scholarly journals Assessing mentalization in psychotherapy: first validation of the Mentalization Imbalances Scale

Author(s):  
Giulia Gagliardini ◽  
Salvatore Gullo ◽  
Edgardo Caverzasi ◽  
Annalisa Boldrini ◽  
Stefano Blasi ◽  
...  

The aim of this study was to provide data on the preliminary validation of a clinician-report multidimensional assessment measure of mentalization (Mentalization Imbalances Scale, MIS). A random national sample of psychotherapists (N=190) completed the MIS to identify mentalization imbalances, and the Personality Disorder Checklist to assess the personality disorders (PDs) of randomly selected patients currently in their care. Factor analysis confirmed the presence of six factors that represented different imbalances of mentalization: cognitive, affective, automatic, external, imbalance toward others, and imbalance toward self. We found several significant relationships between patients’ mentalization imbalances and personality pathology. Paranoid, schizoid, and schizotypal PDs were predicted by an imbalance toward self, an imbalance the patients shared with histrionic, avoidant, and obsessive compulsive PDs, whereas dependent, borderline, and histrionic PDs were related to an imbalance toward others. Cognitive imbalance was related to schizoid, narcissistic, and obsessive compulsive PDs, whereas affective imbalance predicted antisocial, borderline, narcissistic and histrionic PDs. Automatic imbalance was related to schizotypal, antisocial, and borderline PDs. MIS represents a reliable and valid measure that can help clinicians at understanding patients’ specific difficulties of mentalization.

Author(s):  
Michael G. Wheaton ◽  
Anthony Pinto

This chapter reviews the literature on personality pathology in obsessive-compulsive disorder (OCD). It begins by comparing and contrasting OCD with obsessive-compulsive personality disorder (OCPD). These two conditions have a longstanding yet frequently misunderstood relationship. Though they share some overlapping features, recent research has established OCD and OCPD as distinct conditions. Even so, OCD and OCPD frequently cooccur. The chapter reviews the literature on comorbidity and the impact of OCPD on the clinical course and treatment of OCD, including evidence that OCPD may complicate OCD treatment. It also describes other personality disorders observed in OCD. Finally, it describes recent advances in the conceptualization of personality disorders, including dimensional approaches, and concludes with directions for future research.


2020 ◽  
pp. 1-18
Author(s):  
Azad Hemmati ◽  
Brandon Weiss ◽  
Atefeh Mirani ◽  
Farzin Rezaei ◽  
Joshua D. Miller

Scholars of perfectionism have proposed significant modifications to DSM-5's alternative model of personality disorders (AMPD), such that (1) perfectionism be expanded beyond the inclusion of a singular trait—rigid perfectionism—and (2) perfectionistic traits be specified as trait descriptors of personality disorders (PDs) other than obsessive-compulsive PD. In this study, we evaluate these proposals by examining the degree to which (a) perfectionistic traits are already instantiated in Section II and Section III models of personality pathology; and (b) perfectionistic traits meaningfully augment the construct validity of AMPD PDs. We conducted these approaches in a large sample (N =3D 435) from an Iranian undergraduate population that is atypically found in the literature. Results showed that perfectionistic traits are already fairly well instantiated in Section III Criterion B. Perfectionistic traits minimally improved the construct validity of OCPD, but did not meaningfully do so for other PDs. Future investigation into the clinical utility of perfectionistic traits is needed.


2019 ◽  
Author(s):  
Randi Breivik ◽  
Theresa Wilberg ◽  
Julie Evensen ◽  
Jan Ivar Røssberg ◽  
Hanne Sofie Dahl ◽  
...  

