The relevance of schizotypal traits for understanding interpersonal functioning in adolescents with psychiatric problems.

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Level of Personality Functioning Scale-Brief Form 2.0: Validity and reliability of the Polish adaptation

Objectives: This study examined psychometric properties of the Polish adaptation of the Level of Personality Functioning Scale–Brief Form 2.0 (LPFS–BF 2.0) measuring features corresponding to self- and interpersonal impairment of personality functioning as defined in the diagnostic guidelines for Personality Disorder in the DSM-5 Section III. Methods: The study involved a non-clinical sample of N = 242 adults (52.9% female; Mage = 30.63 years, SDage = 11.81 years). To evaluate the criterion validity, the Personality Inventory for DSM-5 (PID-5), Personality Inventory for ICD-11 (PiCD), Agency-Communion-Inventory (AC-IN), and Mental Health Continuum–Short Form (MHC-SF) were administered. Results: The LPFS-BF 2.0 yielded two reliable latent components that correspond to an interpretation of self- and interpersonal functioning and showed relevant associations with a personality disorder severity index, maladaptive personality traits, well-being, and personality constructs of agency and communion. The LPFS–BF 2.0 also demonstrated incremental validity over and above all the PID-5 pathological traits with respect to global well-being as an outcome. Conclusions: The Polish adaptation of the LPFS–BF 2.0 is a psychometrically and conceptually sound measure to assess features corresponding to self and interpersonal impairment of personality functioning as defined in the DSM-5 Section III. However, findings warrant replication in clinical populations

Teachers' readiness in the teaching of Mathematics and Science in English / Richard Anak Banter

When the Malaysian Education Ministry announced a change in the medium of instruction from the national language, Bahasa Malaysia to English for Mathematics and science subjects for Primary one, form one, and lower sixth forms, beginning the year 2003, teachers and students nationwide have to grapple with the switch of language. As the implementation news was announced at a very short notice, many teachers were caught by surprise as some were not prepared to deliver the subjects using English. This is probably due to lack of proficiencies, confidence and inadequate command of English. These problems, if not taken seriously would undermine the process of teaching and learning and subsequently students would be the victim as they are the ones that sit for the assessment and examination. Therefore,this study using questionnaires is undertaken to investigate the Teachers' Readiness in the Teaching of Mathematics and Science in English. Sixty-nine respondents from four selected secondary schools in Kuching, Sarawak participated in this study. The major finding shows that a large number of the respondents felt that they were ready to teach Mathematics and Science in English. The finding also indicated that the respondents were proficient and confident in teaching both the subjects in English as indicated by 75% or 53 of the respondents. Although, courses and training were given 25% or 16 of the respondent encountered problems in understanding some of the terminologies and pronunciation in English. A positive finding from the study revealed that majority of the respondents was well prepared before each lesson as indicated by 80% or 57 of the respondents. Finally, respondents were of the opinion that they were ready to teach both the subjects in English as indicated. In addition, it can be implied that some Mathematics and science teachers should be given motivational training to upgrade their proficiency in English Language. Based on the findings which only involved sixty-nine Mathematics and Science teachers, thus it is recommended that a larger study could be carried out with lager sample from the whole state of Sarawak that could provide a more valid and reliable information.Secondly, this study only concentrates on teachers' readiness, thus, it is appropriate to conduct a study that involves students' readiness too for both the primary and secondary schools. Finally, as this study only covered some aspects of technical training ICT for courseware for the respondents, it is recommended that a special study be conducted on teacher's training on handling of computer course wares in future to further enhance the process of teaching and learning Mathematics and Science in English

A Mentalization-Informed Staging Approach to Clinical High Risk for Psychosis

The practice of diagnosis is fundamentally designed to orient treatment. In the case of early diagnosis for schizophrenia spectrum disorders (SSP) risk, the empirical base for such a practice is still young, and many clinical questions arise in the everyday clinical application of risk algorithms and ensuing therapeutic options. One of the key questions that we will focus on is the following: in cases of SSP where symptoms are successfully treated, why does residual social functioning impairment remain the most serious obstacle to remission and reinsertion in society? We will present the evidence suggesting that the roots of residual social functioning impairment may, in many cases, come from thwarted or arrested development in the specialization of social cognition during adolescence and early adulthood. We will review the evidence suggesting that both during the premorbid phase and clinical high-risk phase, attenuated psychotic symptoms may impede the maturation of key social cognitive processes, particularly the suite of reflective thinking processes coming under the term of mentalization. From this evidence base, we will adapt the staging model of SSP progression in function of our mentalization-informed model, tailored to provide a coherent framework of care addressing the key clinical needs at every stage of psychosis progression

The implementation of mentalization-based treatment for adolescents: a case study from an organizational, team and therapist perspective

Background: Reports on problems encountered in the implementation of complex interventions are scarce in psychotherapy literature. This is remarkable given the inherent difficulties of such enterprises and the associated safety risks for patients involved.Case description: A case study of the problematic implementation process of Mentalization- Based Treatment for Adolescents (MBT-A), a new therapy for 14 to 18 year old youngsters with severe personality disorders, is presented. The implementation process is described and analyzed at an organizational, team and therapist level.Discussion and evaluation: Our analysis shows that problems at all three levels contributed and interacted to make the implementation cumbersome and hazardous.Conclusion: The implementation of complex psychotherapeutic programs for difficult patients could benefit from a structured attention to processes at multiple levels. We therefore propose a new comprehensive heuristic model of treatment integrity. This new model includes organisational, team and therapist adherence to the treatment model as necessary components of treatment integrity in the implementation of complex interventions. The application of this new model of treatment integrity potentially increases the chance of successful implementations and reduces safety risks for first patients enrolling in a new program

A multi-center psychometric evaluation of the Severity Indices of Personality Problems 118 (SIPP-118):Do we really need all those facets?

