Psychodynamic university counseling: which factors predict psychological functioning after intervention?

Introduction: University counseling centers represent important resources for personal development, and students are increasingly turning to them for help. The present study aimed at, first, evaluating changing in psychological functioning before and after a university counseling intervention and, second, exploring which psychological variables predicted the intervention outcome. Methods: For this purpose, 122 students who attended university counseling services were administered measures to assess personality traits, and measures to assess state variables - intended as contextual, rather than stable, alterations in functioning - such as anxiety, hopelessness and depression. Several Linear Mixed Models were performed to measure the differences between OQ-45 scores before and after the intervention (one for each OQ dimension and OQ total score); then, two steps of multiple regression analyses were performed. Results: Significative reductions between pre-test and post-test OQ-45 scores were found, highlighting increased levels of well-being; personality traits seem not to be predictive of the intervention outcome, while state variables significantly contribute to the psychological wellbeing improvement after counseling intervention. Discussion: Our findings highlight the importance of paying attention to the role of affective difficulties in predicting the counseling effectiveness.

Relationship between Executive Functions, Social Cognition, and Attachment State of Mind in Adolescence: An Explorative Study.

BACKGROUND: The passage from pre-adolescence to adolescence is presented as a turning point for the achievement of those abilities in social understanding as they commonly appear in adulthood. Developmental perspectives point to the possible role of neuro-cognitive maturation and social experiences to facilitate this growth. This paper has the goal to goalsto propose a valid and reliable measure of the new quantitative and qualitative advancements in social understanding occurring in the adolescent passage; relying on this, the research has two main objectives (a) to establish the associations between the advancements in social understanding and the executive functions held responsible for the neuro-cognitive rearrangements of adolescence; (c) to evidence the significant associations between attachment models and the development of social understanding in this phase of life. METHODS: 100 subjects (50 boys and 50 girls, aged 11-15) were administered with AICA, SCORS, CNT, Stroop Color-Word Test, and WISC-III. RESULTS: Advancements in the complexity of self-other representations and mentalization of interpersonal exchanges significantly occurs in the passage from pre-adolescence to adolescence and seem to be promoted by increased performances in executive control and cognitive shifting. Dismissing state of mind with respect to attachment is associated with lower development of social understanding in adolescence. The neurocognitive reorganization that underlies the passage from pre-adolescence to adolescence seems to provide the scaffolding for more sophisticated interpretations of the social world. Past and current affective experience can boost or hinder the full deployment of such human maturational potential. Given the importance of social cognition for adjustment and psychopathology, clinical intervention should target the amelioration of individual and family abilities in social reasoning and mentalization.

How socio-institutional contexts and cultural worldviews relate to COVID-19 acceptance rates: A representative study in Italy.

RATIONALE: Despite its importance to counter the COVID-19 pandemic, vaccination has raised hesitation in large segments of the population. This hesitation makes it important to understand the mechanisms underlying vaccine acceptance. To this end, the study adopts the Semiotic Cultural Psychology Theory, holding that social behaviors - and therefore, vaccination acceptance - depend on the cultural meanings in terms of which people interpret the social world. OBJECTIVE: The study aims at estimating the impact a) of the way people interpret the socio-institutional context of the pandemic and b) of the underlying cultural worldviews on vaccine acceptance. More particularly, the study tested the three following hypotheses. a) The meanings grounding the interpretation of the socio-institutional framework - that is, trust in institutions and political values - are an antecedent of vaccination acceptance. b) The impact of these meanings is moderated by the cultural worldviews (operationalized as symbolic universes). And c), the magnitude of the symbolic universes' moderator effect depends on the uncertainty to which the respondent is exposed. The exposure to uncertainty was estimated in terms of socioeconomic status - the lower the status, the high the exposure to uncertainty. METHODS: An Italian representative sample (N = 3020) completed a questionnaire, measuring vaccination acceptance, the meanings attributed to the socio-institutional context - that is, political values and trust in institutions - and symbolic universes. RESULTS: The findings were consistent with the hypotheses. a) Structural equation modelling proved that vaccine acceptance was predicted by trust in institutions. b) Multigroup analysis revealed that symbolic universes moderated the correlation between trust in institutions and vaccine acceptance. And c), the moderation effect of symbolic universes proved to occur only in the segment of lower socio-economic status (i.e., the group exposed to higher uncertainty). CONCLUSIONS: Vaccination acceptance is not only a medical issue; it is also dependent upon the rationalization of the socio-institutional context. Implications for the promotion of vaccination acceptance are discussed.

To Work or Not to Work, That Is the Question: The Psychological Impact of the First COVID-19 Lockdown on the Elderly, Healthcare Workers, and Virtual Workers.

The spread of COVID-19 created a state of emergency all over the world and played a big role in the decline of the mental health of citizens. The context of the workplace became an important variable in the impact of the lockdown on individuals. In this study, we deepened the categories of healthcare workers (HWs), virtual workers (VWs), and the elderly, along with their emotional approach to this emergency. A sample of 257 participants (ElderlyN = 62; HWsN = 104; VWsN = 91) completed: a semi-structured interview on their experience during lockdown via telephone; an online survey with a sociodemographic questionnaire; the Difficulties in Emotional Regulation Scale (DERS); and the Post-Traumatic Growth Inventory (PTGI). Linguistic measures of the Referential Process were utilized to code the interviews. An independent ANOVA explored the variability among groups. The results show more affective language in the Elderly (M = 0.0310, SD = 0.0070) and a growth in spirituality (M = 4.16, SD = 3.17). HWs displayed a higher PTGI (M = 56.84, SD = 20.29), while VWs displayed a lower PTGI (M = 50.02, SD = 21.05). Moreover, VWs presented higher scores in Impulse on the DERS (M = 11.67, SD = 5.05) and a more cognitive/abstract narration (Reflection IREF M = 0.0260, SD = 0.0071; Reorganization IWRRL M = 0.5419, SD = 0.0032; Referential Activity IWRAD M = 0.4978, SD = 0.0029). This study aims to take the work context into consideration to create focused interventions.

