scholarly journals A supportive approach in psychodynamic-oriented psychotherapy. An empirically supported single case study.

2011 ◽  
Vol 14 (1) ◽  
Author(s):  
Daniela Di Riso ◽  
Antonello Colli ◽  
Daphne Chessa ◽  
Cristina Marogna ◽  
Valeria Condino ◽  
...  
Keyword(s):  
Rating Scales ◽  
Rating Scale ◽  
Defense Mechanism ◽  
Single Case ◽  
Hierarchical Regression ◽  
Analysis Model ◽  
Obsessive Compulsive ◽  
Empirically Supported ◽  
Collaborative Interactions ◽  
Log Linear

This paper evaluates process and outcome in a 2 years supportive psychotherapy psychodynamic-oriented of a young adult self-referred for concerns about University choice. The diagnosis was Panic Attack Disorder (DSM-IV) with features of obsessive-compulsive and narcissistic personality disorder (PDM). Twenty-eight verbatim transcripts of the sessions were coded with the Psychodynamic Intervention Rating Scales, the Collaborative Interactions Scale and Defense Mechanism Rating Scale. A log linear analysis model showed the trends of process variables during the treatment. A hierarchical regression analysis evaluated the importance of tailoring the clinician interventions in respect to the average level of defenses. Outcome results showed how patient's diagnosis changed and symptoms decreased.

scholarly journals Beyond the mask of deference: exploring the relationship between ruptures and transference in a single-case study

2016 ◽  
Vol 19 (2) ◽  
Author(s):  
Francesca Locati ◽  
Pietro De Carli ◽  
Emanuele Tarasconi ◽  
Margherita Lang ◽  
Laura Parolin
Keyword(s):  
Sequential Analysis ◽  
Rating Scales ◽  
Rating Scale ◽  
Defense Mechanism ◽  
Single Case ◽  
Assessment Procedure ◽  
Single Case Study ◽  
Alliance Ruptures ◽  
The Relationship

The relationship between transference and therapeutic alliance has been long discussed. It is only recently, however, that empirical evidence has provided support for a tight correspondence between several transference dimensions and rupture and resolution processes. In the present single-case study, we used alliance ruptures as a key dimension to understand patient’s transference dynamics. This was achieved in a particular form of patient’s behavior, i.e., patient’s deference and acquiescent behavior, which describes a significant submission to assertions, skills, judgments and point of views of another person. Therapeutic process was measured by means of the Rupture Resolution Rating Scale, the Core Conflictual Relationship Theme and the Defense Mechanism Rating Scales, whereas therapeutic outcome was measured by means of the Shedler-Westen Assessment Procedure-200. Results of sequential analysis yielded a significant correspondence between rupture markers, characterized by avoidance and shifting of session’s topic, and patient’s narrations. Furthermore, a systematic correspondence between alliance ruptures and patient’s avoidant functioning, which emerged both in transference relationship and in the quality of the defense structure, was found. Together, these findings indicate that patient’s deference inhibits the expression of relational themes, with ruptures in alliance that seem to be supported by a strong defensive structure. In particular, patient’s avoidance played a double role in the treatment. On the one hand, avoidance was the main characteristic of her transference structure, based on extreme intellectualization and emotional closure. On the other hand, it contributed to create an impasse in the treatment, based on a withdrawal ruptures model and on obsessive level defences.

scholarly journals Radiofrequency Lesioning for Movement and Psychiatric Disorders-Experience of 107 Cases

2021 ◽  
Vol 15 ◽  
Author(s):  
Paresh K. Doshi
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Rating Scales ◽  
Focused Ultrasound ◽  
Rating Scale ◽  
Paper Analysis ◽  
Complication Rates ◽  
Obsessive Compulsive ◽  
Select Group ◽  
Obsessive Compulsive Disorders

