Self-invalidation in borderline personality disorder : A content analysis of patients’ verbalizations

Objective The ability to trust one's own perceptions is crucial for psychological well-being and growth. The relevance of its opposite, self-invalidation (SI), to the psychopathology of borderline personality disorder (BPD) is emphasized in many contemporary theories of evidence-based treatments for BPD. Empirical research on this topic remains scarce, however. This study aimed to describe manifestations of SI in individuals with BPD during a 40-session psychoeducational intervention based mainly on schema therapy. Method Transcripts of videotaped group sessions were analyzed inductively using qualitative content analysis. Results SI emerged as a recurrent, ubiquitous phenomenon. The content analysis yielded three core categories of SI: (1) a self-critical and harsh attitude towards the self (subcategories reflected punitive internalizations that could engender fear-based inertia, self-erasing, submissive coping behavior, and temporal fluctuation in SI), (2) a deficient sense of normalcy, and self-doubt, and (3) self-stigma. We also found an association of SI with various dimensions of BPD, including difficulty in the identification of emotions, secondary emotional reactions such as guilt, shame, anger, and resentment, self-related and interpersonal problems, and suicidal urges. Conclusions SI is a detrimental cognitive-emotional process relevant to BPD that merits treatment. Efforts to reduce self-stigma, a pernicious aspect of SI, are imperative.Peer reviewe

"If you don’t have a word for something, you may doubt whether it’s even real” – how individuals with borderline personality disorder experience change

Objective: This study explored how psychological change was experienced and what treatment-related factors or events were perceived as supporting or hindering their process by individuals with borderline personality disorder. Methods: Eight BPD sufferers attended a 40-session psychoeducational group intervention at a community mental health care center. At intervention end, personal experience of meaningful change was explored in an in-depth interview and data were content-analyzed. Change in BPD symptoms was assessed by the Borderline Personality Disorder Severity Index IV interview. Results: The qualitative content analysis on subjectively perceived meaningful change yielded three core categories: (1) improved ability to observe and understand mental events, (2) decreased disconnection from emotions, emergence of new or adaptive emotional reactions and decrease in maladaptive ones, and (3) a new, more adaptive experience of self and agency. Accordingly, (1) learning and (2) normalizing emerged as the main categories of helpful treatment factors. In turn, treatment-related factors perceived as obstacles were: (1) aggression in the group, and (2) inflexibility. With respect to symptom change, four participants were considered clinically as remitted, and two showed a reliable change. Conclusions: Long-term psychoeducational group therapy seems to enhance mentalization / metacognitive functioning and promote self (or personality) integration in BPD patients.Peer reviewe

Processing of Self-concept and Identity in Individuals with Borderline Personality Disorder: Findings from a Content-Analytic Follow-up Study

Peer reviewe

Stories from family life: living with problematic substance use and recovery in Norway

The research project is a small-scale, narrative study aiming to gain insight into problematic substance use (PSU) and PSU recovery processes from a family perspective. Exemplified with ethnographic participant observation and qualitative interviews, the research project shows how family members talk about their lives with PSU at different times and from the perspective of different family positions and roles. Such knowledge is essential for understanding the needs of families and supporting family participation in long-term recovery processes. The overarching research question is: How do people living in families with problematic substance use construct their family life through their stories? The following sub-questions elaborate on the main research question. 1. How do family members talk about their past, present, and future roles while living with problematic substance use? 2. How do family members assemble meaning about the impact of problematic substance use in their roles and relationships in the family? 2. How do family members voice their concerns and fears related to problematic substance use through their stories? The narrative approach was chosen as the main methodology. The findings, presented as stories, demonstrate how complex and multifaceted family members' stories are. "A story of love" and" A story of family ties" are about the importance of family life and relations. In contrast, "A story of fear and preparedness", and "A story of protecting other family members from PSU" are about experienced dangers and efforts to protect the family members. "A story about the unforgivable", "A story of doubt", and "A story about tough choices" provide insight into intolerable dilemmas related to life in families. "Stories difficult to tell", "Directing the stories", and "Stories with chaos" show how stories are told. This research project suggests that researchers and professionals need more awareness of acute tensions and paradoxes in families

Stories from family life: Living with problematic substance use and recovery in Norway

