A meta-analytic study examining the relationship between alexithymia and dissociation in psychiatric and nonclinical populations.

Alexithymia and dissociation have been consistently linked in the literature, particularly in psychiatric populations. Both arise from a disconnection between conscious aspects of self-experiences and perceptions at both the mental self and bodily levels. This results in difficulty integrating thoughts, feelings and experiences into consciousness and memory, negatively impacting emotion awareness/regulation and reflective functioning. We conducted a meta-analysis to examine the strength of the relationship between alexithymia and dissociation in both clinical and non-clinical populations. Studies using two common measures of these constructs were included (i.e., the Toronto Alexithymia Scale - TAS, and the Dissociative Experiences Scale - DES). Analyzing the effect sizes derived from 19 studies (including a total of 4664 participants) revealed moderate to strong relationships between alexithymia and dissociation. The strength of the association was higher in clinical and younger aged non clinical populations. These findings are discussed in the context of treatment recommendations..

The Price of Needing to Belong: Neurobiology of Working Through Attachment Trauma.

Belonging is fundamental to health and well-being. Complex relational trauma disrupts attachments, negatively impacting developing neurobiology and has significant implications for attachment behaviors, mental health, and treatment planning. We have developed a dynamic relational (DR) model of psychotherapy that aims to restore a healthy sense of belonging, targeting levels of activation and integration of large scale neural networks in the service of increasing the emotional capacities (attunement, processing, regulation, and expression) required to work through attachment trauma and establish healthy relationships. Our DR model provides an organizing framework through which to understand both the phenomenology observed in complex trauma and the mechanisms of therapeutic change. Our approach informs the weighting and timing of interventions to actively address capacity deficits, ego-syntonic symptoms, and unconscious resistance. The implications of this model also relate to the pathogenesis of mental disorder, and suggest prevention and early intervention efforts focus on modulation of subcortical (autonomic) responses and the encouragement of balanced cortical integration to enhance cognitive flexibility/psychological resilience. Ultimately, interventions based on our systematic model may modulate the genetic diathesis and comorbidities of relational trauma and increase psychological resilience.

Dynamic Relational Group Psychotherapy: A Neurobiologically Informed Model of Change.

In this article, we introduce a preliminary, neurobiologically informed model of group therapy that links the timing and nature of specific group interventions with hypothesized changing neurobiological needs of the group. We suggest that the observed phases of group development reflect an underlying reorganization of neuronal circuitry that occurs as members progress through a hierarchically organized treatment, and that this reorganization involves the integration and homeostatic rebalancing of subcortical and neural networks. Our preliminary Dynamic Relational Model suggests that an understanding of the neurobiological processes involved in group development may help inform and direct effective group-based psychotherapy interventions.

Dynamic Relational Group Psychotherapy: A Neurobiologically Informed Model of Change.

In this article we introduce a preliminary, neurobiologically informed model of group therapy that links the timing and nature of specific group interventions with hypothesized changing neurobiological needs of the group. We suggest that the observed phases of group development reflect an underlying reorganization of neuronal circuitry that occurs as members progress through a hierarchically organized treatment, and that this reorganization involves the integration and homeostatic rebalancing of subcortical and neural networks. Our preliminary Dynamic Relational model suggests that an understanding of the neurobiological processes involved in group development may help inform and direct effective group-based psychotherapy interventions.

Attachment style changes following intensive short-term group psychotherapy.

In this study, we examined changes in attachment style as measured by the Relationship Scales Questionnaire before and after six weeks of intensive group psychotherapy. We also investigated whether changes in attachment style were associated with changes in interpersonal functioning. Results indicated that participants showed increases in secure attachment and decreases in fearful attachment and, to a lesser degree, preoccupied attachment styles. Change was not found in the dismissive attachment style. Changes in Secure and/or Fearful (but not Preoccupied) attachment styles were related to changes in interpersonal functioning on seven of the eight subscales of the Inventory of Interpersonal Problems. Overall findings suggest intensive group psychotherapy programs show promise for reducing attachment pathology and improving interpersonal functioning. Assessing differential responsiveness to psychotherapy may help us align our interventions to better address differing attachment styles through modifications in focus and approach.

Predictors of parent training efficacy for child externalizing behavior problems--a meta-analytic review.

BACKGROUND: The differential effectiveness of parent training has led researchers to examine a variety of child, parent, and familial variables that may predict treatment response. Studies have identified a diverse set of child, parent psychological/behavioral and demographic variables that are associated with treatment outcome and dropout. METHOD: The parent training literature was examined to isolate child, parent, and family variables that predict response to parent training for child externalizing behavior problems. A literature review was conducted spanning articles published from 1980 to 2004 of indicated prevention (children with symptoms) and treatment (children with diagnosis) studies. Meta-analyses were conducted to determine standardized effect sizes associated with the identified predictors. RESULTS: Many of the predictors of treatment response examined in this meta-analysis resulted in moderate standardized effect sizes when study results were subjected to meta-analytic procedures (i.e., low education/occupation, more severe child behavior problems pretreatment, maternal psychopathology). Only low family income resulted in a large standardized effect size. Predictors of drop-out resulted in standardized effect sizes in the small or insubstantial range. CONCLUSIONS: Response to parent training is often influenced by variables not directly involving the child, with socioeconomic status and maternal mental health being particularly salient factors.