Bulletin of the Menninger Clinic (B MENNINGER CLIN )

Publisher: Menninger Clinic; Menninger Foundation, Guilford Press


The Bulletin of the Menninger Clinic offers a psychodynamic perspective on the application of theory and research in outpatient psychotherapy, hospital treatment, education, and other areas of interest to mental health professionals. This widely indexed, peer-reviewed journal has been published since 1936 by the Menninger Clinic, a nonprofit international mental health center. Occasional topical issues focus on critical subjects, providing an in-depth look at complex treatment dilemmas. Recent topics issues have covered assessment and treatment of psychiatric disorders in the elderly, integrating outcome measurement with clinical practice, and treatment of anxiety disorders.

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    Bulletin of the Menninger Clinic
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Guilford Press

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Publications in this journal

  • [Show abstract] [Hide abstract]
    ABSTRACT: Obsessive-compulsive disorder (OCD) is a debilitating condition that does not always respond well to treatment. People with OCD often require a great deal of assistance from caregivers or family members, which is referred to as family accommodations. Caregivers may experience a great deal of stress, depression, and other problems as a result of caring for their loved one with OCD. They may have decreased relationship satisfaction due to the accommodations required by their family member. The present study examines the experience family members have of caring for someone with OCD and how it relates to caregiver burden, relationship satisfaction, and level of family accommodations. Participants for this study included 50 caregivers of individuals with OCD. Analyses were primarily correlational in nature. Results found that high relationship satisfaction was correlated with caregiver burden and OCD severity.
    Bulletin of the Menninger Clinic 10/2014;
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    ABSTRACT: This is the first study to demonstrate the existence of a relationship between patient pretreatment object relations functioning as measured by the Mutuality of Autonomy (MOA) Scale and patient-rated therapeutic alliance. Specifically, MOA scores were related to a patient-rated alliance Bond score (lower, more adaptive object-relations representations were associated with a stronger alliance). In addition, higher MOA scores indicating more malevolent object relations were related to a greater use of psychodynamic techniques. Specific psychodynamic techniques focused on the patient's relationships with the therapist as well as cyclical patterns in actions, feelings, and experiences. Implications for clinical practice and future research are discussed.
    Bulletin of the Menninger Clinic 09/2014; 78(3):197-227.
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    ABSTRACT: Experiential avoidance (EA) involves an unwillingness to remain in contact or experience unpleasant private events through attempts to avoid or escape from these experiences. EA is hypothesized to play a role in obsessive-compulsive disorder (OCD); however, previous studies have not found a significant relationship between EA and OCD severity. The present study examined the relationship between EA and OCD severity as measured by an updated measure of EA, an established measure of OCD severity (i.e., the Obsessive-Compulsive Inventory-Revised [OCI-R]), and a new measure of OCD symptom dimension severity, the Dimensional Obsessive-Compulsive Scale (DOCS). A sample of 83 nonreferred individuals meeting criteria for OCD completed the measures. Correlations between EA and the OCI-R corroborated previous findings; however, EA was significantly correlated with the DOCS. There were differences across the symptom dimensions, with EA significantly correlated with unacceptable thoughts, responsibility for harm, and symmetry, but not with contamination.
    Bulletin of the Menninger Clinic 09/2014; 78(3):253-269.
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    ABSTRACT: Electronic cigarettes (e-cigarettes) are nicotine-delivery devices that are increasingly used, especially by young people. Because e-cigarettes lack many of the substances found in regular tobacco, they are often perceived as a safer smoking alternative, especially in high-risk situations such as pregnancy. However, studies suggest that it is exposure to nicotine that is most detrimental to prenatal development. The authors studied perceptions of tobacco and e-cigarette health risks using a multiple-choice survey. To study the perceived safety of e-cigarettes versus tobacco cigarettes, 184 modified Global Health Youth Surveys (WHO, http://www.who.int/tobacco/surveillance/gyts/en/ ) were completed electronically or on paper. Age range, smoking status, and perceptions about tobacco cigarettes and e-cigarettes were studied. The results verified that younger people use e-cigarettes more than older people. Tobacco cigarettes were perceived as more harmful than e-cigarettes to health in general, including lung cancer and pregnancy. Although more research is necessary, the authors postulate that the perception that e-cigarettes are safer during pregnancy may induce pregnant women to use these devices more freely. Given that nicotine is known to cause fetal harm, pregnant mothers who smoke e-cigarettes could cause even greater harm to the fetus because e-cigarettes are perceived as being safer than tobacco cigarettes. Until more data about the effects of nicotine during pregnancy are available, the authors advocate for labeling of e-cigarettes as potentially harmful, at least during pregnancy.
