The words of the body: psychophysiological patterns in dissociative narratives

Trauma has severe consequences on both psychological and somatic levels, even affecting the genetic expression and the cell\u2019s DNA repair ability. A key mechanism in the understanding of clinical disorders deriving from trauma is identified in dissociation, as a primitive defense against the fragmentation of the self originated by overwhelming experiences. The dysregulation of the interpersonal patterns due to the traumatic experience and its detrimental effects on the body are supported by influent neuroscientific models such as Damasio\u2019s somatic markers and Porges\u2019 polyvagal theory. On the basis of these premises, and supported by our previous empirical observations on 40 simulated clinical sessions, we will discuss the longitudinal process of a brief psychodynamic psychotherapy (16 sessions, weekly frequency) with a patient who suffered a relational trauma. The research design consists of the collection of self-report and projective tests, pre-post therapy and after each clinical session, in order to assess personality, empathy, clinical alliance and clinical progress, along with the verbatim analysis of the transcripts trough the Psychotherapy Process Q-Set and the Collaborative Interactions Scale. Furthermore, we collected simultaneous psychophysiological measures of the therapeutic dyad: skin conductance and hearth rate. Lastly, we employed a computerized analysis of non-verbal behaviors to assess synchrony in posture and gestures. These automated measures are able to highlight moments of affective concordance and discordance, allowing for a deep understanding of the mutual regulations between the patient and the therapist. Preliminary results showed that psychophysiological changes in dyadic synchrony, observed in body movements, skin conductance and hearth rate, occurred within sessions during the discussion of traumatic experiences, with levels of attunement that changed in both therapist and the patient depending on the quality of the emotional representation of the experience. These results go in the direction of understanding the relational process in trauma therapy, using an integrative language in which both clinical and neurophysiological knowledge may take advantage of each other

Models of collaboration between psychologist and family doctor: a systematic review of primary care psychology

open2noThe prevalence of psychological suffering is greater than the actual request for clinical consultation in Europe (Alonso et al., 2004). In Italy, no more than 5.5% of the population requested psychological assistance during lifetime (Miglioretti et al., 2008). There are different obstacles that prevent the access to mental health services, such as economic restrictions (Mulder et al., 2011), cultural prejudice (Kim et al., 2010), and lack of knowledge about the service providers that can answer to the patient’s psychological needs (Molinari et al., 2012). Therefore, the psychologist is often consulted as a last resort, only after everything else has failed, when problems have become severe, and thus requiring longer, more intensive, and expensive treatments. The introduction of the Primary Care Psychologist, a professional who works together with the family doctor, allows to overcome the above-mentioned problems and intercept unexpressed needs for psychological assistance. This professional role is operating in many countries since several years. In this study, current literature concerning different models of collaboration between physician and psychologist, in Europe and in Italy, was reviewed. A systematic search of Web of Science (ISI), Pubmed, Scopus, and PsychINFO was conducted using the initial search terms Primary Care Psychologist, Family Doctor, Primary Care, Collaborative Practice, and several relevant papers were identified. The review has shown the improved quality of care when mental health care is integrated into primary. Analyzing how different programs are implemented, results indicated that the more efficacious models of Primary Care Psychology are those tailored on the environment’s needs.The results of our systematic review stress the importance of the Primary Care Psychologist implementation also in Italy, to intercept unexpressed psychological needs and enhance clients’ quality of life.openFrancesca, Bianco; Enrico, BenelliBianco, Francesca; Benelli, Enric

Detecting Mental Distresses Using Social Behavior Analysis in the Context of COVID-19: A Survey

Online social media provides a channel for monitoring people\u27s social behaviors from which to infer and detect their mental distresses. During the COVID-19 pandemic, online social networks were increasingly used to express opinions, views, and moods due to the restrictions on physical activities and in-person meetings, leading to a significant amount of diverse user-generated social media content. This offers a unique opportunity to examine how COVID-19 changed global behaviors regarding its ramifications on mental well-being. In this article, we surveyed the literature on social media analysis for the detection of mental distress, with a special emphasis on the studies published since the COVID-19 outbreak. We analyze relevant research and its characteristics and propose new approaches to organizing the large amount of studies arising from this emerging research area, thus drawing new views, insights, and knowledge for interested communities. Specifically, we first classify the studies in terms of feature extraction types, language usage patterns, aesthetic preferences, and online behaviors. We then explored various methods (including machine learning and deep learning techniques) for detecting mental health problems. Building upon the in-depth review, we present our findings and discuss future research directions and niche areas in detecting mental health problems using social media data. We also elaborate on the challenges of this fast-growing research area, such as technical issues in deploying such systems at scale as well as privacy and ethical concerns

