Personality disorders and psychosocial problems in a group of participants to therapeutic processes for people with severe social disabilities

<p>Abstract</p> <p>Background</p> <p>Homeless people have high dropout rates when they participate in therapeutic processes. The causes of this failure are not always known. This study investigates whether dropping-out is mediated by personality disorders or whether psychosocial problems are more important.</p> <p>Method</p> <p>Eighty-nine homeless people in a socio-laboral integration process were assessed. An initial interview was used, and the MCMI II questionnaire was applied to investigate the presence of psychosocial disorders (DSM-IV-TR axis IV). This was designed as an <it>ex post-facto </it>prospective study.</p> <p>Results</p> <p>Personality disorders were very frequent among the homeless people examined. Moreover, the high index of psychosocial problems (axis IV) in this population supported the proposal that axis IV disorders are influential in failure to complete therapy.</p> <p>Conclusion</p> <p>The outcomes of the study show that the homeless people examined presented with more psychopathological symptoms, in both axis II and axis IV, than the general population. This supports the need to take into account the comorbidity between these two types of disorder among homeless people, in treatment and in the development of specific intervention programs. In conclusion, the need for more psychosocial treatments addressing the individual problems of homeless people is supported.</p

Preliminary study of relationships between hypnotic susceptibility and personality disorder functioning styles in healthy volunteers and personality disorder patients

<p>Abstract</p> <p>Background</p> <p>Hypnotic susceptibility is one of the stable characteristics of individuals, but not closely related to the personality traits such as those measured by the five-factor model in the general population. Whether it is related to the personality disorder functioning styles remains unanswered.</p> <p>Methods</p> <p>In 77 patients with personality disorders and 154 healthy volunteers, we administered the Stanford Hypnotic Susceptibility Scale: Form C (SHSSC) and the Parker Personality Measure (PERM) tests.</p> <p>Results</p> <p>Patients with personality disorders showed higher passing rates on SHSSC Dream and Posthypnotic Amnesia items. No significant correlation was found in healthy volunteers. In the patients however, SHSSC Taste hallucination (β = 0.26) and Anosmia to Ammonia (β = -0.23) were significantly correlated with the PERM Borderline style; SHSSC Posthypnotic Amnesia was correlated with the PERM Schizoid style (β = 0.25) but negatively the PERM Narcissistic style (β = -0.23).</p> <p>Conclusions</p> <p>Our results provide limited evidence that could help to understand the abnormal cognitions in personality disorders, such as their hallucination and memory distortions.</p

Motive-Oriented Psychotherapeutic Relationship Facing a Patient Presenting with Narcissistic Personality Disorder: A Case Study

Motive-oriented therapeutic relationship (MOTHER), a prescriptive concept based on an integrative form of case formulation, the Plan Analysis (PA) method (Caspar, in: Eells (ed.), Handbook of psychotherapy case formulations, 2007), has shown to be of particular relevance for the treatment of patients presenting with personality disorders, in particular contributing to better therapeutic outcome and to a more constructive development of the therapeutic alliance over time (Kramer et al., J Nerv Ment Dis 199:244–250, 2011). Several therapy models refer to MOTHER as intervention principle with regard to borderline and Narcissistic Personality Disorder (NPD) (Sachse et al., Clarification-oriented psychotherapy of narcissistic personality disorder, 2011; Caspar and Berger, in: Dulz et al. (eds.), Handbuch der Borderline-Störungen, 2011). The present case study discusses the case of Mark, a 40-year-old patient presenting with NPD, along with anxious, depressive and anger problems. This patient underwent a seven-session long pre-therapy process, based on psychiatric and psychotherapeutic principles complemented with PA and MOTHER, in preparation for further treatment. MOTHER will be illustrated with patient–therapist verbatim from session 4 and the links between MOTHER and confrontation techniques will be discussed in the context of process-outcome hypotheses, in particular the effect of MOTHER on symptom reduction. This research was supported by SNSF and funded by Grant No: 100014_134562/1

I disturbi del narcisismo / A cura di Ronningstam E.F.

In questo volume Elsa Ronningstam ha raccolto contributi di importanti clinici e ricercatori internazionali sul tema del narcisismo. I disturbi del narcisismo vengono affrontati in relazione all'abuso di sostanze, alle patologie psicosomatiche, alle esperienze traumatiche, all'adolescenza, alle cure psichiatriche, alla terapia di coppia

The road from pathological narcissism to suicidality in adolescence: an empirical study

La ricerca clinica ed empirica ha evidenziato un nesso complesso fra il narcisismo patologico e il processo suicidario in età adulta. Data la rilevanza della sucidarietà e delle peculiari vicissitudini narcisistiche per l'adolescenza, la ricerca si propone di investigare la relazione fra narcisismo patologico nella una prospettiva multi-dimensionale dell'Intervista Diagnostica per il Narcisismo (DIN) and l'ideazione e le condotte suicidarie in un campione di adolescenti italiani. Metodi: a103 adolescenti italiani maschi e femmine fra i 12 e i 18 anni sono stati somministrati la DIN, la SCID II, CSSRS e la Kiddie-SADS con un follow-up a sei mesi. Risultati: le correlazioni il t-test e le analisi di regressione multipla hanno evidenziato l'associazione degli stati affettivi e dell'umore narcisistici sia con l'ideazione che con la letalità delle condotte. L'incremento nella dimensione della grandiosità è associata al passaggio a gesti suicidari ad elevata letalità potenziale. Conclusioni: l'ideazione e le condotte suicidarie sembrano assolvere alla funzione di restaurazione del senso di controllo e dell'autostima negli individui narcisistici che sperimentano uno stato di disregolazione affettiva. Il funzionamento narcisistico patologico sembra giocare un ruolo importante nel processo sucidario adolescenziale esattamente come in età adulta. L'assessment del funzionamento narcisistico adolescenziale può fornire delle utili indicazioni nella comprensione e gestione del rischio suicidario in questa fase di vita.Background: Clinical and empirical research evidenced a complex link between pathological narcissism and the suicidal process in adulthood. Given the relevance of suicidality and the peculiar narcissistic vicissitudes of adolescence, the proposed research investigated the relationship between pathological narcissism analyzed from the multi-dimensional perspective of the Diagnostic Interview for Narcissism (DIN) and suicidal ideation conducted in a sample of Italian Adolescents. Methods: One hundred and three Italian male and female adolescents between 12 and 18 were administered the DIN, SCIDII, CSSRS, and Kiddie-SADS with six months follow-up. Results: The correlation, t-test, multiple regression analyses evidenced the association of narcissistic affective states and mood with both suicidal ideation and lethality of conduct. The increase in the dimension of grandiosity is associated with the passage to potentially highly lethal suicidal gestures. Conclu-sions: Suicidal ideation and conduct seem to serve the function of restoring a sense of control and self-esteem in narcissistic individuals experiencing a state of affective dysregulation. Narcissistic pathological functioning seems to play an important role in the adolescent suicidal process, quite like adulthood. Assessing an adolescent’s narcissistic functioning may provide useful clinical information in understanding and managing the suicidal risk in this phase of life