    Bulletin of the Menninger Clinic 09/2014; 78(3):243-252.
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    ABSTRACT: Relationships between Axis II personality disorders and Sidney Blatt constructs of dependency and self-criticism were explored in a late adulthood women sample. The sample consisted of 102 women (M = 72.07 years of age, SD = 7.04) who were administered two measures, the Personality Diagnostic Questionnaire-4+ and the Depressive Experiences Questionnaire. The histrionic, dependent, and obsessive-compulsive personality disorder scales are shown to be significant predictors of dependency, and the narcissistic, borderline, and avoidant scales are significant predictors of self-criticism. The application of a dimensional interpersonal approach to psychopathology is discussed.
    Bulletin of the Menninger Clinic 08/2014;
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    ABSTRACT: Deliberate self-harm (DSH) in young people is a clinical and social problem related to early maltreatment but with little specificity in type of care or abuse determined. A community sample of 160 high-risk young people (aged 16-30) were the offspring of mothers' previously interviewed as vulnerable to major depression. The youth were interviewed to determine DSH (both suicidal and nonsuicidal), childhood maltreatment (using the Childhood Experience of Care and Abuse interview) and major depression (using SCID for DSMIV) before age 17. Around one fifth reported DSH; equal proportions were suicidal and nonsuicidal with a fourth of these with both. DSH was highly related to family context (single mother upbringing and family discord) and poor parental care (including antipathy, neglect, inadequate supervision, and role reversal). Highest odds ratios were for role reversal (OR = 17) and neglect (OR = 11). DSH was unrelated to any type of abuse. Logistic regression showed that role reversal, inadequate supervision, and teenage depression all modeled DSH. There was some specificity, with single mother upbringing, role reversal, and inadequate supervision predicting nonsuicidal DSH, and neglect and role reversal alone predicting suicidal DSH. Role reversal remained a key predictor for both types of DSH when controls were applied. Poor childhood care, which has implications for problematic emotion regulation and empoverished social development, needs to be understood to improve interventions and treatment for DSH in young people.
    Bulletin of the Menninger Clinic 06/2014; 78(2):95-114.
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    ABSTRACT: Many psychoanalysts have offered innovative ideas on the treatment of schizophrenic patients, but none on postpsychotic depression. The author presents a psychoanalytic conceptualization of postpsychotic depression based on Kohut's ideas regarding the development of normal and pathological grandiosity. The main premise is that postpsychotic depression stems from the loss of psychotic grandiosity, and that it is the psychological reaction to the loss of omnipotent identity whose role it is to provide an alternative reality. Through near-experience connectedness, clinicians and practitioners in the psychiatric rehabilitation field can facilitate an empathic milieu in which new mental constructs can be established and new behavioral skills can be learned.
    Bulletin of the Menninger Clinic 03/2014; 78(1):70-86.
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    ABSTRACT: The authors' clinical experience with young girls with Mayer-Rokitansky-Kuster-Hauser syndrome (MRKH), who are facing the often hastily suggested, and accepted, surgical treatment of vaginal reconstruction brings new light to the question of female sexuality and its specific modes of access: its traumatic aspects, the mother-daughter conflict of ambivalence and the associated risk of depression, as well as the importance of the relational factor in the construction of bodily interiority.
    Bulletin of the Menninger Clinic 03/2014; 78(1):57-69.
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    ABSTRACT: This article proposes an understanding of children with reactive attachment disorder (RAD) through psychoanalytic thought and mentalization theory. RAD is presented followed by a discussion on attachment and the need for a better understanding of this disorder. Theories from British psychoanalytic thinkers are used to describe what might be transpiring in the early relationship between mother and child. Particular attention is given to how children's internal objects are influenced by a compromised early mother-child relationship.
    Bulletin of the Menninger Clinic 03/2014; 78(1):34-56.