The research project is a small-scale, narrative study aiming to gain insight into problematic substance use (PSU) and PSU recovery processes from a family perspective. Exemplified with ethnographic participant observation and qualitative interviews, the research project shows how family members talk about their lives with PSU at different times and from the perspective of different family positions and roles. Such knowledge is essential for understanding the needs of families and supporting family participation in long-term recovery processes. The overarching research question is: How do people living in families with problematic substance use construct their family life through their stories? The following sub-questions elaborate on the main research question. 1. How do family members talk about their past, present, and future roles while living with problematic substance use? 2. How do family members assemble meaning about the impact of problematic substance use in their roles and relationships in the family? 2. How do family members voice their concerns and fears related to problematic substance use through their stories? The narrative approach was chosen as the main methodology. The findings, presented as stories, demonstrate how complex and multifaceted family members' stories are. "A story of love" and" A story of family ties" are about the importance of family life and relations. In contrast, "A story of fear and preparedness", and "A story of protecting other family members from PSU" are about experienced dangers and efforts to protect the family members. "A story about the unforgivable", "A story of doubt", and "A story about tough choices" provide insight into intolerable dilemmas related to life in families. "Stories difficult to tell", "Directing the stories", and "Stories with chaos" show how stories are told. This research project suggests that researchers and professionals need more awareness of acute tensions and paradoxes in families

Being a therapist - becoming a researcher: A collaborative autoethnography study

The aim of this study was to explore how four professionals who are both therapists and academics experienced the process of becoming researchers. Within the framework of collaborative autoethnography, and guided by a phenomenological approach, the authors sought to gain a collective understanding of their shared experiences (Ngunjiri et al., 2010). Data gathering involved a two-step process in which all four researchers produced autobiographical transcripts (datasets) in response to the question “What are your experiences of becoming a researcher?” Through the application of reflexive thematic analysis, four themes emerged: (1) “The tensions within academia as a hierarchy”, (2) “The struggle to become an academic”, (3) “Finding meaning and satisfaction in a new career”, and (4) “Evolving a new identity”. All four participants emphasised the hierarchical structure of academic institutions and the prioritization of research over teaching, resulting in conflicts and tensions. Participants also highlighted the demands and difficulties they encountered during the transition from professional practice to academic research: setting aside time for research was often at the expense of other activities, and issues of financial security also emerged. Describing research as “a landscape that is difficult to navigate and in which it is easy to feel overwhelmed”, participants stressed the importance of support from those with more experience in the research arena. However, participants welcomed the opportunity to apply their practical experience as therapists to their research activities and to communicate research findings to those still in practice. All four described gaining a new identity through making the transition. They valued the resulting self-development, which was seen as an ongoing process involving openness to learning new things and diving into new and unfamiliar waters.publishedVersio

Early maladaptive schemas in chronically depressed patients : A preliminary investigation

Background Schema therapy has been proposed as a potentially effective treatment for chronic depression. However, little is known about early maladaptive schemas (EMSs), a key concept in schema therapy, in relation to chronic depression or chronic depression with comorbid personality pathology. The aim of the present study was to compare EMSs between currently chronically depressed patients with comorbid cluster C personality disorder (CDCPD), currently chronically depressed patients (CD), and patients remitted from chronic depression (CDR). Methods Based on data from a naturalistic follow-up study on psychiatric outpatients with major depressive disorder, three groups were formed according to Diagnostic and Statistical Manual of Mental Disorders-IV: CDCPD (n = 15), CD (n = 23), and CDR (n = 13). Groups were compared in terms of background information and measurements for depression (Beck Depression Inventory) and EMSs (Young Schema Questionnaire). Results Patients with CDCPD and CD did not differ in terms of background variables or the severity of depressive symptoms, but patients with CDCPD were more maladaptive with respect to the majority of EMSs. Patients with CDR were less depressed than CDCPD or CD patients, but did not differ in terms of EMSs compared with CD patients. Conclusions Comorbid cluster C personality disorder appears to be associated with more severe EMS endorsement in chronically depressed patients. Remitted patients show similar cognitive vulnerability factors in terms of EMSs compared to those currently chronically depressed. The findings suggest that EMSs may contribute to vulnerability to chronic depression. Focusing on EMSs may be beneficial in the treatment of chronic depression.Peer reviewe

Ahdistuneisuushäiriöt : KÄYPÄ HOITO -SUOSITUS (Tiivistelmä)

Käypä hoito -suositus. Tiivistelmä. English summar

Fliker av virkeligheten. Hvordan opplever fagpersoner samarbeid i rusfeltet?

