Giancarlo Dimaggio

Centro di terapia metacognitiva interpersonale · Centro di Terapia Metacognitiva Interpersonale

In order to effectively treat individuals suffering from Narcissistic Personality Disorder (NPD), it is crucial to establish therapeutic goals and identify tasks to achieve them. However, this is a challenging process with NPD patients because they often struggle to find meaningful goals beyond the pursuit of status. Moreover, in order to change Fu...

Introduction Psychological distress may result in impairment and difficulty understanding oneself and others. Thus, addressing metacognitive issues in psychotherapy may improve psychopathology in adolescents and young adults (AYAs). We aimed to compare metacognitive interpersonal therapy (MIT)-informed psychotherapy with other treatment-as-usual (T...

Background Disrupted metacognition is implicated in development and maintenance of negative symptoms, but more fine‐grained analyses would inform precise treatment targeting for individual negative symptoms. Aims This systematic review identifies and examines datasets that test whether specific metacognitive capacities distinctly influence negativ...

Homework assignments, or specific tasks patients are asked to engage in or complete between sessions, are a controversial topic among psychoanalysts. While many argue these interventions contradict psychoanalytic principles, others believe they can help address problems and promote coping skills. We propose that homework can be a legitimate aspect...

Schizotypal personality disorder (SPD) is a severe condition in need of empirically supported treatment options. Although a recent review (Kirchner et al., Npj Schizophr 4:20, 2018) concluded that evidence-based recommendations cannot be made for the treatment of SPD, metacognitive interpersonal therapy (MIT) has displayed initial evidence of effec...

Eating disorders (ED) are serious disorders characterized by an alteration of eating habits and excessive concern about weight and body shapes (Fairburn, 2002), accompanied by significant impairment inequality of life, high mortality rates and serious organic consequences (Jenkins et al., 2011; Treasure et al., 2015; 2020). Although evidence-based...

In order to treat persons suffering from narcissistic personality disorder (NPD) it is necessary to agree on therapeutic goals and om tasks to undertake in order to meet them. This is difficult with NPD, as they have difficulties finding meaningful goals to strive for, other than the quest for status. Moreover, in order to change they need to expos...

Purpose: Negative symptoms are a persistent, yet under-explored problem in psychosis. Disturbances in metacognition are a potential causal factor in negative symptom development and maintenance. This meta-analysis uses individual participant data (IPD) from existing research to assess the relationship between negative symptoms and metacognition tr...

La presente rassegna delinea le indicazioni di buona pratica clinica per il trattamento psicologico del Disturbo Ossessivo-Compulsivo di Personalità (DOCP) sulla base dei dati presenti in letteratura riguardo al disturbo e agli studi di efficacia prodotti finora.Definiremo il disturbo e i criteri per la formulazione della sua diagnosi secondo il mo...

Il presente lavoro è partito da una rassegna dei contributi storici sulla concettualizzazione del narcisismo e del Disturbo Narcisistico di Personalità (DNP), evidenziando l'evoluzione in termini di diagnosi clinica all'interno della classificazione DSM sui disturbi mentali. Si è focalizzato sulla complessità del Disturbo Narcisistico di Personalit...

Questa review si concentra sugli aspetti diagnostici e sul trattamento del Disturbo Evitante di Personalità (DE). Gli studi attuali sottolineano la stretta relazione tra DE e Disturbo d'Ansia Sociale e la relativa stabilità dei sintomi oltre che l'impatto in termini sociali ed economici.Le scarse evidenze empiriche mostrano risultati promettenti pe...

Homework assignments in psychoanalysis are contentious; some believe they contradict psychoanalytic principles, while others argue they enhance coping skills. We propose that homework can be a legitimate aspect of relational psychoanalysis when used in a way that is attuned to the patient’s experience and that homework may be an important component...

The interplay between the therapeutic relationship and experiential techniques is powerful. The whole is more than the sum of its parts. Therapeutic relationship predicts therapy outcomes, especially when this involves shared goals, agreed methods, and a strong interpersonal bond. When patients feel safely held in a therapeutic relationship, they f...

Experiential techniques can be used to address maladaptive interpersonal patterns in patients with personality disorders (PDs) as long as they are delivered minding about the therapeutic relationship. We present the case study of Laura, a 38-year-old woman presenting with covert narcissism, generalized anxiety disorder, depression, and complicated...