Abstract Background The Feeling Word Checklist (FWC) is a self-report questionnaire designed to measure therapists’ countertransference (CT) feelings. The primary aim of the study was to evaluate the psychometric properties of a brief version of the Feeling Word Checklist comprising twelve feeling words (FWC-12). The second aim was to validate the factor structure by examining the associations between the FWC-12 factors, patients’ personality pathology and therapeutic alliance (TA). Methods Therapists at 13 different outpatient units within the Norwegian Network of Personality Disorders completed the FWC-12 every 6 months during the course of treating a patient with a personality disorder (PD), over a period of up to 2.5 years. A large sample of patients with personality pathology participated in the study. The data were analysed with exploratory (EFA) and confirmatory (CFA) factor analysis. Internal consistency was estimated using Cronbach’s alpha. The Structured Clinical Interview for DSM-IV – Axis II (SCID II) and Mini International Neuropsychiatric Interview (MINI) were used as diagnostic instruments, and patient-rated TA was assessed using the Working Alliance Inventory (WAI-SR). Results Factor analyses revealed three clinically meaningful factors: Inadequate, Idealised and Confident. These factors had acceptable psychometric properties. Most notably, a number of borderline PD criteria correlated positively with the factors Inadequate and Idealised, and negatively with the factor Confident. All the factors correlated significantly with at least one of the WAI-SR subscales. Conclusions The FWC-12 measures three clinically meaningful aspects of therapists’ CT feelings. This brief version of the FWC seems satisfactory for use in further research and in clinical contexts. Keywords: Countertransference, Feeling Word Checklist, factor analysis, personality disorder, psychometrics


2020 ◽  
Author(s):  
Randi Breivik ◽  
Theresa Wilberg ◽  
Julie Evensen ◽  
Jan Ivar Røssberg ◽  
Hanne Sofie Dahl ◽  
...  

Abstract Background The Feeling Word Checklist (FWC) is a self-report questionnaire designed to measure therapists’ countertransference (CT) feelings. The primary aim of the study was to evaluate the psychometric properties of a brief version of the Feeling Word Checklist (FWC-BV) comprising 12 feeling words. The second aim was to validate the factor structure by examining the associations between the FWC-BV factors, patients’ personality pathology and therapeutic alliance (TA). Methods Therapists at 13 different outpatient units within the Norwegian Network of Personality Disorders completed the FWC-BV every 6 months during the course of treating a patient with a personality disorder (PD), over a period of 2.5 years. A large sample of patients (N=2425) with personality pathology participated in the study. The data were analysed with exploratory (EFA) and confirmatory (CFA) factor analysis. Internal consistency was estimated using Mc Donald’s coefficient Omega (ωt). The Structured Clinical Interview for DSM-IV – Axis II (SCID II) and Mini International Neuropsychiatric Interview (MINI) were used as diagnostic instruments, and patient-rated TA was assessed using the Working Alliance Inventory (WAI-SR). Results Factor analyses revealed three clinically meaningful factors: Inadequate, Idealised and Confident. These factors had acceptable psychometric properties. Most notably, a number of borderline PD criteria correlated positively with the factors Inadequate and Idealised, and negatively with the factor Confident. All the factors correlated significantly with at least one of the WAI-SR subscales Conclusions The FWC-BV measures three clinically meaningful aspects of therapists’ CT feelings. This brief version of the FWC seems satisfactory for use in further research and in clinical contexts. Keywords: Countertransference, Feeling Word Checklist, factor analysis, personality disorder, psychometrics


1999 ◽  
Vol 4 (6) ◽  
pp. 5-6

Abstract Personality disorders are enduring patterns of inner experience and behavior that deviate markedly from those expected by the individual's culture; these inflexible and pervasive patterns reflect issues with cognition, affectivity, interpersonal functioning and impulse control, and lead to clinically significant distress or impairment in social, occupational, or other important areas of functioning. The AMA Guides to the Evaluation of Permanent Impairment, Fourth Edition, defines two specific personality disorders, in addition to an eleventh condition, Personality Disorder Not Otherwise Specified. Cluster A personality disorders include paranoid, schizoid, and schizotypal personalities; of these, Paranoid Personality Disorder probably is most common in the legal arena. Cluster B personality disorders include antisocial, borderline, histrionic, and narcissistic personality. Such people may suffer from frantic efforts to avoid perceived abandonment, patterns of unstable and intense interpersonal relationships, an identity disturbance, and impulsivity. Legal issues that involve individuals with cluster B personality disorders often involve determination of causation of the person's problems, assessment of claims of harassment, and assessment of the person's fitness for employment. Cluster C personality disorders include avoidant, dependent, and obsessive-compulsive personality. Two case histories illustrate some of the complexities of assessing impairment in workers with personality disorders, including drug abuse, hospitalizations, and inpatient and outpatient psychotherapy.