Masteroppgaven er en kvalitativ studie om fagpersoners opplevelser om fenomenet samarbeid i rusfeltet. Statlige retningslinjer definerer samarbeidet både som målsetting og utfordring for fagpersoner som tilrettelegger tjenester for mennesker med rusrelaterte utfordringer. Samarbeid er også en stor del av arbeidshverdagen for fagpersoner i forskjellige tjenester innenfor rusfeltet

VAIKEAVAMMAISTEN HENKILÖIDEN SUORIUTUMINEN TYÖNANTAJAVELVOITTEISTA

Tutkimuksen tarkoituksena oli kartoittaa vaikeavammaisten henkilöiden suoriutumista työnantajavelvoitteiden hoitamisesta toimiessaan henkilökohtaisen avustajan työnantajana ja sitä millaisia toiveita heillä oli henkilökohtaisen avun järjestämistavasta. Opinnäytetyön aihe tuli Kouvolan kaupungin vammaispalveluilta. Tutkimuskysymyksen valintaan vaikutti vammaispalveluiden kiinnostus selvittää henkilökohtaista apujärjestelmää työnantajavelvoitteiden näkökulmasta. Tutkimuksen kohderyhmäksi muodostuivat ne Kouvola kaupungin vammaispalveluiden asiakkaat, joilla oli vammaispalvelulain mukainen henkilökohtaisen avun päätös. Teoreettisena viitekehyksenä on käytetty vammaisuuden määrittelyä, henkilökohtaisen avun lainsäädännöllistä lähtökohtaa ja työnantajuuteen liittyviä velvoitteita. Lisäksi haluttiin tuoda esiin vammaisten omia näkemyksiä henkilökohtaisen avun järjestämistavoista. Aineiston keruumenetelmänä oli survey, joka toteutettiin postikyselynä kesäkuussa 2010. Kyselylomakkeita lähetettiin 120, joista palautui 66. Palautuneista lomakkeista hylättiin kaksi tyhjänä palautunutta lomaketta, joten kyselyyn vastanneiden kokonaismääräksi tuli 64 ja vastausprosentti oli 53,3. Tutkimustuloksista ilmeni, että vaikeavammaiset työnantajat kokivat suoriutuvansa työnantajavelvoitteista melko itsenäisesti. Työnantajuus haluttiin säilyttää vammaisella henkilöllä itsellään, koska työnjohdollista oikeutta pidettiin tärkeänä. Paperien ja kuittien kierrättäminen koettiin raskaiksi ja aikaa vieviksi tehtäviksi. Tutkimustulosten mukaan vammaiset työnantajat toivoivat työnjohdollisten tehtävien säilyvän edelleen vammaisella henkilöllä, mutta palkkaukseen ja lakisääteisten maksujen hoitamiseen liittyvät tehtävät haluttiin siirtää esimerkiksi kaupungin hoidettaviksi.The purpose of this study was to determine how severely disabled people performed their engagements as an employer of personal aids, and what kind of wishes they had in terms of the methods of arranging personal aid. The topic for the project was given by Social Welfare of the Disabled in Kouvola. The choice of a research question was affected by the level of interest the disability services had towards mapping out a personal aid system from the perspective of employer engagements. The target group for the study was formed by those clients of the disability services, who were entitled to personal aid according to the act of services for disabled. The theoretical frame of reference is based on the definition of disability, the statutory basis for personal aid and employer engagements. In addition, we wanted to present the methods of arranging personal aid as perceived by the disabled themselves. Research data gathered via a survey, which was mailed to the participants in June 2010. 120 survey forms were sent out, and 66 of them were returned. Two of the returned forms were empty and therefore disqualified; thus the total amount of responses was 64 and the response percentage 53.3. The results of the study show that severely disabled employers considered themselves to be able to perform their engagements as an employer fairly independently. The disabled considered their right for supervision important so the participants wanted to remain their work independent to the disabled persons. Handling papers and receipts from one person to another was considered heavy and time-consuming. The results show that the disabled employers wanted the supervisory tasks to remain with the disabled person but they were willing to move tasks concerning hiring and statutory payments to the duties of the city