Rowlandkolding2745
Patient 1 showed reliable to clinically significant improvements on several quantitative symptom levels and with consistent qualitative findings (e.g., semistructured therapist interview). Symptoms of Patient 2 remained mostly unchanged, while life satisfaction and posttraumatic growth reliably improved and qualitative measures pointed to a reduction of suffering. The studies illustrate that reminiscence can be used in adaptive ways even after the experience of massive traumatization. The coexistence of resilience and vulnerability, complex individual symptom profiles, and influencing factors are discussed. (PsycInfo Database Record (c) 2021 APA, all rights reserved).A review of high intensity, high dose mentalization-based inpatient psychiatric treatment indicated large effect-size reductions in symptoms of depression, anxiety, somatization, and improving emotion-regulation functioning (Allen et al., 2017). This study examined the impact of pathological personality traits has on baseline symptoms and functioning, as well as their impact on the longitudinal course in a large cohort of adult inpatient psychiatric sample (N = 804). The Personality Inventory for DSM-5 (PID-5; Krueger et al., 2012) was used to assess trait domains impact on longitudinal outcomes (anxiety, depression, somatic symptoms, and functional impairment) using hierarchical repeated measures modeling. Results indicate Negative Affectivity and Detachment were related to higher admission severity in all four outcome domains. Psychoticism was related to somatic symptoms, while Antagonism and Disinhibition were related to functional impairment. Paradoxically, when symptoms were plotted over 2-week intervals during hospitalization, patients with higher admission PID-5 trait scores exhibited greater improvement over time. The PID-5 appears to contribute to prediction of treatment outcome response above and beyond demographic and burden of illness. Importantly, the findings add to a growing body of literature indicating that impairments in personality traits do not preclude positive treatment response, particularly when treatments target pathological personality features. (PsycInfo Database Record (c) 2022 APA, all rights reserved).Most research to date with Interpersonal Reconstructive Therapy (IRT Benjamin, 2006) involves application with patients who qualify for the acronym "CORDS" Comorbid, Often Rehospitalized, Dysfunctional, and Suicidal. A case formulation (CF) based on interpersonal copy process theory defines links between presenting symptoms and patterns of affect, cognition, and behavior that invoke safety or threat and were learned and internalized in close relationships. The "gift of love" (GOL) hypothesis is that the wish to receive love and acceptance from specific internalized attachment figures organizes and propels problem patterns and their associated symptoms. Through a series of steps, IRT seeks to help patients become aware of and learn about their copied patterns, including where they were learned, the role they play in maintaining connection with internalized attachment figures, and their functions in the present. The goal is to help a patient differentiate from their "family in the head" and pursue healthy behaviors and self-concepts. With awareness and differentiation comes the possibility of letting go of problematic quests for love and acceptance from the internalized attachments and to choose healthy alternatives instead. As an integrative method, safety planning in IRT shares much with other approaches. What is unique is how therapists utilize the CF to guard against unsafe behavior as an ongoing part of the treatment process with patients with suicidality. This article provides an overview and illustration emphasizing these unique aspects of the IRT approach to safety planning in the context of individual psychotherapy with adults. (PsycInfo Database Record (c) 2021 APA, all rights reserved).Suicidal ideation (SI) is a highly prevalent public health issue in the veteran population and is increasingly common in veterans who are diagnosed with other mental health conditions, such as posttraumatic stress disorder (PTSD; U.S. Department of Veterans Affairs, 2020). The present study has an initial aim of examining changes in SI over treatment, and it is hypothesized that SI will decrease across PTSD treatments. A second aim is to examine the association of SI status with PTSD symptoms across treatment, and it is hypothesized that PTSD symptomatology will decrease at similar rates over the course of treatment for those who did and did not endorse SI at pretreatment. Akt inhibitor Participants included 717 (86.3% male) veterans who participated in outpatient treatment within a Veterans Affairs Post Traumatic Stress Disorder (VA PTSD) specialty clinic between July 2014 and December 2017. Descriptive analyses found that 37.2% of veterans endorsed SI at pretreatment, while 18.6% endorsed SI at posttreatment. The relationship between pre- and posttreatment SI was significant, χ²(1, N = 247) = 23.77, p less then .001. A significant proportion of veterans who endorsed SI at pretreatment no longer endorsed SI at posttreatment (64.7%). There were no differences in changes in PTSD Checklist for DSM-5 (PCL-5) scores across treatment for those with and without SI at pretreatment. While those who endorsed SI at pretreatment had higher PCL-5 scores throughout treatment, they experienced a similar rate of improvement in symptoms as those without SI at pretreatment. This finding suggests that the presence of SI does not reduce the effectiveness of PTSD treatment. Limitations include the use of a single-item measure of SI, lack of adequate power to detect difference among treatments, and a cross-sectional design. Clinical and research implications are discussed. (PsycInfo Database Record (c) 2021 APA, all rights reserved).Many patients evince significant post-traumatic stress disorder (PTSD) symptoms after a dose of an evidence-based treatment (EBT) for PTSD. Little research systematically addresses if individual PTSD symptoms are more or less resistant to change through an EBT for PTSD or have greater or lesser post-treatment severity levels. Two studies within VA medical centers provided data. Study 1 (n = 81) was drawn from a randomized clinical trial of Prolonged Exposure (PE), an EBT for PTSD. Study 2 (n = 225) was drawn from two PTSD specialty clinics employing PE. Symptoms were assessed pre- and post-treatments via semi-structured clinician interview (Study 1) and patient self-report (Studies 1 and 2). Most individual symptoms reduced about the same amount through the course of treatment except for avoidance, which showed greater reductions. High heterogeneity in post-treatment symptom severity was found with troubled sleep and hypervigilance displaying above average levels, and traumatic amnesia, foreshortened future, and flashbacks displaying below average levels. Method of symptom measurement had a modest impact on results, as semi-structured clinical interview results were moderately more differentiated than self-report measures. Results were generally consistent between an efficacy (i.e., extremely high, potentially artificial methodological control) and effectiveness (i.e., relatively more real world) context. Primary limitation is analysis of single items on semi-structured clinician interview and patient self-report scale when psychometric validation studies did not interpret measures this way. Moreover, DSM-IV criteria for PTSD were assessed. EBT augmentation and new treatment development should focus on further reducing both PTSD symptoms in general and on the specific symptoms of troubled sleep and hypervigilance, which persist to a greater degree. (PsycInfo Database Record (c) 2021 APA, all rights reserved).People regularly interact with new acquaintances, yet little research has examined the hedonic dynamics of these conversations or the extent to which people are aware of them. Five preregistered laboratory experiments (N = 1,093 participants, including 966 spoken conversations) address these gaps. We find that people misunderstand the hedonic trajectory of conversation After enjoying the initial minutes of conversation with a new acquaintance, participants expected their enjoyment to decline as their conversations continued, but experienced stable or increasing enjoyment in reality. This miscalibration arose at least partly because participants underestimated how much they would have to discuss. Thus, instructing participants to mentally simulate the conversation in detail drew their attention to the conversation material they could discuss and helped to calibrate their enjoyment predictions. When left uncorrected, misunderstanding the hedonic trajectory of conversation can undermine well-being. In one study, participants preferred to spend less time in conversation and more time alone than was optimal for their enjoyment-a finding that emerged even among participants who reported wanting to enjoy themselves. Throughout our experiments we assessed various conversational contexts (including whether participants had one long conversation with a single partner or several short conversations with different partners), and features of conversation (including participants' perceived and actual interest in talking to each other, fatigue, and the intimacy of conversation), thus shining novel light on conversational dynamics more broadly. People hold incorrect assumptions about how social interaction changes over time and, consequently, may avoid longer-lasting conversations that would forge closer connections. (PsycInfo Database Record (c) 2021 APA, all rights reserved).The present research investigates whether and how mindfulness meditation influences the guilt-driven tendency to repair harm caused to others. Through a series of eight experiments (N > 1,400), we demonstrate that state mindfulness cultivated via focused-breathing meditation can dampen the relationship between transgressions and the desire to engage in reparative prosocial behaviors. Experiment 1 showed that induced state mindfulness reduced state guilt. Experiments 2a-2c found that induced state mindfulness reduced the willingness to engage in reparative behaviors in normally guilt-inducing situations. Experiments 3a and 3b found that guilt mediated the negative effect of mindfulness meditation on prosocial reparation. Experiment 4 demonstrated that induced state mindfulness weakened the link between a transgression and reparative behavior, as well as documented the mediating role of guilt over and above other emotions. Finally, in Experiment 5, we found that loving kindness meditation led to significantly more prosocial reparation than focused-breathing meditation, mediated by increased other-focus and feelings of love. We discuss theoretical and practical implications. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
This project aimed to develop a synthesized framework of multidimensional wellness for people aging with serious mental health conditions (SMHC) using existing frameworks to serve as a guide for policy and interventions to address the unique needs, experiences, and strengths of the population.
A concept analysis compared a widely used wellness approach (Swarbrick, 1997) for people with SMHC and one for older adults (Fullen, 2019) to synthesize into a practical framework for people aging with SMHC.
Nine dimensions were proposed for conceptualizing the wellness of this population including (a) Developmental, (b) Intellectual/Cognitive, (c) Physical, (d) Emotional, (e) Social, (f) Occupational, (g) Spiritual, (h) Environmental, and (i) Financial. Practical suggestions for implementation are identified. Conclusions and Implication for Practice People aging with SMHC require rehabilitation services that address their unique perspectives, strengths, and challenges. The proposed adapted wellness framework offers a guide to comprehensively address well-being in people aging with SMHC.