BackgroundRadiofrequency lesioning (RFL) though used since the 1950s, had been replaced by DBS in the 1990s. The availability of magnetic resonance-guided focused ultrasound for lesioning has renewed the interest in RFL.ObjectiveThis paper analysis RFL in contemporary Functional Neurosurgery for various indications and its outcome. Complication rates of RFL are compared with the same author’s experience of DBS.MethodsOne hundred and seven patients underwent RFL between 1998 and 2019. Indications included Parkinson’s Disease (PD), tremors, dystonia, and obsessive-compulsive disorders (OCD). The surgeries performed include thalamotomy (29), pallidotomy (49), subthalamotomy (23), and anterior capsulotomy/nucleus accumbens lesioning (6). Appropriate rating scales were used for preoperative and postoperative evaluations.ResultsThere was a 25% recurrence rate of tremors for PD after thalamotomy. Writer’s cramp rating scale improved from a mean of 10.54–1.6 in task specific dystonia (TSD) patients, after thalamotomy. In PD patients, after pallidotomy, contralateral motor Unified Parkinson’s Disease Rating Scale (UPDRS) and dyskinesia scores, improved by 41 and 57%, respectively, at 1-year. Burke-Fahn-Marsden Dystonia Rating Scale in hemidystonia patients improved from 18.04 to 6.91, at 1-year. There was 32 and 31% improvement in total and motor UPDRS, respectively, in the subthalamotomy patients, at 2-year. All patients of OCD were in remission. There were three deaths in the pallidotomy group. Postoperative, dysarthria, confusion, hemiparesis, dyskinesia, and paraesthesia occurred in 12 patients, of which, 7 were transient.ConclusionRFL is a useful option in a select group of patients with tremors and dystonia. It is our preferred treatment option for TSD and OCD.

Acceptance and Commitment Therapy-Specific Processes in the Psychotherapeutic Treatment of Obsessive Compulsive Disorder: A Single Case Study

2017 ◽  
Vol 16 (4) ◽  
pp. 313-327
Author(s):  
Claire Heather Boynton Wheeler
Keyword(s):  
Acceptance And Commitment Therapy ◽  
Rating Scale ◽  
Single Case ◽  
Well Being ◽  
Single Case Study ◽  
Obsessive Compulsive ◽  
Clinical Change ◽  
Compulsive Disorder ◽  
Acceptance And Commitment

This single case study describes acceptance and commitment therapy (ACT) with exposure and response prevention (ERP) used with a client presenting with symptoms of obsessive compulsive disorder (OCD). Standardized and idiographic outcome measures, including OCD-specific measures (Brief Yale-Brown Obsessive Compulsive Scale; Obsessional Compulsive Inventory), general measures of well-being and risk (CORE Outcome Measure; Outcome Rating Scale), an idiographic measure (Easy Personal Questionnaire), and a Sessional Rating Scale, were used across baseline and treatment phases. Statistical measures of reliable and clinical change were calculated, and client perspective on change was sought through interview. Cause–effect analysis was used to evaluate the extent to which therapeutic change was due to ACT-specific processes. Results showed reliable positive change with a probability of p < .05 across measures, and clinical change in three of five of the measures in which it could be calculated. The client reported improvements in well-being and the extent to which she lives her life according to her values. ACT-specific processes as well as generic therapy processes influenced change. The client’s own strengths and personal contributions to therapy played a major role in her achievement of therapeutic goals. The use of ACT with ERP in treating OCD and collaborative use of outcome measures with careful evaluation are recommended to clinicians.

scholarly journals Deep Brain Stimulation for Obsessive-Compulsive Disorder: Real World Experience Post-FDA-Humanitarian Use Device Approval

2021 ◽  
Vol 12 ◽  
Author(s):  
Lora Kahn ◽  
Brianne Sutton ◽  
Helena R. Winston ◽  
Aviva Abosch ◽  
John A. Thompson ◽  
...  
Keyword(s):  
Deep Brain Stimulation ◽  
Obsessive Compulsive Disorder ◽  
Brain Stimulation ◽  
Rating Scales ◽  
Rating Scale ◽  
Case Series ◽  
Autism Spectrum ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Deep Brain