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    ABSTRACT: Interpersonal trust is fundamental for the recovery of trauma survivors and the effectiveness of group psychotherapy. Yet there is limited research on the relationship between interpersonal trust and group psychotherapy. Twenty-one male Vietnam combat veterans with posttraumatic stress disorder (PTSD) (6 in a long-term process group [LTP], 10 in a short-term cognitive processing therapy group [CPT], and 5 treatment-as-usual controls) were evaluated before and after group psychotherapy using the Posttraumatic Stress Disorder Checklist-Military Version (PCL-M) and an in-vivo measure of interpersonal trust, the Iterated Trust Game. Three (14.3%) of the veterans were African American, 9 were Caucasian (42.9%), and 9 were Hispanic (42.9%); they averaged 61.9 years of age (SD = 1.8 years). Change in PCL-M scores differed by group (controls: -1.0 ± 3.7; CPT: -15.5 ± 6.8; LTP: -1.3 ± 12.2; p = .003). CPT group subjects improved more than controls (p < .001) and trended toward more improvement than the LTP group (p = .081). Members of the LTP group, compared to nonprocess group participants, showed greater initial (p = .042), and posttherapy trust (p = .003). Posttreatment, interpersonal trust was significantly higher in the LTP than the CPT group (p < .001). These results suggest that CPT treatment may be better than LTP treatment for improving PTSD symptoms, but LTP therapy may be better than CPT therapy for improving interpersonal trust in veterans with PTSD. They suggest important roles for both group treatments and point to the value of interpersonal trust in successful recovery from PTSD.
    Bulletin of the Menninger Clinic 01/2014; 78(4):335-48.
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    ABSTRACT: Contemporary psychology and psychiatry have increasingly focused on hope as a human phenomenon relevant to physical and psychological well-being. Contemporary psychological research, however, often considers hope anthropocentrically and cannot speak directly of the particular cultural, religious and theological sustaining contexts of hope that, especially for persons of faith, give hope its shape and meaning. In this paper I focus on three articulations of hope within Jewish and Christian tradition-the Summa theologiae of Thomas Aquinas, the lament psalms of the Hebrew Bible, and the post-Holocaust writing of Emil Fackenheim-to argue that attention to these sustaining contexts is essential for understanding what religious traditions mean by hope. Religious traditions display insights and practices related to hope that both complement and challenge contemporary psychological approaches to hope. Close attention to these determinative traditions can therefore enrich and deepen the treatment of hope within contemporary psychotherapeutic practice.
    Bulletin of the Menninger Clinic 12/2013; 77(4):369-94.
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    ABSTRACT: Spiritual awakening is inherent to development in the second decade, as reflected not only in millennia of religious faith traditions and indigenous culture but also in recent genetic-twin and epidemiological studies. Developmentally concomitant with spiritual awakening is the window of onset for the most prevalent forms of adolescent suffering in post-industrial societies: depression and related substance abuse and risk taking. Over the past fifteen years, spirituality-a lived relationship with a Higher Power-has been found to be the most robust protective factor against depression known to medical and social sciences. The magnitude of the protective effect and its timing in adolescence raises the question of a singular process or shared biological substrate underlying spiritual awakening and onset of depression. Evidence for such a shared physiology comes from a recent magnetic resonance imaging (MRI) study suggesting that depression and spirituality in youth reveal "two sides of the same coin."
    Bulletin of the Menninger Clinic 12/2013; 77(4):332-48.
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    ABSTRACT: A growing body of research has highlighted the value of spiritual resources for patients and their families. However, spirituality has been largely overlooked as a source of hope and support for providers themselves. In this paper, the author draws on theory, research, and practical examples to suggest that spirituality could potentially assist providers struggling to generate and sustain their own hope in work with clients who are in the midst of despair. The paper focuses on three ways practitioners might access spiritual resources to facilitate hope in their work: (1) by illuminating the sacred character of mental health work; (2) by attending to the sacred dimension of clients' lives; and (3) by attending to the experience of sacred moments in the healing relationship. These resources may be of value not only to theistically-oriented practitioners but to nontheists as well.
    Bulletin of the Menninger Clinic 12/2013; 77(4):395-412.
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    ABSTRACT: Using Karl Menninger's and Paul Pruyser's seminal writings, the author reviews the tradition of thought about hope at The Menninger Clinic and discusses the application of this tradition to patient education. From the perspective of contemporary attachment theory and research, he expands on Paul Pruyser's view of hope as based on an experience of benevolent connection. Such connection can be found-and disrupted-in attachment to God and in spirituality more broadly. The article concludes with commentary on the challenges clinicians face in making use of religion and spirituality as a resource for fostering hope.
    Bulletin of the Menninger Clinic 12/2013; 77(4):302-31.