Introduction to the issue in honor of Sidney Blatt

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Personality factors and depressive configurations. An exploratory study in an italian clinical sample

Introduction: This study focuses on the relationship between personality configurations and depressive experiences. More specifically, the aim of this study is to investigate the relationship between self-criticism and dependency and personality styles or disorders, exploring the association between personality features and depressive symptoms. The two-configurations model of personality developed by Blatt (2004, 2008) is adopted as a reference point in sharing a valid framework and in understanding the results. Methods: Five instruments are administered to 51 participants with a diagnosis of depressive disorder, in accordance with DSM-IV-TR (American Psychiatric Association, 2000): Self-criticism and dependency dimensions of depression are measured with the Depressive Experiences Questionnaire (DEQ); self-reported depression is assessed with the Beck Depression Inventory-ll (BDI-II); observer-rated depression is assessed with the Hamilton Depression Rating Scale (HDRS); personality is assessed with the Clinical Diagnostic Interview (CDI) and the Shedler Westen Assessment Procedure-200 (SWAP-200). Results: Only self-criticism, and not dependency, is associated with depressive symptoms. In addition, the SWAP Borderline PD Scale and the Dysphoric: Emotionally dysregulated Q-factor emerge as significant in predicting depression. Conclusions: Findings support the assumption that depressive personality configurations can enhance the vulnerability to developing depression. Theoretical and clinical implications of these results are discussed

Assessing personality change with Blatt's anaclitic and introjective configurations and Shedler-Westen Assessment Procedure profiles: two case studies in psychodynamic treatment

A growing body of empirical and clinical research attests to the influence of personality features on the development, course and outcome of psychotherapy. Over the last four decades, Blatt adopted a psychoanalytic and cognitive developmental approach in developing a theoretically and empirically grounded two-configurations model of personality. The main aim of this study was to evaluate possible changes in anaclitic and introjective configurations – as measured by the Depressive Experience Questionnaire (DEQ) (Blatt, D’Afflitti, & Quinlan, 1976) – set against simultaneous changes in personality profile measured by Shedler-Westen Assessment Procedure (SWAP-200). Two young patients, a man and a woman, characterized by different personality profiles – introjective and anaclitic, respectively – were assessed for one year in the context of a psychodynamic psychotherapy. A battery of instruments – Beck Depression Inventory II (BDI-II), Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders I and II, Defense Mechanism Rating Scale, DEQ and SWAP-200 – were administered at the beginning, during the assessment process, and after one year. Both patients displayed lower BDI-II scores, along with evident clinical progress. Defence profiles and Core Conflict Relationship Themes showed interesting developments, in keeping with the evolution of the psychotherapy process. Lastly, while DEQ profiles outlined substantial stability after one year, some important changes in SWAP-200 profiles – in particular with regard to Q factors – were observed. Although these findings should be considered as preliminary, these results appear to be consistent with the description of Self-criticism and Dependency as relatively stable personality dimensions. The potential influence of profile diversity – introjective vs anaclitic – on other key variables of the psychotherapy process is also discussed

The Italian version of the Depressive Experiences Questionnaire: psychometric properties and validation in students, community, and clinical groups

The current study evaluated the psychometric properties of the Italian validation of the Depressive Experiences Questionnaire (DEQ), conceived as a measure of self-criticism and dependency, i.e. two personality factors acting, according to Blatt (2004), as risk factors for depression in particular and psychopathology in general. A series of standardized measures [Beck Depression Inventory-II (BDI-II), DEQ, Symptom Checklist-90-R (SCL-90-R), Millon Clinical Multiaxial Inventory, 3rd edition (MCMI-III)] was administered to three samples (i.e., students, community and clinical). Factorial validity was evaluated along with convergent and predictive validity. In order to evaluate the reliability and internal consistency, a specific subgroup of participants was retested on the DEQ and BDI-II. Results showed correlations between DEQ dimensions and some personality traits of the MCMI-III. The traditional three-factor model of the DEQ structure as identified by principal component analysis appears to be as stable factors as typically found in American samples, although some items showed elevated cross-loading or low loadings on any factor. Clinical and diagnostic implications of the findings will be discussed

The Italian version of the Depressive Experiences Questionnaire: psychometric properties and validation in students, community, and clinical groups

The current study evaluated the psychometric properties of the Italian validation of the Depressive Experiences Questionnaire (DEQ), conceived as a measure of self-criticism and dependency, i.e. two personality factors acting, according to Blatt (2004), as risk factors for depression in particular and psychopathology in general. A series of standardized measures [Beck Depression Inventory-II (BDI-II), DEQ, Symptom Checklist-90-R (SCL-90-R), Millon Clinical Multiaxial Inventory, 3rd edition (MCMI-III)] was administered to three samples (i.e., students, community and clinical). Factorial validity was evaluated along with convergent and predictive validity. In order to evaluate the reliability and internal consistency, a specific subgroup of participants was retested on the DEQ and BDI-II. Results showed correlations between DEQ dimensions and some personality traits of the MCMI-III. The traditional three-factor model of the DEQ structure as identified by principal component analysis appears to be as stable factors as typically found in American samples, although some items showed elevated cross-loading or low loadings on any factor. Clinical and diagnostic implications of the findings will be discussed

Dissecting the determinants of depressive disorders outcome: an in depth analysis of two clinical cases

