Search

Introduction: Patients with avoidant personality disorder (AvPD) pathology tend to have poor prognosis in psychotherapy, yet there has been little research conducted to better understand why their outcomes are limited, making it difficult to improve treatments for them. Expressive suppression is a dysfunctional emotion regulation strategy that may exacerbate avoidant tendencies, further complicating the therapeutic process. Methods: Using data from a naturalistic study ( N = 34) of a group-based day treatment program, we examined whether there was an interactive effect of AvPD symptoms and expressive suppression on treatment outcome. Results: Findings revealed a significant moderating effect of expressive suppression on the association between AvPD symptoms and treatment outcome. The outcome for patients with more severe AvPD symptoms was particularly poor when they engaged in high levels of expressive suppression. Discussion: The findings suggest that the combination of significant AvPD pathology and high expressive suppression is associated with poorer responsiveness to treatment.

Background: While there is some evidence that patients with elevated depression symptoms experience greater benefits from negative-affect expression, this amplifying effect has not been investigated within a psychotherapeutic context. This is particularly notable considering the substantial evidence linking affect expression with desired outcomes across psychotherapeutic approaches. The primary purpose of the present study was to investigate if depression symptoms amplified (i.e., moderated) the association between negative-affect expression and reductions in interpersonal problems for patients in a psychiatric day treatment for personality disorders. The secondary purpose was to investigate milieu (i.e., other patients concurrently enrolled) negative-affect intensity and its association with patients' reductions in interpersonal problems., Methods: Participants (N = 239) were patients consecutively admitted into a psychiatric day treatment program for people with personality disorders. Patients completed measures of (1) depression symptoms at pre-treatment, (2) interpersonal problems at pre- and post-treatment, and (3) negative-affect expression each week of treatment., Results: The association between patient negative-affect expression and reductions in interpersonal problems was amplified by depression symptoms. Depression symptoms also amplified the association between milieu negative-affect intensity and reductions in interpersonal problems., Conclusions: Our findings indicate that depression symptoms amplified the therapeutic value of negative-affect expression and amplified the value of an affectively intense milieu. Practical and theoretical implications are discussed., Competing Interests: Declaration of Competing Interest All authors declare no conflicts of interest., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Across a breadth of psychotherapeutic approaches, feeling affect intensely and then talking about those feelings is a common means for increasing insight and other desired outcomes. While several naturalistic and laboratory studies have found that depression symptoms attenuate (i.e., weaken) the association between negative-affect intensity and negative-affect expression, depression's attenuating effect has not been examined in a psychotherapeutic context. The first aim of the present study was to examine if depression symptoms' attenuating effect on the association between negative-affect intensity and negative-affect expression extended into group psychotherapy. Our second aim was to examine group effects on patients' negative-affect expression. Participants (N = 239) were patients consecutively admitted into a psychodynamic group-psychotherapy day treatment program for people with personality disorders. Patients indicated their negative-affect intensity and negative-affect expression each week that they were in treatment. Depression symptoms were assessed at baseline. Results indicated that depression symptoms attenuated (i.e., moderated) the association between negative-affect intensity and negative-affect expression. Further, while the association between patient intensity and expression increased over the course of treatment, the moderating effect of depression on this association did not vary over treatment. Regarding group effects, group negative-affect intensity was associated with higher levels of patient negative-affect expression. Inversely, group affect expression was associated with lower levels of patient affect expression. Patient depression symptoms did not moderate the association between group negative-affect intensity and patient negative-affect expression. Our findings indicate that while group affect intensity and affect expression impacts patients' expression, depression's attenuating effect on negative-affect expression extends to patient effects but not group effects. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Although the self-image distortions and sensitivities of pathological narcissism have been theorized to contribute to somatization, limited empirical research has been devoted to this issue. The present study was developed to test the hypothesis that pathological narcissism contributes to somatic symptoms through increased hypervigiliance to physical sensations. A community sample of 248 adults completed measures of pathological narcissism, somatosensory amplification, somatic symptoms, and depression. Mediation analysis was conducted, controlling for depression, using 99% bootstrapped confidence intervals to examine the indirect effect of pathological narcissism on somatic symptoms via somatosensory amplification. Although pathological narcissism was not directly related to somatic symptoms, a significant indirect effect was observed for pathological narcissism on somatic symptoms via somatosensory amplification. This finding suggests that pathological narcissism contributes to physical hypersensitivity, in turn influencing perceptions of somatic distress. The role of narcissistic dysfunction in somatization indicates the importance of further research and potential clinical consideration.

Objective(s): Interpersonal problems are one of the most persistent difficulties facing those with personality disorders (PDs) and are linked with dysfunction across numerous social domains. Using an interpersonal model of PDs, we examined the indirect effects of Avoidant PD (AvPD) symptoms and social dysfunction through interpersonal problems, as well as Borderline PD (BPD) symptoms and social dysfunction. Methods: Participants were 226 adults taking part in an outpatient treatment program. Results: Using cross‐sectional data from self‐reported measures, we found that cold (b = 0.10, 95% confidence interval (CI) [0.038, 0.176]) and overly nurturant (b = 0.04, 95% CI [0.001, 0.090]) interpersonal problems showed an indirect association between AvPD symptoms and social dysfunction. The only significant indirect association between BPD symptoms and social dysfunction was overly nurturant (b = 0.05, 95% CI [0.001, 0.120]). Conclusions: Results may aid in the development of more individualized treatments for AvPD and BPD symptoms. [ABSTRACT FROM AUTHOR]

Background: Absorption is a trait‐like dimension reflecting a tendency to immerse oneself in sensory and imaginative experiences. This characteristic has scarcely been investigated in group psychotherapy. The present study examined absorption in relation to clients′ experience of early group process, and as a moderator of group cohesion and improvement in psychiatric symptoms, in an integrative group treatment programme. Methods: Participants included 81 clients, who completed an 18‐week programme of intensive, integrative, group treatment for personality dysfunction. Clients completed assessments of absorption and psychiatric symptom severity, and rated three aspects of group cohesion at week 5 of the programme. Results: Absorption was significantly associated with stimulation from the group after controlling for severity of symptoms and personality dysfunction. Moderation analyses found a significant interaction effect for absorption and the stimulation component of group cohesion with regard to symptom improvement. Absorption thus had a moderating effect on the relationship between stimulation from the group and improvement in psychiatric symptoms; for clients with higher levels of absorption, stimulation from group therapy contributed significantly to reduced symptom severity at post‐treatment. Discussion: Findings suggest that absorption may be a salient personality feature to consider in group therapy for clients with personality dysfunction. Conclusion: Absorption may contribute to treatment outcome, in that clients′ absorption tendencies could interact with their enthusiasm for the group experience, thereby leading to reduced symptoms following intensive group treatment. [ABSTRACT FROM AUTHOR]