The idea that the therapeutic relationship is at the core of psychotherapy is shared by most therapeutic approaches. Also, an increasing variety of therapeutic approaches, consider experiential techniques as central tools to promote effective therapeutic change. Commonly, it is argued that the creation of a positive, empathic, safe, and solid thera...

Background Schizotypal personality disorder is characterized by a pervasive pattern of maladaptive behavior that has been associated with the liability for schizophrenia. Little is known about effective psychosocial interventions. This pilot non-inferiority randomized controlled trial aimed to compare a novel form of psychotherapy tailored for this...

I pazienti con Disturbo Narcisistico di Personalità (DNP) possono provare senso di colpa e attuare specifiche strategie di fronteggiamento nel tentativo di gestire l'emozione. Le strategie più comunemente riscontrate nel funzionamento nel disturbo narcisistico di personalità sono l'espiazione, l'esternalizzazione della rabbia sugli altri e la rinun...

Background and aimsPatients with obsessive-compulsive (OC) disorder are impaired in disengaging attention from negative valence stimuli and show an attentional bias toward the right space. This pattern in OC disorder is similar to the impaired disengagement of attention from stimuli in the ipsilesional space as a consequence of a right-hemispheric...

Access to evidence-based early intervention for adolescents with psychosis is critically important. The aim of this work was analysing the feasibility, acceptability and potential effects of a psychological intervention based on metacognitive interpersonal therapy (MIT) in adolescents presenting with early psychosis. Twenty-three participants (aged...

This study aims at evaluating the effectiveness of an intensive 1-month residential treatment course in an Italian psychiatric unit for patients meeting criteria for personality disorders (PD). This study involved 189 patients consecutively admitted to the unit and assessed at admission and discharge. The inpatient program was based on Dialectical...

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Introduction: Early intervention studies for adolescents and early adults are required to explore the acceptability and effectiveness of psychological therapies across the full range of personality disorders (PDs) beyond just borderline PD. The main aim of the current paper was to describe a Metacognitive Interpersonal Therapy group adaptation for...

Intimate partner violence (IPV) is responsible for loss of lives and significant psychological, financial, and social costs. Research into therapeutic effectiveness show inconsistent results irrespective of therapeutic orientation. The capacity to understand one's own mental states as subjective and distinct from others is an important factor in th...

Avoidant personality disorder (AvPD) is a severe but understudied condition. The current pilot project reports data on acceptability and outcomes of a novel treatment combining biweekly individual metacognitive interpersonal therapy (MIT) and weekly mentalization-based therapy (MBT) group therapy. A total of 30 patients with AvPD were consecutively...

Young adults presenting with personality disorders (PDs) featuring overcontrol and social inhibition urgently require effective psychological interventions to help them navigate important life transitions. metacognitive interpersonal therapy-group (MIT-G) is a time-limited group program designed to enable individuals to find adaptive solutions to t...

Depression in personality disorders come from multiple sources, ranging from poor metacognition to maladaptive interpersonal schemas and dysfunctional coping strategies, such as avoidance or perfectionism. A modular treatment is needed in order to tackle with the different path leading to low mood in this population. Metacognition Interpersonal The...

Paranoid personality disorder (PPD) is a severe condition, lacking specialized and empirically supported treatment. To provide the clinician with insights into how to treat this condition, we present a case study of a 61‐year‐old man with severe PPD who presented with ideas of persecution, emotionally charged hostility, and comorbid antisocial pers...

Research using the integrated model of metacognition has suggested that the construct of metacognition could quantify the spectrum of activities that, if impaired, might cause many of the subjective disturbances found in psychosis. Research on social cognition and mentalizing in psychosis, however, has also pointed to underlying deficits in how per...

Individuals experiencing avoidant personality disorder (AvPD) tend to make sense of social interactions via ma-ladaptive self-and other attributions. They also experience difficulties in recognizing emotions. A further feature of AvPD psychopathology is the tendency to resort to mala-daptive coping strategies, such as behavioral avoidance and perfe...

Intimate partner violence (IPV) is responsible for significant social, psychological, and financial costs. The challenges in developing approaches that result in long-term change has been well documented. Outcome research into perpetrator treatment often portray varying degrees of success or otherwise. Metacognitive Interpersonal Therapy (MIT) offe...