Clinicians face everyday the complexity of depression. Available pharmacotherapies and psychotherapies improve patients suffering in a large part of subjects, however up to half of patients do not respond to treatment. Clinicians may forecast to a good extent if a given patient will respond or not, based on a number of data and sensations that emerge from face to face assessment. Conversely, clinical predictors of non response emerging from literature are largely unsatisfactory. Here we try to fill this gap, suggesting a comprehensive assessment of patients that may overcome the limitation of standardized assessments and detecting the factors that plausibly contribute to so marked differences in depressive disorders outcome. For this aim we present and discuss two clinical cases. Mr. A was an industrial manager who came to psychiatric evaluation with a severe depressive episode. His employment was demanding and the depressive episode undermined his capacity to manage it. Based on standardized assessment, Mr. A condition appeared severe and potentially dramatic. Mrs. B was a housewife who came to psychiatric evaluation with a moderate depressive episode. Literature predictors would suggest Mrs. B state as associated with a more favourable outcome. However the clinician impression was not converging with the standardized assessment and in fact the outcome will reverse the prediction based on the initial formal standard evaluation. Although the present report is based on two clinical cases and no generalizability is possible, a more detailed analysis of personality, temperament, defense mechanisms, self esteem, intelligence and social adjustment may allow to formalize the clinical impressions used by clinicians for biologic and pharmacologic studies

Psychological Wellbeing during the COVID-19 Pandemic: The Influence of Personality Traits in the Italian Population

Coronavirus disease 19 (COVID-19) has had a strong psychological impact on the Italian population. Italy was heavily affected by the virus before other countries in Europe, experiencing the highest number of deaths. Unknown symptoms in the early stages of the pandemic and the absence of clear transmission links affected people’s wellbeing. Individual personality differences played a key role in perceived psychological wellbeing during the pandemic. The present exploratory study sought to evaluate the impact of COVID-19 on psychological health and identify how psychological wellbeing is influenced by personality traits. A total of 2103 participants (64% female and 36% male) completed an online survey that included the Psychological General Wellbeing Index (PGWBI), the Italian Short Personality Inventory (ITAPI), and a general questionnaire. Descriptive statistics and hierarchical regressions were performed using SPSS 25.0 (IBM Corp., Armonk, NY, USA) (The findings showed poor psychological wellbeing in the Italian population. Young people reported the lowest scores. Vulnerability traits negatively influenced some PGWBI domains, such as the total score (β = −0.62), anxiety (β = −0.55), depression (β = −0.46), positivity and wellbeing (β = −0.51), vitality (β = −0.45), general health (β = −0.12), and self-control (β = −0.52). On the other hand, dynamism traits positively affected vitality (β = 0.12) and positivity and wellbeing (β = 0.14). In other words, personality factors related to vulnerability in particular created risk, whereas dynamism offered protection. The results highlight how COVID-19 helped to trigger anxious and depressive states. People feel helpless and vulnerable when facing new, unexpected conditions caused by the virus. These findings may assist mental healthcare professionals in safeguarding psychological wellbeing during emergencies such as the pandemic

La psicologia dinamica e Sigmund Freud

Il libro \ue8 pensato come strumento in grado di fornire un\u2019introduzione sia alla Psicologia dinamica, sia alla Psicoanalisi e in particolare a Freud. E\u2019 suddivisibile in due sezioni. La prima intende mostrare la specificit\ue0 dell\u2019approccio psicodinamico all\u2019uomo; si daranno poi dei cenni di diagnosi e nosografia psichiatrica e psicoanalitica. Chiuder\ue0 la sezione il riferimento ad autori appartenenti alla Prima Psichiatria dinamica, preparatori allo sviluppo del pensiero di Freud. La seconda sezione \ue8 interamente dedicata a Freud: lo sviluppo del suo pensiero sar\ue0 seguito a partire da un inquadramento storico degli eventi personali e sociali del tempo; particolare attenzione sar\ue0 data anche ai suoi casi clinici, mostrando quindi gli aspetti tecnici dell\u2019agire psicoanalitico. Nell\u2019ultima parte della sezione si dar\ue0 infine particolare risalto ad alcuni fondamentali concetti del pensiero di Freud, da cui prenderanno avvio alcune correnti psicoanalitiche a lui successive

Hans e Arpad: note a margine su fantasma e trauma

Agli inizi del secolo scorso, sullo sfondo del costituendo movimento psicoanalitico, Sigmund Freud e Sándor Ferenczi iniziano ad interrogarsi sull’infante, a osservarlo e a chiedersi quali siano le possibilità di cura, cercando di uscire da un modus operandi puramente teorico e pedagogico. In particolare, Freud e Ferenczi si «mettono all’ascolto» di due bambini, il piccolo Hans e il piccolo Árpád, e del loro disagio. Ne scaturiscono ipotesi originali, solo apparentemente allineate. Il confronto critico tra i due casi clinici cerca di evidenziare alcuni nuclei tematici che appartengono ad entrambi e altri che li differenziano. Lo scopo è quello di mettere in scena l’inconscio che oscilla tra traumi fantasmatici e traumi reali, tra realtà psichica e realtà ambientale. Le pionieristiche riflessioni di Freud e Ferenczi sul bambino e il suo sviluppo costituiscono così un imprescindibile punto di partenza di importanti sviluppi e dibattiti all’interno del movimento psicoanalitico.At the beginning of the last century, in the background of the emerging psychoanalytic movement, Sigmund Freud and Sándor Ferenczi started wondering about the infant, observing him and evaluating the chances of cure, trying to break out from a purely theoretical and pedagogical modus operandi. In particular, Freud and Ferenczi «set out to listen» to two children, little Hans and little Árpád, and their psychic suffering. This led to some original hypotheses that were aligned with each other only superficially. The critical comparison between the two clinical cases presented in this paper underlines some thematic core ideas belonging to both, and others which differentiate between them. The aim is to show the unconscious oscillation between phantasmatic and real traumas, between psychic and environmental reality. Thus, Freud and Ferenczi’s pioneering considerations about children and their development represent an essential starting point for study and debate within the psychoanalytic movemen