scholarly journals Adapting group schema therapy for older adults with personality disorders: lessons learnt

2021 ◽  
Vol 14 ◽  
Author(s):  
A. C. Videler ◽  
K. A. van Beest ◽  
M. A. Ouwens ◽  
G. Rossi ◽  
R. J. J. van Royen ◽  
...  
Keyword(s):  
Older Adults ◽  
Personality Disorder ◽  
Primary Outcome ◽  
Treatment Protocol ◽  
Brief Symptom Inventory ◽  
Individual Treatment ◽  
Schema Therapy ◽  
List Type ◽  
Younger Adults ◽  
Small Effect Size

Abstract A first empirical study into group schema therapy in older adults with mood disorders and personality disorder (PD) features has shown that brief group schema therapy has potential to decrease psychological distress and to change early maladaptive schemas (EMS). Effect sizes however were smaller than those found in similar studies in younger adults. Therefore, we set out to adapt the treatment protocol for older adults in order to enhance its feasibility and outcome in this age group. We examined this adapted protocol in 29 older adults (mean age 66 years) with PDs from four Dutch mental health institutes. The primary outcome was symptomatic distress, measured by the Brief Symptom Inventory. Secondary outcomes were measured by the Young Schema Questionnaire, the Schema Mode Inventory, and the short version of the Severity Indices of Personality Problems. Contrary to our expectations, the adapted treatment protocol yielded only a small effect size in our primary outcome, and no significant improvement in EMS, modes and personality functioning. Patients pointed out that they were more aware of their dysfunctional patterns, but maybe they had not been able yet to work on behavioural change due to this schema therapy treatment being too brief. We recommend more intensive treatment for older patients with PDs, as they might benefit from more schema therapy sessions, similar to the treatment dosage in younger PD patients. They might also benefit from a combination of group therapy and individual treatment sessions. Key learning aims (1) How to adapt group schema therapy for older adults. (2) How to explore feasibility and outcome. (3) Treat older personality disorder patients as intensively as younger adults.

The unified protocol for anxiety and depression with comorbid borderline personality disorder: a single case design clinical series

2019 ◽  
Vol 12 ◽  
Author(s):  
Michelle E. Lopez ◽  
Steven R. Thorp ◽  
Matthew Dekker ◽  
Andrew Noorollah ◽  
Giovanna Zerbi ◽  
...  
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Emotional Disorders ◽  
Single Case ◽  
Borderline Personality ◽  
Anxiety And Depression ◽  
Individual Treatment ◽  
List Type ◽  
Unified Protocol ◽  
Clinical Series

AbstractThis study used a single case experimental design to investigate the use of the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP) among a sample of individuals with depression and anxiety who also presented with borderline personality disorder (BPD). Eight women received individual treatment with the UP over the course of 14–16 treatment sessions, and were assessed for anxiety and depression severity on a weekly basis over a 2–6 week baseline period and throughout treatment. Three of the eight participants demonstrated reliable pre- to post-treatment clinical improvements on depression and stress scales, and one participant demonstrated a reliable reduction on an anxiety scale. Two participants demonstrated a reliable improvement in overall anxiety. The results indicate that the UP applied to individuals diagnosed with primary BPD may lead to clinical improvement in depression, stress and anxiety for some individuals. However, the majority of individuals with BPD in our sample did not show strong improvement, and this suggests the need for additional sessions of UP or an intervention that focuses on the symptoms of BPD specifically for some women.Key learning aims (1)To describe the applicability of the Unified Protocol in the treatment of individuals with borderline personality and co-occurring anxiety or depression.(2)To understand the value of utilizing a transdiagnostic approach as an alternative to diagnosis-specific approaches to treatment.(3)To identify the four core modules of the Unified Protocol and describe the general format for individual treatment.

