The potential use of artificial intelligence in the therapy of borderline personality disorder

This paper explores the possibility of AI-based addendum therapy for borderline personality disorder, its potential advantages and limitations. Identity disturbance in this condition is strongly connected to self-narratives, which manifest excessive incoherence, causal gaps, dysfunctional beliefs, and diminished self-attributions of agency. Different types of therapy aim at boosting self-knowledge through self-narratives in BPD. The suggestion of this paper is that human-to-human therapy could be complemented by AI assistance holding out the promise of making patients' self-narratives more coherent through improving the accuracy of their self-assessments, reflection on their emotions, and understanding their relationships with others. Theoretical and pragmatic arguments are presented in favour of this idea, and certain technical solutions are suggested to implement it

Dialogical self strategies of self-organization: psychotherapy and restructuring of internal management

A identidade tem sido um conceito central na literatura em psicologia e na forma como as diferentes abordagens terapêuticas têm concebido os processos de mudança. Entre as inúmeras perspectivas desenvolvidas sobre essa dimensão do ser humano, destacamos o paradigma dialógico que tem vindo a influenciar de forma crescente a teoria e prática em psicoterapia. Segundo esta perspectiva, a funcionalidade psicológica está relacionada com o modo como os indivíduos conseguem articular e colocar em diálogo produtivo as suas várias vozes ou posições de identidade. Neste artigo apresentamos uma revisão da literatura sobre as estratégias que subjazem a essa capacidade auto-organizadora do sistema identitário e sobre as diretrizes que poderão orientar uma intervenção terapêutica dialógica quando essa capacidade se torna disfuncional.Self-concept has been playing a crucial role in psychological literature and in the way the different therapeutic approaches conceive the processes of change. From the diverse perspectives developed about this human dimension, we emphasise the dialogical paradigm that has been increasingly influential in the psychotherapeutic theory and practice. According to the dialogical perspective the psychological well-being is dependent on the way individuals articulate and maintain productive dialogues between the different voices of the self or “I-Positions”. In this paper we present a review of the literature on the strategies that underlie this self-regulatory ability of the self-system and the guidelines of the dialogical therapeutic intervention that could be used when these self-regulatory strategies become dysfunctional.(undefined

Assessing cognitive insight in nonpsychiatric individuals and outpatients with schizophrenia in Taiwan: an investigation using the Beck Cognitive Insight Scale

<p>Abstract</p> <p>Background</p> <p>The Beck Cognitive Insight Scale (BCIS) was designed for the assessment of the cognitive processes involved in self-reflection and the ability to modify erroneous beliefs and misinterpretations. Studies investigating the factor structure of the BCIS have indicated a two-factor model in the psychotic population. The factor structure of the BCIS, however, has not received much consideration in the nonpsychiatric population. The present study examined the factor structure and validity of the BCIS and compared its scores between nonpsychiatric individuals and outpatients with psychosis.</p> <p>Method</p> <p>The Taiwanese version of the BCIS was administered to 507 nonpsychiatric individuals and 118 outpatients with schizophrenia. The psychometric properties of the BCIS were examined through the following analyses: exploratory and confirmatory factor analyses, reliability, correlation analyses, and discriminative validity.</p> <p>Results</p> <p>The BCIS showed adequate internal consistency and stability over time. Exploratory and confirmatory factor analyses on the 15-item measure indicated a two-factor solution that supported the two dimensions of the Taiwanese BCIS, which was also observed with the original BCIS. Following the construct validation, we obtained a composite index (self-reflectiveness minus self-certainty) of the Taiwanese BCIS that reflected cognitive insight. Consistent with previous studies, our results indicated that psychosis is associated with low self-reflectiveness and high self-certainty, which possibly reflect lower cognitive insight. Our results also showed that better cognitive insight is related to worse depression in patients with schizophrenia spectrum disorders, but not in nonpsychiatric individuals. The receiver operating characteristic (ROC) analyses revealed that the area under the curve (AUC) was 0.731. A composite index of 3 was a good limit, with a sensitivity of 87% and a specificity of 51%.</p> <p>Conclusion</p> <p>The BCIS proved to be useful for measuring cognitive insight in Taiwanese nonpsychiatric and psychotic populations.</p

Metacognitive Reflection and Insight Therapy (MERIT) with a Patient with Persistent Negative Symptoms

Metacognition comprises a spectrum of mental activities involving thinking about thinking. Metacognitive impairments may sustain and trigger negative symptoms in people with schizophrenia. Without complex ideas of the self and others, there may be less reason to pursue goal-directed activities and less ability to construct meaning in daily activities, leading to the experience of negative symptoms. As these symptoms tend to be nonresponsive to pharmacotherapy and other kinds of treatment metacognition might be a novel treatment target; improvement of metacognition might lead to improvements in negative symptoms. One therapy that seeks to promote metacognition is the Metacognitive Reflection and Insight Therapy (MERIT). In this study, a case is presented in which a first episode patient with severe negative symptoms is treated with MERIT. A case illustration and the eight core principles of MERIT are presented. Independent assessments of metacognition and negative symptoms before and after therapy show a significant increase of metacognition and decrease of negative symptoms over the course of 40 weeks

Metacognition, borderline pathology and psychotherapeutic change: A single-case study

The aim of this study is to analyze whether: (a) a specific type of metacognitive deficit is present in a patient with Borderline Personality Disorder; (b) a metacognitive improvement can be detected during the psychotherapy treatment; (c) if this improvement can be indicative of the effectiveness of psychotherapy itself. A single case study has been conducted; metacognitive deficits have been measured with the Metacognition Assessment Scale (MAS). In line with the hypothesis, the results show a global and progressive improvement of meta-cognitive functions. We conclude in agreement with the current literature, the existence of a major deficit in Differentiation and Integration subfunctions (belonging to Self-reflexivity), compared to Characterization and Relation between variables subfunctions (belonging to Metacognitive monitoring)

Processi metacognitivi e disturbo borderline di personalità: studio di un caso singolo attraverso la S.Va.M

L’obiettivo del presente lavoro è stato quello di valutare la presenza di una specifica tipologia di deficit metacognitivo nel disturbo borderline di personalità e se, nel corso di una psicoterapia, sia possibile rilevare un incremento metacognitivo tale da essere indicativo del grado d’efficacia della psicoterapia stessa. Dall’analisi delle frequenze rilevate, abbiamo osservato un miglioramento delle funzioni metacognitive progressivo e globale, che non disconferma l’ipotesi di partenza

Countertransference, transference and personality pathology: An empirical study

The aim of this study is to investigate the relation between transference and countertransference patterns and personality pathology. A sample of 30 randomly selected patients has been assessed by their cognitive psychotherapists with a battery of instruments including 1) the Shedler-Westen Assessment Procedure-200 (Westen, Shedler, 1999a) for personality traits and disorders; 2) the Countertransference Questionnaire (Betan et al., 2005) for countertransference patterns, 3) the Psychotherapy Relationship Questionnaire (Bradley et al., 2005) for transference patterns; and 4) the Symptom Check List Revised (Derogatis, 1983), to assess levels of psychopathology. Preliminary results suggest that countertransference and transference dimensions emerging in the therapeutic relationship are not arbitrary: clinicians’ responses to patients with specific types of personality pathology occur in coherent and predictable patterns (Dimaggio et al., 2007)