Background: While case series have established the efficacy of deep brain stimulation (DBS) in treating obsessive-compulsive disorder (OCD), it has been our experience that few OCD patients present without comorbidities that affect outcomes associated with DBS treatment. Here we present our experience with DBS therapy for OCD in patients who all have comorbid disease, together with the results of our programming strategies.Methods: For this case series, we assessed five patients who underwent ventral capsule/ventral striatum (VC/VS) DBS for OCD between 2015 and 2019 at the University of Colorado Hospital. Every patient in this cohort exhibited comorbidities, including substance use disorders, eating disorder, tic disorder, and autism spectrum disorder. We conducted an IRB-approved, retrospective study of programming modifications and treatment response over the course of DBS therapy.Results: In addition to patients' subjective reports of improvement, we observed significant improvement in the Yale-Brown Obsessive-Compulsive Scale (44%), the Montgomery-Asberg Depression Rating Scale (53%), the Quality of Life Enjoyment and Satisfaction Questionnaire (27%), and the Hamilton Anxiety Rating scales (34.9%) following DBS. With respect to co-morbid disease, there was a significant improvement in a patient with tic disorder's Total Tic Severity Score (TTSS) (p = 0.005).Conclusions: DBS remains an efficacious tool for the treatment of OCD, even in patients with significant comorbidities in whom DBS has not previously been investigated. Efficacious treatment results not only from the accurate placement of the electrodes by the surgeon but also from programming by the psychiatrist.

Alexithymia and Suicide Risk among Patients with Obsessive-compulsive Disorder

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
D. De Berardis ◽  
N. Serroni ◽  
A.M. Pizzorno ◽  
F.S. Moschetta ◽  
G. Sepede ◽  
...  
Keyword(s):  
Suicidal Ideation ◽  
Obsessive Compulsive Disorder ◽  
Suicide Risk ◽  
Rating Scales ◽  
Suicide Ideation ◽  
Rating Scale ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Chronic Course ◽  
Tas 20

Objective:The aim of our study was to evaluate relationships between alexithymia and suicidal ideation a sample of adult outpatients with obsessive-compulsive disorder (OCD).Methods:A sample of 86 adult outpatients with OCD (44 females and 42 males), was evaluated with a series of rating scales such as the Yale-Brown Obsessive Compulsive Scale (Y-BOCS), the Toronto Alexithymia Scale (TAS-20), the Scale for Suicide Ideation (SSI) and Montgomery-Åsberg Depression Rating Scale (MADRS). the score of item #11 on the Y-BOCS was considered as a measure of insight.Results:Alexithymics showed a more early onset, a longer duration of illness and were more suitable to have a chronic course than nonalexithymics; they also reported higher MADRS and SSI scores. Alexithymics without insight (n=21) reported higher SSI scores than alexithymics with insight, nonalexythimics without insight and nonalexithymics with insight. A linear regression showed that chronic OCD course together with DIF dimension of TAS-20 and higher MADRS scores were significantly associated with higher suicide risk.Conclusions:Alexithymia and depressive symptoms were highly correlated in OCD patients and were significantly associated with higher suicide risk. DIF dimension of TAS-20 seems to be significantly associated with presence of suicidal ideation as well as chronic course of disorder. However, further longitudinal studies on larger samples are needed to definitely clarify this topic.

scholarly journals Defense Mechanisms and Treatment Response in Depressed Inpatients

2021 ◽  
Vol 12 ◽  
Author(s):  
Yves de Roten ◽  
Slimane Djillali ◽  
Fabienne Crettaz von Roten ◽  
Jean-Nicolas Despland ◽  
Gilles Ambresin
Keyword(s):  
Treatment Response ◽  
Psychodynamic Psychotherapy ◽  
Defense Mechanisms ◽  
Rating Scales ◽  
Rating Scale ◽  
Defense Mechanism ◽  
Symptomatic Improvement ◽  
Inpatient Setting ◽  
Therapy Program ◽  
Defensive Functioning

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.

scholarly journals Accordo assoluto tra valutazioni espresse su scala ordinale

2021 ◽  
Author(s):  
Giuseppe Bove ◽  
Daniela Marella
Keyword(s):  
Rating Scales ◽  
Rating Scale ◽  
Single Case ◽  
Interrater Agreement ◽  
Ordinal Scale ◽  
Global Measure ◽  
Case Subject ◽  
Education Psychology ◽  
Measuring Agreement ◽  
Specific Comparison

Many methods for measuring agreement among raters have been proposed and applied in many domains in the areas of education, psychology, sociology, and medical research. A brief overview of the most used measures of interrater absolute agreements for ordinal rating scales is provided, and a new index is proposed that has several advantages. In particular, the new index allows to evaluate the agreement between raters for each single case (subject or object), and to obtain also a global measure of the interrater agreement for the whole group of cases evaluated. The possibility of having evaluations of the agreement on the single case is particularly useful, for example, in situations where the rating scale is being tested, and it is necessary to identify any changes to it, or to request the raters for a specific comparison on the single case in which the disagreement occurred. The index is not affected by the possible concentration of ratings on a very small number of levels of the ordinal scale.