PURPOSE: The Severity Indices of Personality Problems 118 (SIPP-118) is a self-report questionnaire that aims to measure core components of (mal)adaptive personality functioning that can change over time. In this study, we aimed to assess the facet strength of the 16 facets across three large clinical samples.METHODS: Data from Norwegian and Dutch psychiatric patients were analyzed in this international multi-center study (N1 = 2814, N2 = 4751, N3 = 2217). Bi-factor modeling was used to assess to what degree the SIPP items tap into an overall general factor. The incremental value (distinctiveness) of the facets was studied using proportional reduction in mean squared error (PRMSE) based statistics.RESULTS: The estimated model showed adequate fit. The explained common variance (ECV) attributable to the general factor equaled 50% for all three samples. All but two facets (stable self-image and frustration tolerance) showed sufficient levels of distinctiveness. The findings were observed to be comparable across the three samples.CONCLUSION: Our findings showed that the general factor was relatively weak, and the facets had a clear incremental value.</p

The ICD-11 classification of personality disorders: a European perspective on challenges and opportunities

The 11th revision of the World Health Organization (WHO) International Classification of Diseases (ICD-11) includes a fundamentally new approach to Personality Disorders (PD). ICD-11 is expected to be implemented first in European countries before other WHO member states. The present paper provides an overview of this new ICD-11 model including PD severity classification, trait domain specifiers, and the additional borderline pattern specifier. We discuss the perceived challenges and opportunities of using the ICD-11 approach with particular focus on its continuity and discontinuity with familiar PD categories such as avoidant PD and narcissistic PD. The advent of the ICD-11 PD classification involves major changes for health care workers, researchers, administrators, and service providers as well as patients and families involved. The anticipated challenges and opportunities are put forward in terms of specific unanswered questions. It is our hope that these questions will stimulate further research and discussion among researchers and clinicians in the coming years

Diagnosis of personality disorders in adolescents: A study among psychologists

Background: Recent guidelines concerning the treatment of personality disorders (PDs) recommend diagnosing PDs in adolescents. However, it remains unclear whether these guidelines influence the current opinions and practices of mental health care professionals.Methods: Five hundred sixty-six psychologists completed an online survey concerning PDs in adolescents, of whom 367 professionals reported working with adolescents. The survey contained demographical questions (age, gender, profession, work setting) and specific questions related to PD in adolescence.Results: Although a majority of psychologists working with adolescents acknowledged the existence of PDs in adolescents (57.8%), only a small minority diagnoses PDs in adolescence (8.7%) and offers a treatment specifically aimed at targeting PD pathology (6.5%). Reasons for not diagnosing PDs in adolescence mainly concerned the belief that adolescent personality problems are transient (41.2%) and that the DSM-IV-TR does not allow diagnosing PDs in adolescence (25.9%).Conclusions: Although practice guidelines might have influenced clinicians' opinions about PDs in adolescence, they have had little impact so far on routine clinical practice

Euthanasia and assisted suicide in patients with personality disorders: a review of current practice and challenges.

Over the last two decades an increasing number of countries have legalized euthanasia and physician-assisted suicide (EAS) leading to considerable debate over the inherent ethical dilemmas. Increasing numbers of people with personality disorders, faced with unbearable suffering, have requested and received assistance in terminating their lives. EAS in people with personality disorders has, however, received very sparse attention from clinicians and researchers. In this paper, we examine the literature on the practice and prevalence of EAS in people with personality disorders to date and discuss the associated challenges for research and practice. Narrative review of the literature combined with the authors' collective experience and knowledge of personality disorders. In six of the eight countries where EAS is currently legal, mental disorders are accepted as disorders for which EAS may be granted. In four of these countries, EAS in minors with mental disorders is also accepted. Our literature search resulted in 9 papers on the subject of EAS in people with personality disorders. These studies suggest that most clinicians who grant EAS have indeed perceived their patients' suffering as chronic, unbearable and untreatable without prospect of improvement. The majority of patients with personality disorders had tried some form of psychotherapy, but very few had received any of the relevant evidence-based treatments. The decision to grant EAS based on a perception of the patient's illness as being untreatable with no prospect of improvement, could, thus, in many cases fail to meet the due care criteria listed in EAS laws. People with personality disorders more often wish for death for extended periods of time than people without these disorders. However, there is ample empirical data to show that suicidal tendencies and behaviour can be treated and that they fluctuate rapidly over time. In light of our findings, we believe that the current legislation and practice of EAS for people with personality disorders is based on an inadequate understanding of underlying psychopathology and a lack of awareness about the contemporary treatment literature. Moreover, we assert that this practice neglects the individual's potential for having a life worth living