2020

  • Benjamin N Johnson, Tracy L Clouthier, Lia K Rosenstein, Kenneth N Levy (2020) Psychotherapy for Personality Disorders

    The terms pampering and spoiling have roots within early psychoanalytic literature, and over time they have become a part of the vernacular. This entry will focus on pampering/spoiling as described in psychoanalytic literature and address the following: the mechanics of pampering/spoiling, why it might happen, and the possible risks for development.

  • Susanne Hörz, Diana Diamond, John F Clarkin, Kenneth N Levy, Michael Rentrop, Melitta Fischer Kern, Nicole M Cain, Stephan Doering (2020) Características clínicas del trastorno comórbido de la personalidad narcisística en pacientes con trastorno límite de la personalidad

    Pages 44-52

    Journal: RET: revista de toxicomanías 

    Issue 84

    Este estudio examina la psicopatología y las características clínicas de pacientes con trastorno límite de la personalidad (TLP) y trastorno de personalidad narcisista comórbido (TPN) de dos ensayos controlados aleatorizados internacionales. De una muestra combinada de 188 pacientes con TLP, 25 también cumplían los criterios para un diagnóstico comórbido de TPN de acuerdo con el DSM-IV. Los pacientes con TLP y TPN comórbido, en comparación con los pacientes con TLP sin TPN comórbido, mostraron significativamente más criterios de TLP (M= 7, 44 vs. M= 6, 55, p< 0,001), cumplían más criterios de comorbilidad histriónica (M= 3, 84 vs M= 1, 98, p< 0,001), paranoide (M= 3, 12 vs M= 2, 27, p= 0,014) y esquizotípica (M= 1, 64 vs. M= 1, 02, p= 0,018) trastornos de la personalidad y era más probable que cumplieran con los criterios para el diagnóstico de TP histriónico completo (44, 0% vs. 14, 2%, p< 0,001). El grupo TLP-TPN también reportó significativamente menos hospitalizaciones psiquiátricas en el año anterior (M= 0, 40 vs M= 0, 82, p= 0,019) y menos trastornos del eje I (M= 2, 68 vs M= 3, 75, p= 0,033). No se pudieron encontrar diferencias en el funcionamiento general, la conducta de autolesión y los intentos de suicidio.

  • Comments on the original chapter by P. Fonagy et al.(see record 2020-10989-069) regarding contemporary psychodynamic treatments (PDTs) for personality disorders. In this commentary, the author highlights some of the points that he think could have had more emphasis in stressing the unique contributions and utility of a psychodynamic approach. Psychodynamic approaches to personality disorders, although diverse, all share certain basic tenets. Arguably there may be additional tenets for consideration, but the author focuses on the following:(1) that early childhood relationships with caregivers play an important role in shaping how we experience and view subsequent relationships (this is the idea of transference);(2) that some mental processes, such as motives, desires, and memories, are not readily available to awareness or conscious introspection (the idea of the unconscious);(3) people are sometimes …

  • Yogev Kivity, Kenneth N Levy, Stéphane Kolly, Ueli Kramer (2/2020) The therapeutic alliance over 10 sessions of therapy for borderline personality disorder: Agreement and congruence analysis and relation to outcome

    Journal: Journal of personality disorders

    Volume: 34 Issue: 1

    Pages: 1-21 

    The authors examined whether alliance dynamics are affected by tailoring the therapeutic relationship to the individual patient in brief psychotherapy of borderline personality disorder. Sixty patients were randomized to 10-session Good Psychiatric Management (GPM-BV) or GPM combined with Motive-Oriented Therapeutic Relationship techniques (MOTR+GPM-BV). Patient- and therapist-rated alliance was assessed weekly. Self-reported symptomatic distress was assessed pre-, mid-, and posttreatment. In MOTR+GPM-BV, stronger therapist-rated alliance predicted lower symptomatic distress in the same timepoint, but not in a lag, whereas symptomatic distress predicted therapist-rated alliance in a lag. Therapist-rated alliance was lower than patient-rated alliance in GPM-BV but not in MOTR+GPM-BV. In MOTR+GPM-BV, higher agreement on strong alliance tended to predict lower symptomatic distress. Patient …

  • Benjamin N Johnson, Kenneth N Levy (3/2020) Identifying unstable and empty phenotypes of borderline personality through factor mixture modeling in a large nonclinical sample.

