personality , Personality Inventory , Psychotherapy
18.
J Nerv Ment Dis ; 195(10): 819-29, 2007 Oct.
Article in English | MEDLINE | ID: mdl-18043522

ABSTRACT

Otto Kernberg has developed a model of personality and psychological functioning centered on the concept of personality organization. The purpose of this study is to empirically examine the relationships between this model, the five-factor model, and mental health. The Personality Organization Diagnostic Form (Diguer et al., The Personality Organization Diagnostic Form-II (PODF-II), 2001), the NEO Five-Factor Inventory (Costa and McCrae, Revised NEO Personality Inventory (NEO-PI-R) and NEO Five-Factor Inventory (NEO-FFI) Professional Manual. 1992a), and the Health-Sickness Rating Scale (Luborsky, Arch Gen Psychiatry. 1962;7:407-417) were used to assess these constructs. Results show that personality organization and personality factors are distinct but interrelated constructs and that both contribute in similar proportion to mental health. Results also suggest that the integration of personality organization and factors can provide clinicians and researchers with an enriched understanding of psychological functioning.


Subject(s)
Mental Disorders/diagnosis , Models, Psychological , Personality/classification , Adult , Factor Analysis, Statistical , Female , Humans , Male , Mental Disorders/psychology , Mental Health/classification , Personality Inventory/statistics & numerical data , Psychiatric Status Rating Scales/statistics & numerical data , Psychometrics , Surveys and Questionnaires
19.
Psychotherapy (Chic) ; 44(2): 175-92, 2007 Jun.
Article in English | MEDLINE | ID: mdl-22122209

ABSTRACT

To gain a closer understanding of client collaboration and its determinants, the first goal of this study involved the investigation of clients' perceptions of collaboration using a discovery-oriented methodology. Content analysis of 30 clients' written descriptions revealed three different modes of client collaboration, labeled active, mutual, and therapist-dependent, which emphasized client initiative and active participation, joint participation, and reliance on therapists' contributions to the work and change process, respectively. The majority of clients valued the therapist's active involvement and also emphasized the helpfulness of their collaborative experiences. In general, the therapist actions and attitudes involved in clients' views of good collaboration varied among clients. A second goal was to examine the relationships between client psychological functioning, quality of interpersonal relationships, and motivation, and clients' collaborative contributions, as rated by clients and therapists. Of these, only motivation was significantly associated with client collaboration, particularly in the perceptions of therapists. (PsycINFO Database Record (c) 2010 APA, all rights reserved).

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