2004 ◽  
Vol 32 (6) ◽  
pp. 595-606
Author(s):  
David C. Watson ◽  
Andrew J. Howell

Dysfunction in personality disorder symptoms was assessed using multivariate techniques to analyse lay judges' (N = 216) ratings of occupational impairment, social impairment, and personal distress. Factor analysis revealed that ratings of occupational impairment and social impairment loaded onto distinct factors. Personal distress ratings loaded onto two separate factors: high distress and low distress. Multidimensional scaling revealed two dimensions for overall dysfunction among personality disorders: severity of dysfunction and internalization-externalization. The dimensions were independence-dependence and severity of dysfunction for occupational impairment, interpersonal involvement and dominance-submission for social impairment, and internalization-externalization and severity for personal distress.


Author(s):  
Susan C. South ◽  
Ted Reichborn-Kjennerud ◽  
Nicholas R. Eaton ◽  
Robert F. Krueger

The purpose of this chapter is to provide an overview of the behavior and molecular genetics of personality disorder. We begin with a thorough review of findings from the field of behavior genetics of personality pathology, including univariate twin studies, multivariate twin studies, and new models of gene–environment interplay. We then discuss the molecular genetics of personality pathology, including a consideration of candidate gene analysis, linkage analysis, and genome-wide association studies. We focus in particular on research concerning antisocial personality disorder (including antisociality and aggression), borderline personality disorder, schizotypal personality disorder, Cluster B and C personality disorders, and normal personality traits. We then provide a discussion of challenges and future directions with respect to behavior and molecular genetic research. We conclude the chapter with a discussion of the implications of this research for the forthcoming fifth edition of the American Psychiatric Association’s diagnostic manual.


2002 ◽  
Vol 32 (2) ◽  
pp. 219-226 ◽  
Author(s):  
S. FAZEL ◽  
T. HOPE ◽  
I. O’DONNELL ◽  
R. JACOBY

Background. Psychiatric disorders are purported to play a role in the aetiology of violent crime, but evidence for their role in sexual offending is less clear. The authors investigated the prevalence of psychiatric morbidity and personality disorders in elderly incarcerated sex offenders compared with elderly non-sex offenders.Method. One hundred and one sex offenders and 102 non-sex offenders aged over 59 years were interviewed using standardized semi-structured interviews for psychiatric illness (the Geriatric Mental State) and the personality disorder (Structured Clinical Interview for DSM-IV personality disorders). Data on demographic, offence and victim characteristics were collected.Results. Six per cent of the elderly sex offenders had a psychotic illness, 7% a DSM-IV major depressive episode and 33% a personality disorder; and 1% had dementia. These prevalence figures were not different from the elderly non-sex offenders interviewed in this study. Differences emerged at the level of personality traits with sex offenders having more schizoid, obsessive–compulsive, and avoidant traits, and fewer antisocial traits compared with non-sex offenders.Conclusions. Elderly sex offenders and non-sex-offenders have similar prevalence rates of mental illness. However, elderly sex offenders have increased schizoid, obsessive–compulsive, and avoidant personality traits, supporting the view that sex offending in the elderly is associated more with personality factors than mental illness or organic brain disease.


Author(s):  
Peter Fonagy ◽  
Patrick Luyten

This chapter provides an overview of psychodynamic approaches to personality pathology and their core assumptions, and it reviews empirical research supporting these approaches. It also includes a review of contemporary psychodynamic approaches to classification, diagnosis, and treatment of personality disorders. Finally, a summary of findings concerning the effectiveness of psychodynamic treatments for personality disorder is provided.


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