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ABSTRACT: The objective of this study was to assess the prevalence of decreasing, consistent and increasing reports of sexual and physical abuse after 12 months of long-term psychological treatment of personality disorders, to investigate demographic and clinical characteristics predictive of inconsistency of reporting abuse, and to explore whether autobiographical memory may account for this inconsistency. In 229 clinical participants with an SCID II diagnosed personality disorder, 180 (78.6%) reported the same instances of invasive sexual and/or physical abuse on a trauma questionnaire (SPAQ) at baseline and follow-up, 25 (10.9%) decreased and 24 (10.4%) increased their abuse reports. Consistency of reporting abuse did not differ between schema-focused therapy, clarification-oriented psychotherapy and treatment-as-usual. Current depressive episode (SCID-I) and decreased capacity to produce specific negative memories on the Autobiographical Memory Test were characteristic of decreasing abuse reporters, while increasing abuse reporters showed higher levels of Cluster A personality pathology (in particular schizotypal traits) on the Assessment of DSM-IV Personality Disorders (ADP-IV). These results suggest that even in treatment procedures directed at exploring someone's personal past with abuse-related imagery consistency of reporting abuse is quite stable. However, certain clinical characteristics may make some persons more likely to change their trauma reports. Moreover, reduced negative memory specificity may represent an avoidant strategy associated with no longer reporting instances of abuse.
Journal of behavior therapy and experimental psychiatry 12/2012; 43 Suppl 1:S43-50. · 2.48 Impact Factor
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ABSTRACT: We sought to investigate the relationships between negative family factors such as insecure attachment and adverse parental rearing, and internalizing and externalizing symptoms in a large sample of non-clinical children (N = 237) aged 9 to 12 years. All children completed a set of self-report questionnaires including a single-item measure of attachment style towards the mother and the father as well as an index of perceived parental rearing behaviors. Further, measures of internalizing symptoms (e.g., anxiety and depression) and externalizing symptoms (e.g., aggression) were completed. Results showed that perceived rearing behaviors of both mother and father (in particular rejection and anxious rearing) consistently accounted for a significant proportion of the variance in internalizing and externalizing symptoms. Attachment style was found to play a less prominent role. Some support for gender-specific relationships was found, indicating that the presence of negative family factors in fathers had more impact on symptoms in boys, whereas the presence of such factors in the mothers had more influence on symptoms in girls. Altogether, these results suggest that in addition to common pathways by which both parents promote psychopathological symptoms in children, there may also be separate pathways by which the father or the mother may have a unique impact on the development of such symptoms in boys or girls respectively.
Journal of Child and Family Studies 04/2012; 15(3):319-332. · 1.12 Impact Factor
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ABSTRACT: Word use has been shown to reflect various psychological processes and psychological change. This study examines the self-view in personality disorders (PDs) and its change over the course of therapy using the Linguistic Inquiry and Word Count analysis procedure. A sample of 299 participants with PDs and 108 community control participants wrote short essays about their lives. Patients repeated the assignment three times over two years and completed assessments of PD-pathology, general psychopathology, PD-beliefs, and quality of life. Results show that as hypothesized the use of words in the 1st Person Singular Pronouns, Negative Emotion, Causation, Past and Future Tense Verbs categories significantly declines over the course of treatment, while the use of Present Tense Verbs and Positive Emotion increases. These categories tend to distinguish patients from non-patients prior to treatment. We also found 12 additional word categories changing over time, including Word Count and Negations. Change in word use statistically predicts better treatment outcome on all outcome measures (p < .001). Reductions in the use of Negative Emotion Words and Negations are the strongest predictors of outcome. The non-hypothesized role of Negations was explored and seemed to reflect that PD-patients miss a lot in their lives. Reduction of what they miss seems central to recovery. This issue seems relatively neglected in theoretical and treatment models of PDs. An increased focus on what patients miss in their lives might improve our understanding and treatment of PDs. In sum, Negative Emotion and Negation word categories appear to reflect key treatment targets.
Behaviour research and therapy 01/2012; 50(3):191-202. · 3.00 Impact Factor
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ABSTRACT: In a recent study, Rude, Gortner, and Pennebaker (2004) found word use to be related to depression and vulnerability to depression in the essays of college students. We sought to replicate and extend these findings in a clinical sample. Written essays of 304 psychiatric outpatients with a personality disorder and a mixed psychiatric profile on DSM-IV axis-I and 108 healthy controls were examined with word count software. Data on the tendency to be discrepant about the current self compared to a more ideal self were also gathered. We found that psychiatric outpatients in general used more words referring to the self and negative emotion words and fewer positive emotion words, compared to healthy controls. However, word-use proved unrelated to depression specifically. Actual-ideal self discrepancies were related to patient status and to current depression. Contrary to our hypothesis, these discrepancies did not correlate with the use of words referring to the self. We conclude that the negative content and self-focus of written essays and high levels of discrepancy reflect a negative thinking style that is common to a range of psychiatric disorders rather than being specific to depression.
Behaviour research and therapy 09/2009; 48(1):44-51. · 3.00 Impact Factor
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ABSTRACT: The study objective was to investigate whether, compared with nonclinical controls, participants with an avoidant, dependent, or obsessive-compulsive Cluster C personality disorder (PD) manifested reduced levels of memory specificity and whether the association of Cluster C PDs with memory specificity is mediated by repetitive negative thoughts and experiential avoidance. The Autobiographical Memory Test (R. J. McNally, N. B. Lasko, M. L. Macklin, & R. K. Pitman, 1995) was administered along with self-report measures (translated into Dutch) for repetitive, uncontrollable, and negative thinking in the form of worry (Penn State Worry Questionnaire; T. J. Meyer, M. L. Miller, R. L. Metzger, & T. D. Borkovec, 1990) and experiential avoidance (Acceptance and Action Questionnaire; S. C. Hayes et al., 2004) to 294 clinical participants diagnosed with Axis I disorders (assessed with the Structured Clinical Interview for DSM-IV Axis I Disorders [SCID-I]; M. B. First, R. L. Spitzer, M. Gibbon, & J. B. W. Williams, 1994) and Axis II disorders (assessed with the SCID-II; M. B. First, R. L. Spitzer, M. Gibbon, & J. B. W. Williams, 1997)--202 with avoidant, 49 with dependent, and 120 with obsessive-compulsive PD--and to 108 matched nonclinical controls. Participants with a Cluster C PD showed lower levels of memory specificity than did nonclinical controls. Depression and worry mediated the effect of Cluster C PDs on memory specificity. Besides depression severity, repetitive, uncontrollable, and negative thinking may constitute a general mechanism mediating the association of various Axis I and II disorders with memory specificity.
Journal of Abnormal Psychology 08/2009; 118(3):520-30. · 4.86 Impact Factor