Positive schemas in schema therapy with older adults: clinical implications and research suggestions

2020 ◽  
Vol 48 (4) ◽  
pp. 481-491
Author(s):  
Arjan C. Videler ◽  
Rita J.J. van Royen ◽  
Marjolein J.H. Legra ◽  
Machteld A. Ouwens
Keyword(s):  
Older Adults ◽  
Personality Disorder ◽  
Empirical Support ◽  
Later Life ◽  
Adaptive Behaviour ◽  
Schema Therapy ◽  
Complex Disorders ◽  
Early Maladaptive Schema ◽  
Therapy Model ◽  
Positive Schemas

AbstractBackground:Schema therapy is an effective treatment for borderline personality disorder and other complex disorders. Schema therapy is feasible in older adults, and the first empirical support for its effectiveness in later life was provided in older patients with a cluster C personality disorder. The central concept of the schema therapy model is the early maladaptive schema (EMS). Early adaptive schemas (EAS) give rise to adaptive behaviour, and they also emerge during childhood, when core emotional needs are adequately met by primary caregivers.Aims:To examine the concept of EAS and its application in schema therapy with older adults.Method:Literature review and case example: the role of EAS in schema therapy with older adults is discussed and suggestions for integrating EAS in schema therapy in later life are proposed.Results:Directing attention in therapy to EAS may help strengthen the healthy adult mode, and it might also help change a negative life review. Working with positive schemas may be an important avenue for re-awakening positive aspects of patients, reinforcing the therapeutic relationship, creating a positive working atmosphere, and also for facilitating the introduction of experiential schema therapy techniques.Conclusions:This review suggests that positive schemas may be important vehicles of therapeutic change when working with older people. There is a need for validating the Young Positive Schema Questionnaire (YPSQ) in older adults, and for examining whether integrating EAS in schema therapy with older adults indeed has a positive effect on therapy outcome.

scholarly journals Cognitive and motor perseveration are associated in older adults

2020 ◽  
Author(s):  
Carly Sombric ◽  
Gelsy Torres-Oviedo
Keyword(s):  
Older Adults ◽  
Cognitive Task ◽  
Motor Task ◽  
Cognitive Tasks ◽  
Matching Task ◽  
List Type ◽  
Younger Adults ◽  
Age Related ◽  
Neural Processes ◽  
Matching Rules

AbstractAging causes perseveration (difficulty to switch between actions) in motor and cognitive tasks, suggesting that the same neural processes could govern these abilities in older adults. To test this, we evaluated the relation between independently measured motor and cognitive perseveration in young (21.4±3.7 y/o) and older participants (76.5±2.9 y/o). Motor perseveration was measured with a locomotor task in which participants had to transition between distinct walking patterns. Cognitive perseveration was measured with a card matching task in which participants had to switch between distinct matching rules. We found that perseveration in the cognitive and motor domains were positively related in older, but not younger individuals, such that participants exhibiting greater perseveration in the motor task also perseverated more in the cognitive task. Additionally, exposure reduces motor perseveration: older adults who had practiced the motor task could transition between walking patterns as proficiently as naïve, young individuals. Our results suggest an overlap in neural processes governing cognitive and motor perseveration with aging and that exposure can counteract the age-related motor perseveration.HighlightsMovement carryover from the treadmill to overground indicates motor perseveration.Greater motor and cognitive perseveration are associated in older adults.Motor perseveration in older adults can be reduced with practice.New motor memories are similarly forgotten in older and younger adults.

Cognitive Load Affects Speech Motor Performance Differently in Older and Younger Adults

2019 ◽  
Vol 62 (5) ◽  
pp. 1258-1277 ◽  
Author(s):  
Megan K. MacPherson
Keyword(s):  
Older Adults ◽  
Cognitive Load ◽  
Motor Performance ◽  
Age Groups ◽  
Incongruent Condition ◽  
Sentence Production ◽  
Movement Duration ◽  
Production Task ◽  
Younger Adults ◽  
Speech Motor