    Journal: Personality Disorders: Theory, Research, and Treatment

    Volume: 11 Issue: 2

    Pages: 141

    Borderline personality disorder (BPD) is serious, prevalent, and symptomatically heterogeneous. Identifying distinct phenotypes of BPD features promises useful diagnostic and treatment implications. Although a series of subtyping studies exist, only two have examined BPD symptom configurations while taking into account BPD severity. We used factor mixture modeling to identify discrete subtypes of BPD features, simultaneously considering symptom severity, in the largest nonclinical young adult sample to date. Undergraduates (N= 20,010; 63.86% women; M age= 18.75, SD= 1.73) completed the McLean Screening Instrument for BPD, which was condensed to measure the 9 Diagnostic and Statistical Manual of Mental Disorders BPD criteria dichotomously. We used a model comparison approach to determine the optimal latent factor and class structure of BPD symptoms and validated classes via BPD-relevant …

  • William D Ellison, Kenneth N Levy, Michelle G Newman, Aaron L Pincus, Stephen J Wilson, Peter Molenaar (3/2020) Dynamics among borderline personality and anxiety features in psychotherapy outpatients: An exploration of nomothetic and idiographic patterns.

    Journal: Personality Disorders: Theory, Research, and Treatment

    Volume: 11 Issue: 2 Pages: 131

    Borderline personality disorder (BPD) involves instability in self-concept, emotions, and behavior. However, the dynamic, longitudinal relations among BPD symptoms and between these symptoms and other problematic emotional experiences are poorly understood. It is also unclear whether these dynamics are the same across persons (including across diagnostic boundaries), specific to individuals with BPD, or idiographic. The current study uses ecological momentary assessment and group iterative multiple model estimation, a novel, data-driven approach to identifying dynamic patterns in time-series data at group, subgroup, and individual levels, to investigate the dynamic connections among select features of BPD (anger, impulsivity, and identity disturbance) and anxiety-related experiences. Forty-two psychiatric outpatients diagnosed with BPD (n= 27) or with an anxiety disorder, but not BPD (n= 15), rated …

  • Sindes Dawood, Michael N Hallquist, Aaron L Pincus, Nilam Ram, Michelle G Newman, Stephen J Wilson, Kenneth N Levy (3/2020) Comparing Signal-Contingent and Event-Contingent Experience Sampling Ratings of Affect in a Sample of Psychotherapy Outpatients

    Journal of psychopathology and behavioral assessment

    Volume 42, Issue 1, Pages 13-24

    Experience sampling methods are widely used in clinical psychology to study affective dynamics in psychopathology. The present study examined whether affect ratings (valence and arousal) differed as a function of assessment schedule (signal- versus event-contingent) in a clinical sample and considered various approaches to modeling these ratings. A total of 40 community mental health center outpatients completed ratings of their affective experiences over a 21-day period using both signal-contingent schedules (random prompts) and event-contingent schedules (ratings following social interactions). We tested whether assessment schedules impacted 1) the central tendency (mean) and variability (standard deviation) of valence or arousal considered individually, 2) the joint variability in valence and arousal via the entropy metric, and 3) the between-person differences in configuration of valence-arousal …

  • Kenneth N Levy, Joanna Pantelides (9/18/2020) Borderline Personality Disorder

    Journal:The Wiley Encyclopedia of Personality and Individual Differences: Clinical, Applied, and Cross‐Cultural Research

    Pages: 89-95

    Borderline personality disorder (BPD) is a highly prevalent, chronic, and debilitating disorder characterized by instability in one's sense of self, others, and mood. This instability is expressed as emotional lability, impulsivity, interpersonal dysfunction, angry outbursts, suicidality, and non‐suicidal self‐injury. One in 10 patients with BPD will end up dying from suicide. Those suffering from BPD are more likely to commit suicide than those with depression, PTSD, eating disorders, and unmediated bipolar disorder. BPD has historically been thought to be difficult to treat. However, several integrative treatments – deriving from both the cognitive‐behavioral and psychodynamic traditions – that have shown efficacy in randomized controlled trials and are now available to clinicians and their patients.