Internet Addiction and the Relationship to Self and Interpersonal Functioning Within the Alternative Model for Personality Disorders (AMPD): Implications for Psychosocial Development

Internet addictive use inclusive of inextricably interconnected mobile devices, applications, and social media predicts diminished Self and Interpersonal functioning. Internet addiction research is burdened by conflicting theoretical views, lack of standardized definitions and criteria, and the use of assessment measures adapted from those used for substance use disorders. Alternative and dimensional diagnostic models for internet addiction through a psychosocial developmental lens might further understanding of Internet addiction and reduce challenges which impact the ability to advance research and achieve clinically useful, culturally informed, and evidence-based practices for the assessment and treatment of Internet addiction

Dissociation and interpersonal autonomic physiology in psychotherapy research: an integrative view encompassing psychodynamic and neuroscience theoretical frameworks

Interpersonal autonomic physiology is an interdisciplinary research field, assessing the relational interdependence of two (or more) interacting individual both at the behavioral and psychophysiological levels. Despite its quite long tradition, only eight studies since 1955 have focused on the interaction of psychotherapy dyads, and none of them have focused on the shared processual level, assessing dynamic phenomena such as dissociation. We longitudinally observed two brief psychodynamic psychotherapies, entirely audio and video-recorded (16 sessions, weekly frequency, 45 min.). Autonomic nervous system measures were continuously collected during each session. Personality, empathy, dissociative features and clinical progress measures were collected prior and post therapy, and after each clinical session. Two-independent judges, trained psychotherapist, codified the interactions\u2019 micro-processes. Time-series based analyses were performed to assess interpersonal synchronization and de-synchronization in patient\u2019s and therapist\u2019s physiological activity. Psychophysiological synchrony revealed a clear association with empathic attunement, while desynchronization phases (range of length 30-150 sec.) showed a linkage with dissociative processes, usually associated to the patient\u2019s narrative core relational trauma. Our findings are discussed under the perspective of psychodynamic models of Stern (\u201cpresent moment\u201d), Sander, Beebe and Lachmann (dyad system model of interaction), Lanius (Trauma model), and the neuroscientific frameworks proposed by Thayer (neurovisceral integration model), and Porges (polyvagal theory). The collected data allows to attempt an integration of these theoretical approaches under the light of Complex Dynamic Systems. The rich theoretical work and the encouraging clinical results might represents a new fascinating frontier of research in psychotherapy

La revisión sistemática de la relación indirecta entre la pertenencia social frustrada y la sensación de ser una carga en el suicidio

Joiner's Interpersonal-Psychological Theory of Suicide (IPTS) considers the interpersonal variables of low social belonging and the perception of being a burden on others as drivers of suicidal ideation. This study has sought to review the empirical evidence on this prediction. In all, 40 studies were found. The findings report a major mediator and moderator role of perceived burdensomeness (PB) and thwarted belongingness (TB) in the relationship between the propensity toward suicide and psychological, social, and environmental factors. As the theory predicts, expecting to find that the interaction of both of these variables would be more closely linked to suicidal ideation, this does not appear to have been fully supported, generally finding a greater significance when they were integrated into separate models. It seems that attributing other forms of relationship with suicide for the variables identified by Joiner would provide IPTS with greater empirical support.La teoría interpersonal psicológica del suicidio de Joiner considera las variables interpersonales de baja pertenencia social y la percepción de ser una carga para los demás como impulsores de la ideación suicida. Este estudio revisa la evidencia empírica sobre esta predicción. En total, se han encontrado 40 estudios. Los hallazgos descubren un importante papel mediador y moderador de la carga percibida y la pertenencia frustrada en la relación entre la propensión al suicidio y los factores psicológicos, sociales y ambientales. Como predice la teoría, esperando encontrar que la interacción de ambas variables estaría más estrechamente ligada a la ideación suicida, esto no parece haber sido totalmente respaldado, encontrando generalmente una mayor significación cuando estas se integraron en modelos separados. Parece que atribuir otras formas de relación con el suicidio para las variables identificadas por Joiner proporcionaría a la teoría interpersonal psicológica del suicidio un mayor apoyo empíric

EXPLORING THE CLINICAL UTILITY OF MOBILE APPLICATIONS FOR PROMOTING AFFECT REGULATION AMONG CLIENTS WITH BEHAVIORAL HEALTH PROBLEMS