PurposeThe aim of this study was to determine the impact of cognitive load imposed by a speech production task on the speech motor performance of healthy older and younger adults. Response inhibition, selective attention, and working memory were the primary cognitive processes of interest.MethodTwelve healthy older and 12 healthy younger adults produced multiple repetitions of 4 sentences containing an embedded Stroop task in 2 cognitive load conditions: congruent and incongruent. The incongruent condition, which required participants to suppress orthographic information to say the font colors in which color words were written, represented an increase in cognitive load relative to the congruent condition in which word text and font color matched. Kinematic measures of articulatory coordination variability and movement duration as well as a behavioral measure of sentence production accuracy were compared between groups and conditions and across 3 sentence segments (pre-, during-, and post-Stroop).ResultsIncreased cognitive load in the incongruent condition was associated with increased articulatory coordination variability and movement duration, compared to the congruent Stroop condition, for both age groups. Overall, the effect of increased cognitive load was greater for older adults than younger adults and was greatest in the portion of the sentence in which cognitive load was manipulated (during-Stroop), followed by the pre-Stroop segment. Sentence production accuracy was reduced for older adults in the incongruent condition.ConclusionsIncreased cognitive load involving response inhibition, selective attention, and working memory processes within a speech production task disrupted both the stability and timing with which speech was produced by both age groups. Older adults' speech motor performance may have been more affected due to age-related changes in cognitive and motoric functions that result in altered motor cognition.

Regulation of Experienced and Anticipated Regret for Daily Decisions in Younger and Older Adults in a Swedish One-Week Diary Study

GeroPsych ◽  
2013 ◽  
Vol 26 (4) ◽  
pp. 233-241 ◽  
Author(s):  
Pär Bjälkebring ◽  
Daniel Västfjäll ◽  
Boo Johansson
Keyword(s):  
Older Adults ◽  
Diary Study ◽  
Anticipated Regret ◽  
Younger Adults ◽  
Web Based ◽  
Decision Regret ◽  
Diary Method ◽  
Regulation Strategies

Regret and regret regulation were studied using a weeklong web-based diary method. 108 participants aged 19 to 89 years reported regret for a decision made and a decision to be made. They also reported the extent to which they used strategies to prevent or regulate decision regret. Older adults reported both less experienced and anticipated regret compared to younger adults. The lower level of experienced regret in older adults was mediated by reappraisal of the decision. The lower level of anticipated regret was mediated by delaying the decision, and expecting regret in older adults. It is suggested that the lower level of regret observed in older adults is partly explained by regret prevention and regulation strategies.

Video Games and Emotion Regulation

GeroPsych ◽  
2018 ◽  
Vol 31 (4) ◽  
pp. 205-213 ◽  
Author(s):  
Kathryn L. Ossenfort ◽  
Derek M. Isaacowitz
Keyword(s):  
Older Adults ◽  
Emotion Regulation ◽  
Video Games ◽  
Age Differences ◽  
Interactive Media ◽  
Age Groups ◽  
Younger Adults ◽  
Media Usage ◽  
The Everyday ◽  
Media Preferences

Abstract. Research on age differences in media usage has shown that older adults are more likely than younger adults to select positive emotional content. Research on emotional aging has examined whether older adults also seek out positivity in the everyday situations they choose, resulting so far in mixed results. We investigated the emotional choices of different age groups using video games as a more interactive type of affect-laden stimuli. Participants made multiple selections from a group of positive and negative games. Results showed that older adults selected the more positive games, but also reported feeling worse after playing them. Results supplement the literature on positivity in situation selection as well as on older adults’ interactive media preferences.

Slow Down You’re Moving Too Fast

2015 ◽  
Vol 27 (2) ◽  
pp. 53-63 ◽  
Author(s):  
Annie Lang ◽  
Nancy Schwartz ◽  
Sharon Mayell
Keyword(s):  
Older Adults ◽  
Cognitive Aging ◽  
Attention And Memory ◽  
Younger Adults ◽  
Media Messages ◽  
Two Factors ◽  
The Difference

The study reported here compared how younger and older adults processed the same set of media messages which were selected to vary on two factors, arousing content and valence. Results showed that older and younger adults had similar arousal responses but different patterns of attention and memory. Older adults paid more attention to all messages than did younger adults. However, this attention did not translate into greater memory. Older and younger adults had similar levels of memory for slow-paced messages, but younger adults outperformed older adults significantly as pacing increased, and the difference was larger for arousing compared with calm messages. The differences found are in line with predictions made based on the cognitive-aging literature.

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