The coronavirus COVID-19 and the global pandemic has already had a substantial disruptive impact on society, posing major challenges to the provision of mental health services in a time of crisis, and carrying the spectre of an increased burden to mental health, both in terms of existing psychiatric disorder, and emerging psychological distress fro...

Borderline personality disorder (BPD) is a severe disease, characterized by severe instabilities in identity, affect and relationships. Clinical improvement of BPD can be facilitated by psychotherapy aimed at tackling multiple specific cross-modality impairments and their patterns of interaction: impaired sense of self, maladaptive interpersonal sc...

The resistance of negative symptoms to pharmacologic treatment has spurred interest in understanding the psychological factors that contribute to their formation and persistence. However, little is understood about the psychological processes that reinforce and sustain the negative symptoms domain of diminished expression. Prior research has shown...

Psychotherapy for obsessive-compulsive personality disorder (OCPD), where perfectionism is a defining criterion, is understudied. Despite a high prevalence few evidence-based treatments are available for the presentation. Here we describe the course of a 6-month program of meta-cognitive interpersonal therapy with an OCPD patient with prominent per...

States of mind are forms of subjective experience that involve cognitions, emotions, needs, desires and physical sensations, subjectively, some charged with emotional suffering and some charged with well-being. This study presents a new questionnaire designed of States of Mind Questionnaire (SMQ), focused on the self-assessment of recurring pattern...

Avoidant Personality Disorder (APD) is the most prevalent diagnosis amongst the personality disorders. However, it remains under-researched, and few psychotherapeutic approaches have proven effectiveness in treating the disorder. Focusing on specific elements of psychopathology may therefore help in refining treatments for this disorder. Here we pr...

To build the evidence for a randomized controlled trial, a pilot study was conducted to investigate the feasibility, acceptability and effectiveness of a group-psychotherapy based on Metacognitive Interpersonal Therapy (MIT-G) for patients with personality disorders (PDs). Ten outpatients with PD diagnoses were offered 16 sessions of MIT-G delivere...

Perfectionism includes a tendency for high standards for self and others with a clear goal of successful performance in a variety of areas. A perfectionist often reacts with critical evaluations whenever performance falls below these standards. Moreover, perfectionists emphasize personal goals to gauge their worth, neglecting intimate bonds or open...

Auditory verbal hallucinations (AVHs) are perceptive-like experiences happening without appropriate stimuli that in individuals with schizophrenia very often feature distressing contents. AVH frequently interfere with social relationships or result in dangerous behaviours. We hypothesize that in schizophrenia several vulnerability factors, especial...

Mindreading is contingent upon interpersonal context. Little is known about how competitive contexts influence mindreading skills. The idea was that the capacity to think about mental states would decline when individuals experiencing failure in competition. This study aims to assess effects of a competitive experience (a computer competitive PC ga...

Gambling addiction (GA) is now considered a worldwide health issue. Although the topic of disorder awareness is a central issue in clinical practice, there are few studies examining this dimension in relation to GA. To bridge this gap, we conducted a qualitative study, administering interviews focused on awareness of GA and eliciting narratives of...

Background Healthy metacognition involves several capacities, including the ability to integrate information about the self and others in order to formulate ways of coping with social challenges and psychological distress. Multiple studies have demonstrated that reduced general metacognitive capacity is predictive of the development and persistence...

Background The resistance of negative symptoms to pharmacologic treatment has spurred interest in understanding the psychological factors that contribute to their formation and persistence. However, little is understood about the psychological processes that reinforce and sustain the negative symptoms domain of diminished expression. Prior research...

Las personas con trastornos de personalidad tienden a atribuir significados según patrones mentales estereotipados que les dificultan alcanzar una adaptación y satisfacción social. Estos patrones van más allá de ser meras representaciones cognitivas sobre uno mismo y los demás, sino que están repletos de emociones, disposiciones de conducta y exper...

This is a commentary on fifteen articles addressing some of the major emergent challenges in provision of mental health services during the COVID-19 pandemic crisis, offering telepsychiatry as a viable and elegant solution to maintaining psychotherapy within and post-pandemic. The papers in the special issue both build on existing telepsychotherapy...