AAC Collaboration Using the Self-Anchored Rating Scales (SARS): An Aphasia Case Study

2012 ◽  
Vol 21 (4) ◽  
pp. 136-143
Author(s):  
Lynn E. Fox
Keyword(s):  
Augmentative And Alternative Communication ◽  
Rating Scales ◽  
Rating Scale ◽  
Therapeutic Process ◽  
Family Counseling ◽  
The Self ◽  
Alternative Communication ◽  
Her Family ◽  
Solution Focused

Abstract The self-anchored rating scale (SARS) is a technique that augments collaboration between Augmentative and Alternative Communication (AAC) interventionists, their clients, and their clients' support networks. SARS is a technique used in Solution-Focused Brief Therapy, a branch of systemic family counseling. It has been applied to treating speech and language disorders across the life span, and recent case studies show it has promise for promoting adoption and long-term use of high and low tech AAC. I will describe 2 key principles of solution-focused therapy and present 7 steps in the SARS process that illustrate how clinicians can use the SARS to involve a person with aphasia and his or her family in all aspects of the therapeutic process. I will use a case study to illustrate the SARS process and present outcomes for one individual living with aphasia.

Childbirth and Posttraumatic Stress Responses

2006 ◽  
Vol 22 (4) ◽  
pp. 259-267 ◽  
Author(s):  
Eelco Olde ◽  
Rolf J. Kleber ◽  
Onno van der Hart ◽  
Victor J.M. Pop
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Posttraumatic Stress ◽  
Stress Responses ◽  
Rating Scales ◽  
Rating Scale ◽  
Stress Disorder ◽  
Traumatic Experience ◽  
Event Scale ◽  
Self Rating ◽  
The Impact

Childbirth has been identified as a possible traumatic experience, leading to traumatic stress responses and even to the development of posttraumatic stress disorder (PTSD). The current study investigated the psychometric properties of the Dutch version of the Impact of Event Scale-Revised (IES-R) in a group of women who recently gave birth (N = 435). In addition, a comparison was made between the original IES and the IES-R. The scale showed high internal consistency (α = 0.88). Using confirmatory factor analysis no support was found for a three-factor structure of an intrusion, an avoidance, and a hyperarousal factor. Goodness of fit was only reasonable, even after fitting one intrusion item on the hyperarousal scale. The IES-R correlated significantly with scores on depression and anxiety self-rating scales, as well as with scores on a self-rating scale of posttraumatic stress disorder. Although the IES-R can be used for studying posttraumatic stress reactions in women who recently gave birth, the original IES proved to be a better instrument compared to the IES-R. It is concluded that adding the hyperarousal scale to the IES-R did not make the scale stronger.

D-test: A New Test for Analyzing Scale Invariance Using Symbolic Dynamics and Symbolic Entropy

Methodology ◽  
2011 ◽  
Vol 7 (3) ◽  
pp. 88-95 ◽  
Author(s):  
Jose A. Martínez ◽  
Manuel Ruiz Marín
Keyword(s):  
Symbolic Dynamics ◽  
Scale Invariance ◽  
Rating Scales ◽  
Rating Scale ◽  
Marketing Research ◽  
Response Patterns ◽  
Measurement Scales ◽  
Improve Measurement ◽  
Entropy Measures ◽  
The Difference

The aim of this study is to improve measurement in marketing research by constructing a new, simple, nonparametric, consistent, and powerful test to study scale invariance. The test is called D-test. D-test is constructed using symbolic dynamics and symbolic entropy as a measure of the difference between the response patterns which comes from two measurement scales. We also give a standard asymptotic distribution of our statistic. Given that the test is based on entropy measures, it avoids smoothed nonparametric estimation. We applied D-test to a real marketing research to study if scale invariance holds when measuring service quality in a sports service. We considered a free-scale as a reference scale and then we compared it with three widely used rating scales: Likert-type scale from 1 to 5 and from 1 to 7, and semantic-differential scale from −3 to +3. Scale invariance holds for the two latter scales. This test overcomes the shortcomings of other procedures for analyzing scale invariance; and it provides researchers a tool to decide the appropriate rating scale to study specific marketing problems, and how the results of prior studies can be questioned.

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