Nearly 25 percent of adults in the United States are diagnosed with a behavioral health condition, most commonly depression, anxiety disorders and substance use disorders. Each of these diagnoses is associated with significant disruptions in affect regulation which encompasses the capacity to up and down regulate emotions. Best practice treatment for these conditions includes psychotropic medications combined with individual or group-based psychotherapeutic modalities which regardless of the therapist’s theoretical orientation attempt to promote affect regulation through skill transfer and strategies for observing one’s ability to regulate emotions. Similarly, attention to regulatory capacity is central to many emerging self-help technologies involving smart phone applications. These technologies encourage users to observe, track, and offer strategies for regulating feelings through sleep, exercise, nutrition, alcohol use and many others. However, while anecdotally reported, few studies have examined the ways in which smart phone applications are incorporated into psychotherapy. In response, the current exploratory study used focus groups comprised of masters prepared behavioral health clinicians (N=25) to examine the appropriateness, accessibility, practicality and acceptableness of smart phone technologies as an adjuvant tool in the clinical setting. More specifically this study explored the use of technology to promote self-observation, skill transfer and subsequently affect regulation. Results suggested clinicians frequently use smart phone technologies in their practice and find these applications to be appropriate for tracking a range of symptoms (e.g. mood, substance use, sleep disruptions) and for promoting coping skills (e.g. meditation applications). Clinicians also reported these applications were fairly accessible and practical for use. Results indicated clinicians are judicious in their use of smart phone applications based on the client’s developmental needs and their particular symptom presentation. While these technologies were deemed effective, accessible and practical, focus group participants were wary of the impact of technology on society and the developing mind, citing that overuse of technology could promote an exacerbation of social isolation and loneliness. Further, practitioners reported that use of technology in psychotherapy could disrupt the interpersonal relationship in treatment. Respondents also reported they were unclear how to vet applications and desired additional training on their use in treatment. In conclusion, while smart phone applications were used and helpful for promoting affect regulation, future research needs to further examine best practice strategies for integrating smart phone applications into psychotherapeutic treatment, as well as refine technologies to fit more closely with the goals of psychotherapy. Keywords: Technology, Mobile Applications, Affect Regulation, Clinical Utilit

A Phenomenological Study of the Relationship Experiences of Partners of Individuals Who Suffer with Premenstrual Dysphoric Disorder (PMDD)

Premenstrual Dysphoric Disorder (PMDD) is a debilitating disorder that adversely affects the lives of individuals and their intimate relationships. The purpose of this transcendental phenomenological study was to describe the lived experience of the partners of individuals who suffer from Premenstrual Dysphoric Disorder. The theories guiding this study were the interpersonal theory of suicide and the adult attachment theory. This study examined the overall relationship experience of partners of individuals suffering from PMDD and their cyclic attachment styles during the luteal and follicular phases of the menstrual cycle. A selection of three PMDD partners and three PMDD sufferers, who have been in an intimate relationship for six months or longer, were interviewed to measure the fluctuation in the overall relationship experience and cyclic attachment styles. Overall, the attachment styles of the PMDD partners may be affected because of the cyclic anguish of the PMDD sufferers during the luteal and follicular phases of menstruation. The fluctuating attachment styles of the PMDD sufferer can impact the PMDD partner’s overall relationship experience

Examining How Adverse Childhood Experiences and the Underlying Processes of Trait and State Impulsivity Influence Suicidal Behavior

ABSTRACT Due to the effects of ACEs and impulsive behavior on mental and physical health, it is important to better understand the relationship between these two as well as how they both may influence choices, such as suicide. Numerous studies have identified impulsive behavior as a risk factor for suicide, however, recent research has identified several underlying independent processes that make up impulsivity. This study uses a broad assessment of trait and state impulsivity to gather a more discrete understanding of the underlying processes that contribute to impulsive behavior. The short version UPPS-P scale was used to measure negative urgency, lack of premeditation, lack of perseverance, sensation seeking, and positive urgency, and behavioral lab tasks were used to measure prepotent response inhibition, delay discounting, and distortions in elapsed time. Simple bivariate regressions revealed ACEs are a significant predictor of prepotent response inhibition, total S-UPPS-P scores, as well as the subscales of negative urgency, positive urgency, and sensation seeking. A hierarchical regression found total ACE scores, negative urgency, and distortions in elapsed time to be significant predictors of total suicidal behavior scores. Lastly, an ordinal logistic regression suggests a greater likelihood of going from suicidal ideation to planning, and from planning to attempting when ACEs, negative urgency, and lack of premeditation scores are greater. By identifying these specific dimensions of impulsivity as risk factors for suicidal behaviors, we can recognize individuals at greater risk of attempting, as well as target and mitigate the effects of these behaviors through interventions. Keywords: Trait Impulsivity, State Impulsivity, ACEs, Suicidal Behavior