Cognitive forms of Theory of Mind (ToM) have been linked to social function in Bipolar Disorder (BD). To explore this social functioning was assessed with the GAF and cognitive ToM was assessed with the Hinting Task and the Picture Sequencing Task (PST) in 45 patients with BP and 45 healthy controls. As predicted, the BD group took longer to comple...

La Terapia Metacognitiva Interpersonale (TMI) è stata formalizzata in particolare per pazienti con disturbi di personalità a prevalente sovra-regolazione emotiva e comportamentale. In questi pazienti gli aspetti di sofferenza sono innescati e sostenuti da schemi interpersonali maladattivi, metacognizione compromessa e conseguenti coping disfunziona...

The coronavirus COVID-19 and the global pandemic has already had a substantial disruptive impact on society, posing major challenges to the provision of mental health services in a time of crisis, and carrying the spectre of an increased burden to mental health, both in terms of existing psychiatric disorder, and emerging psychological distress fro...

Misophonia is a chronic condition in which specific sounds cause intense negative emotions and autonomic arousal. Misophonia is considered a psychological disorder without any relationship with specific alterations of hearing receptors and independent from physical characteristics of the sound. Moreover if misophonia can be defined as a specific ps...

According to proponents of Dialogical Self Theory (DST), the self is made up of a series of I-positions, which continuously interact, negotiating potential courses of action, and attributing meaning to events. Individuals with personality disorders tend to attribute meaning according to stereotyped dialogical relationship patterns which prevent the...

La ricerca empirica mostra un'associazione stretta tra buon funzionamento della relazione terapeutica e buon esito del trattamento. L'attenzione alla relazione terapeutica è uno dei fulcri della terapia metacognitiva interpersonale (TMI). In questo articolo, dopo aver sintetizzato gli aspetti fondamentali del modello, descriveremo come in TMI il la...

Impairments in metacognition or the ability to form integrated senses of self and others have been linked to deficits in laboratory-based measures of social functioning in schizophrenia. This study examined whether self-reported social functioning was related to metacognition in 88 adults in a nonacute phase of schizophrenia. Concurrent assessments...

Therapists self-disclose when they reveal personal information to the patient. Literature reports motivations for using self-disclosure and which information is more appropriate for this purpose. In spite of the potential usefulness of this strategy, indications about how to make it are often unclear and contradict each other. There is no a current...

Individuals with personality disorders experience worry and repetitive thoughts regarding interpersonal scenarios. Mainstream mindfulness-based approaches may be insufficient to soothe these individual's distress due to difficulties in letting thoughts go and refocusing attention to the present moment. For this reason, we devised an adapted form of...

Most patients present with a combination of symptoms and relational problems, but often psychotherapies are not conducted in a way to deal with both. Many therapists take a top-down approach to treatments. That is, the techniques they use are based on their theories of therapy (that suggest how certain diagnoses should be treated) rather than on an...

To change interpersonal patterns it is necessary both to change the knowledge about oneself and others in relationships, and to change the habits rooted in the body, in the form of motor patterns. Leading patients to create patterns of different actions, including the motor component, together with cognitive restructuring, produces truly effective...

Integrative case conceptualization means a wide use of relevant clinical constructs of different theoretical orientations to tailor treatment at individuals characteristics and needs. Research showed that transtheoretical self stances like psychological needs lie at the core of mental health and symptoms. Here we explore for the first time the asso...

Antisocial personality disorder (ASPD) has long been described focusing exclusively on behavioral features, like aggression. Although the role of mentalizing for aggression is well established, research on the role of mentalizing in ASPD remains limited. The present study examined the independent and interactive effects of mentalizing abilities and...

Schizotypal personality disorder represents a broad range of maladaptive behaviour, which has been linked to both personality disorder and schizophrenia spectrum disorders; however, to date, little effort has been devoted to developing psychosocial treatment approaches to address it. In response, we conducted two case studies exploring the effects...

Objective: The therapeutic alliance is possibly a crucial factor in treatment for borderline personality disorder (BPD). Among predictors of therapeutic alliance, aspects that have not yet been considered are metacognition or the patient’s capacity to be aware of mental states. We therefore explored whether metacognition predicted alliance and if m...

Personality disorders are common in most clinical settings and their presence can slow or disrupt the treatment process. The present paper examines central issues in the treatment of the anxious and fearful cluster of personality disorders. Treatment benefits from a strong focus on the therapeutic alliance, a sound plan for treatment, and a compreh...

