Linkages between childhood emotional abuse and marital satisfaction: The mediating role of empathic accuracy for hostile emotions.

Research linking childhood emotional abuse (CEA) and adult marital satisfaction has focused on individuals without sufficient attention to couple processes. Less attention has also been paid to the effects of CEA on the ability to read other's emotions, and how this may be related to satisfaction in intimate relationships. In this study, 156 couples reported on histories of CEA, marital satisfaction and empathic accuracy of their partners' positive and hostile emotions during discussion of conflicts in their relationships. Actor-Partner Interdependence Modeling was used to examine links between CEA and marital satisfaction, with empathic accuracy as a potential mediator. Both men's and women's CEA histories were linked not only with their own lower marital satisfaction but also with their partners' lower satisfaction. Empathic accuracy for hostile emotions mediated the link between women's CEA and their satisfaction and their partners' satisfaction in the relationship. Findings suggest that a history of CEA is associated with difficulties with empathic accuracy, and that empathic inaccuracy in part mediates the association between CEA and adult marital dissatisfaction.

Two to tango: a dyadic analysis of links between borderline personality traits and intimate partner violence.

Although research has shown links between borderline personality and intimate partner violence (IPV), few studies have examined how each partner's personality traits may influence the other's behavior (Hines, 2008). This study incorporated dimensional assessments of borderline personality organization (BPO) in both partners into a dyadic model that examined associations with IPV. In a community sample of 109 couples, an Actor-Partner Interdependence Model was used to examine links between BPO traits in each partner and victimization and perpetration of IPV. Men's level of BPO traits was associated with more IPV toward and more victimization by their partners. Women's level of BPO traits was associated with their victimization only. This study is unique in examining links between BPO and IPV in couples using analyses that account for the interdependence of these variables in dyads.

Levels of dissociation and histories of reported abuse among women outpatients.

A total of 99 female patients consecutively admitted to an adult psychiatric outpatient clinic were surveyed about their history of physical and sexual abuse. Sixty-five percent of this sample reported having been physically abused, sexually abused, or both during their lifetimes. Scores on the Dissociative Experiences Scale were significantly higher among those reporting a history of sexual abuse than among those reporting a history of physical abuse or no history of abuse, who did not differ from each other. Dissociative Experiences Scale scores were important predictors of histories of sexual abuse among this sample. The implications of these findings for outpatient evaluation are discussed.

The role of psychodynamic concepts in the diagnosis of borderline personality disorder.

This review examines the role of psychodynamic concepts in the diagnosis of borderline personality disorder. The author discusses the current status of psychodynamic diagnosis of borderline personality disorder and outlines those psychodynamic features of borderline personality upon which most contemporary theorists agree. Psychodynamic concepts add essential dimensions to the diagnostic process in the following ways: (1) they give coherence to seemingly unconnected behavioral phenomena in a way that the descriptive approach to diagnosis does not, (2) they predict clinical dilemmas that arise in working with individuals with borderline personality disorder that are not predicted by DSM-III-R criteria, and (3) they explain important limitations inherent in the diagnostic process that may prevent accurate diagnosis in an initial assessment.

Transference and the vicissitudes of medication use by borderline patients.

This paper discusses the psychodynamics of medication use by borderline patients who are involved in ongoing psychotherapy. Particular attention must be paid to the transference reactions that these patients have to the therapist and to the medication, and to countertransference responses as well. Shifts in the transference must be monitored, as rapidly fluctuating views of self and other may hamper borderline patients' abilities to use medication responsibly at certain points in treatment. Case examples are used to illustrate the complexities of the prescribing process in such situations. The implications for prescribing strategies are considered.

Clinicians' experiences in combining medication and psychotherapy in the treatment of borderline patients.

Combining pharmacotherapy and psychotherapy in the treatment of borderline personality disorder is increasingly common, yet the experiences of clinicians who use the two modalities have not been studied. Forty psychotherapists were surveyed about their prescribing practices with borderline patients. Results corroborate the clinical impression that therapists' decisions about medication use are influenced by psychosocial factors as well as by target symptoms. Therapists were most likely to prescribe medications when they felt pessimistic about patients' capacity to benefit from psychotherapy and were rarely willing to prescribe medications for patients who had a history of substance abuse or suicide attempts. An average of 47 percent of the borderline patients in the therapists' practices misused prescription medications. Patients were most likely to abuse medications after experiencing an interpersonal loss or failure.

Intensive psychodynamic therapy with borderline patients: an overview.

The author reviews major controversies in the literature regarding techniques of intensive psychodynamic therapy with borderline patients. These include debates about the importance of content versus process in the therapist's early interventions, the origins of transference, the primacy of positive versus negative transference in therapeutic work, the usefulness of early interpretation of negative transference, and the therapist's role in providing "corrective" experiences. He suggests that different conceptions of borderline psychopathology, different patient populations studied, variations in therapists' personality styles, and emphasis on different phases of treatment may account for the diversity of treatment techniques advocated in the literature.

Completed psychotherapies with borderline patients.

Retrospective assessments of the type and outcome of psychotherapy with seventy-eight borderline patients were obtained from eleven experienced therapists. Differences in outcome based on length and type of treatment and amount of previous treatment, and differences in patterns of termination were reported and discussed.