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Self-contempt may be a frequent but overlooked clinical phenomenon, associated with a number of psychological problems such as increased sadness and shame. It was shown that self-contempt interferes with productive emotional processing and the quality of therapeutic alliance. This study aims to develop a reliable measure of expressed self-contempt given that a previous three-point assessment may be too restrictive in range, resulting in non-significant results. Thus, the present study applied an extended observer-rated scale to different participant groups in different contexts. This explorative phase focuses on a sample of N = 61 participants divided into three groups, including n = 20 controls, n = 21 patients with a diagnosis of borderline personality disorderand n = 20 patients with a diagnosis of major depressive disorder. Levels of self-contempt are compared between the groups and are associated with symptom indicators. Reliability of the instrument is analysed using inter-rater reliability and internal consistency, which are sufficient. The level of expressed self-contempt is not related to symptom intensity. Patients with borderline personality disorder do not express more self-contempt than the other groups. While further research should establish full validity of the scale, reliability is satisfactory and the use of the scale can be recommended. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate the influence of one parent's presence on the quality of the interaction between the other parent and their three-month-old infant. Family interactions were observed in a sample of 69 two-parent families. Parental sensitivity was assessed during two sessions, first in a "dyadic" context (D) and then in a "dyad within the triad" context (DT). Subsequently, we compared maternal and paternal sensitivity in the D and DT contexts according to the quality of family functioning ("high coordination" versus 'low coordination'). The results showed that parents were significantly more sensitive in the DT context than in the D context. This effect appeared to vary according to the quality of family alliance. Moreover, family alliance was globally associated with sensitive parenting. This study helps clarify the role of the triad as a protective factor for early infant--parent dyads.

In-session emotional processing is a central component of psychotherapy, but little is known about the types and the quality of emotional processing individuals engage in daily life. An ecological momentary assessment (EMA) schedule has been validated to assess distinct emotional experiences as they emerge in daily life. It remains an open question whether changes observed in distinct emotional experiences over a week of assessment are related to in-session self-esteem. In total, N = 42 university students participated in a one-week assessment of emotions using ecological momentary assessment, as well as in a one-session experiential task of resolving self-criticism (using a two-chair dialogue from emotion-focused therapy). The emotions in daily life were self-reported by the participants on a regular basis, and self-esteem was assessed three times during the two-chair dialogue. Two-level hierarchical linear models reveal emotional changes in daily life, and in-session self-esteem is introduced as predictor at level 2. In-session self-esteem was correlated with symptom levels. The results showed that changes in primary maladaptive emotions in the one-week assessment were predicted by state and trait components of in-session self-esteem, which took place at the outset of the EMA. Trait-components of self-esteem were linked with the level of symptoms, whereas state-components of self-esteem were not. The present study underscores the importance of extending research from within-session observations of emotional processing towards daily life.. [ABSTRACT FROM AUTHOR]

Short-term dynamic psychotherapy (STDP) has rarely been investigated with regard to its underlying mechanisms of change, even if psychoanalytic theory informs us about several potential putative mechanisms of change in patients. Change in overall defensive functioning is one. In this study, we explored the role of overall defensive functioning, by comparing it on the process level with the neighbouring concept of overall coping functioning. A total of N = 32 patients, mainly presenting adjustment disorder, were included in the study. The patients underwent STDP up to 40 sessions; three sessions per psychotherapy were transcribed and analyzed by using two observer-rating scales: Defense Mechanism Rating Scales (Perry, 1990) and Coping Action Patterns (Perry, Drapeau, Dunkley, & Blake, 2005). Hierarchical linear modeling was applied to model the change over the course of therapy and relate it to outcome. Results suggest that STDP has an effect on the target variable of overall defensive functioning, which was absent for overall coping functioning. Links with outcome confirm the importance of the effect. These results are discussed from methodological and clinical viewpoints. Keywords: defense mechanisms; coping; psychodynamic psychotherapy; hierarchical linear modeling DOI: 10.1002/jclp.20719

Background: Emotional processing has been studied in psychotherapy as a state‐dependent, sequential process of change. So far, no studies have applied this conceptualisation of emotional processing to the assessments of emotion in daily life. This is particularly important in the light of the pertinence of day‐by‐day fluctuations of emotions for understanding mental health and for monitoring the impact of prevention and psychotherapy programmes. This study examined the internal and ecological validity of a state‐dependent conceptualisation of emotional processing in daily life, in comparison with an experiential‐psychodynamic psychotherapy analogue session. Methods: In total, N = 42 university students participated in an experiential‐psychodynamic session, completed symptom measures and responded to a one‐week period of ecological momentary assessment (EMA) using a smartphone. Emotional processing in the session was assessed using the valid observer‐rated measure Classification of Affective Meaning States (CAMS), and emotional responses in daily life were assessed using newly developed theory‐consistent items self‐rated via an interactive smartphone program. Results: Internal validity was generally satisfactory across the subscales used in EMA. Correspondence between EMA and in‐session emotional processing was generally low, but specific relationships were found between self‐rated fear, rejecting anger, hurt/grief or loneliness and the observer‐rated productive emotions in the psychotherapy analogue session. Relationships between maladaptive emotional processing and intensity in symptoms were found. Conclusions: This is the first study to have examined the validity of a state‐dependent conception of emotional processing in daily life, in direct comparison with a psychological session. We recommend using this assessment schedule to develop or complement integrative prevention or intervention programmes. [ABSTRACT FROM AUTHOR]

Background: Problematic interpersonal patterns, as defined by the core conflictual relationship theme (CCRT) method, are part of the clinical presentation of clients with borderline personality disorder (BPD). So far, we do not know whether the pervasiveness of interpersonal patterns changes and if this change explains therapy outcome. Methods: In a secondary analysis of a randomized controlled trial on a brief version of psychiatric treatment for BPD, a treatment with a psychodynamic focus, the present study included N = 39 clients. One early session and one late session of the treatment were transcribed and analyzed using the CCRT method. Results: It appeared that pervasiveness of the predominant CCRT decreased over the course of the brief treatment; this effect was robust across treatment conditions. Change in pervasiveness in any CCRT component explained a small portion of variance of the decrease in borderline symptoms observed at the end of treatment. Discussion: Lessening of pervasiveness of problematic in‐session interpersonal patterns may be hypothesized as potential mechanism of effective treatment for BPD which should be tested in controlled designs. [ABSTRACT FROM AUTHOR]

Patients and therapists have somewhat divergent perspectives of alliance. Usually in psychotherapy research, the focus is on the patient's view of alliance, predicting parts of outcome. This study questions this hypothesis by applying the shape-of-change procedure to patient's and therapist's view of alliance-building processes in dynamic psychotherapy. The results of this naturalistic study indicate that none of the 3 patient patterns is related to outcome at the end of psychotherapy, but a specific therapist's pattern--out of 2--is linked to positive symptom change. These results are discussed in the context of present research on therapeutic alliance, especially in terms of level and process, its measurement, and potential in predicting outcome in dynamic psychotherapy. Keywords: therapeutic alliance, outcome, dynamic psychotherapy, process study, shape of change