Individuals with personality disorders (PD) demonstrate poor metacognition, here defined as the capacity to use mental state knowledge for regulation of interpersonal relationships. Metacognitive interpersonal therapy (MIT) targets the symptoms of PD via a series of formalized procedures. Its goal is to help individuals improve their metacognitive...

Personality disorders have a deleterious impact on individual quality of life, and are associated with a significant social burden. Despite a broad range of presentations across the various personality disorders, clinical research has shown a strong bias toward borderline personality disorder. In contrast to the emotional dysregulation of borderlin...

¿Para exponer o no exponer? El terapeuta integrador y el trastorno por estrés postraumático Actualmente, hay muchos tratamientos diferentes disponibles en el mercado para tratar el trastorno por estrés postraumático (TEPT). La Asociación Americana de Psicología sugiere que algunos de ellos tienen pruebas sólidas, mientras que otros solo pueden ser...

Objectives Recognizing and reflecting on one's own and other people's mental states represent a major difficulty for patients with borderline personality disorder (BPD). Only recently have studies begun exploring whether these capacities increase with successful therapies and if such an improvement is linked with outcome. The present study investig...

Patients with personality disorders (PDs) other than borderline, with prominent features of social inhibition and over-regulation of emotions, are in need of specialized treatments. Individuals present with poor metacognition, that is the capacity to understand mental states and use psychological knowledge for the sake of purposeful problem solving...

Background/aims: Disturbances in first person experience is a broadly noted feature of schizophrenia, which cannot be reduced to the expression of psychopathology. Yet, though categorically linked with profound suffering, these disturbances are often ignored by most contemporary treatment models. Methods: In this paper, we present a model, which...

A persecutory delusion (PD) is a person's false belief that others are focusing their attention on him or her with malevolent intentions, which often results in intense anxiety and significant disruption of daily life. PDs are common in schizophrenia, and many patients with schizophrenia do not respond well to current pharmacological treatments. Th...

Adherence to antiretroviral therapy (ART) is a key issue for people with human immunodeficiency virus. Optimal adherence leads to benefits in terms of survival and quality of life, which do not occur with incomplete adherence. One factor that may influence adherence to ART is emotional unawareness deficits. To explore this possibility, we assessed...

A pilot study of the effects of metacognition-oriented social skills training (MOSST) on social functioning in patients with schizophrenia spectrum disorders (SSDs) reported promising results. The main purpose of the current trial was to compare the effectiveness and potential benefits of MOSST vs conventional social skills training (SST). Single-b...

Patients with personality disorders suffer from impairment in self-reflective capacities. This is not a matter of making incorrect judgments about self-experience but reflects problems with (a) labeling internal experience consistent with the type and level of bodily arousal, (b) seeing how thoughts and feelings are connected to one another within...

The present study was designed to test an emotion regulation framework to understand individual differences in personality disorder (PD) traits in a non-clinical sample. Specifically, we tested whether: selected dimensions of emotion dysregulation were differentially related to PD traits; and whether emotion dysregulation and impulsivity had indepe...

Young adults with personality disorders (PD) other than borderline are in urgent need of validated treatments to help them in managing important life transitions. Therapeutic interventions focused upon social and interpersonal difficulties may facilitate these individuals in maximizing opportunities for employment, forming stable romantic relations...

Background and Aims Some individuals with Personality Disorders (PD), particularly of a non-Borderline type, present with difficulties relating to over-control of cognitions, emotion and behavior, perfectionistic traits, and impaired social interactions. The current study sought to evaluate the strength of association, and interactions of both emot...

Metacognitive interpersonal therapy (MIT) is an integrative psychotherapeutic approach targeting personality disorders (PDs) featuring inhibition and avoidance. The current case series reports the outcome of a time-limited, 12-month MIT intervention for people with PDs featuring emotional inhibition. Seven participants were diagnosed with a PD on t...

Metacognición: Un Mecanismo Potencial de Cambio en la Psicoterapia de los Perpetradores de Violencia Doméstica La perpetración de violencia doméstica contra individuos es responsable de un dolor indecible, sufrimiento y la mortalidad prematura. Investigaciónes en la efectividad de resultados de intervenciones para perpetradores muestran resultados...

Treatment adherence by patients with HIV ensures they gain the full benefit of antiretroviral medications and