A Phase Transition of the Unconscious: Automated Text Analysis of Dreams in Psychoanalytic Psychotherapy.

AIM: Psychotherapy could be interpreted as a self-organizing process which reveals discontinuous pattern transitions (so-called phase transitions). Whereas this was shown in the conscious process of awake patients by different measures and at different time scales, dreams came very seldom into the focus of investigation. The present work tests the hypothesis that, by dreaming, the patient gets progressively more access to affective-laden (i.e., emotionally charged) unconscious dimensions. Furthermore, the study investigates if, over the course of psychotherapy, a discontinuous phase transition occurs in the patient's capacity to get in contact with those unconscious dimensions. METHODS AND PROCEDURES: A series of 95 dream narratives reported during a psychoanalytic psychotherapy of a female patient (published as the "dreams of Amalie X") was used for analysis. An automated text analysis procedure based on multiple correspondence analysis was applied to the textual corpus of the dreams, highlighting a 10-factor structure. The factors, interpreted as affective-laden unconscious meaning dimensions, were adopted to define a 10-dimensional phase space, in which the ability of a dream to be associated with one or more local factors representing complex affective-laden meanings is measured by the Euclidean distance (ED) from the origin of this hyperspace. The obtained ED time series has been fitted by an autoregressive integrated moving average (ARIMA) model and by non linear methods like dynamic complexity, recurrence plot, and time frequency distribution. Change point analysis was applied to these non linear methods. RESULTS: The results show an increased frequency and intensity of dreams to get access to affective-laden meanings. Non linear methods identified a phase transition-like jump of the ED dynamics onto a higher complexity level of the dreaming process, suggesting a non linear process in the patient's capacity to get in contact with unconscious dimensions. CONCLUSION: The study corroborates the hypothesis that, by dreaming, the patient gets progressively more access to affective-laden meaning intended as unconscious dimensions. The trajectory of this process has been reproduced by an ARIMA model, and beyond this, non linear methods of time series analysis allowed the identification of a phase transition in the unconscious process of the psychoanalytic therapy under investigation.

What Differentiates Poor- and Good-Outcome Psychotherapy? A Statistical-Mechanics-Inspired Approach to Psychotherapy Research, Part Two: Network Analyses.

Statistical mechanics is the field of physics focusing on the prediction of the behavior of a given system by means of statistical properties of ensembles of its microscopic elements. The authors examined the possibility of applying such an approach to psychotherapy research with the aim of investigating (a) the possibility of predicting good and poor outcomes of psychotherapy on the sole basis of the correlation pattern among their descriptors and (b) the analogies and differences between the processes of good- and poor-outcome cases. This work extends the results reported in a previous paper and is based on higher-order statistics stemming from a complex network approach. Four good-outcome and four poor-outcome brief psychotherapies were recorded, and transcripts of the sessions were coded according to Mergenthaler's Therapeutic Cycle Model (TCM), i.e., in terms of abstract language, positive emotional language, and negative emotional language. The relative frequencies of the three vocabularies in each word-block of 150 words were investigated and compared in order to understand similarities and peculiarities between poor-outcome and good-outcome cases. Network analyses were performed by means of a cluster analysis over the sequence of TCM categories. The network analyses revealed that the linguistic patterns of the four good-outcome and four poor-outcome cases were grounded on a very similar dynamic process substantially dependent on the relative frequency of the states in which the transition started and ended ("random-walk-like behavior", adjusted R 2 = 0.729, p < 0.001). Furthermore, the psychotherapy processes revealed statistically significant changes in the relative occurrence of visited states between the beginning and the end of therapy, thus pointing to the non-stationarity of the analyzed processes. The present study showed not only how to quantitatively describe psychotherapy as a network, but also found out the main principles on which its evolution is based. The mind, from a linguistic perspective, seems to work-through psychotherapy sessions by passing from the most adjacent states and the most occurring ones. This finding can represent a fertile ground to rethink pivotal clinical concepts such as the timing of an interpretation or a comment, the clinical issue to address within a given session, and the general task of a psychotherapist: from someone who delivers a given technique toward a consultant promoting the flexibility of the clinical field and, thus, of the patient's mind.

Monitoring Nonlinear Dynamics of Change in a Single Case of Psychodynamic Play Therapy.

A systematic single case study with a mixed quantitative and qualitative methodology was conducted to investigate the nonlinear dynamics of change in play profiles of a child in psychodynamic play therapy. The first aim of the study was to cluster the different features of play characteristics (i.e., descriptive, cognitive, affective, and social characteristics of play, and the defensive strategies used in play) in order to construct the different play profiles of this child, and secondly to assess the transitions between profiles over the course of treatment. It was expected that there would be an increase in critical fluctuations during the transitions between the profiles and an increase in the variability of play profiles. Results showed that the child's play characteristics clustered into eight states and three attractors. The Markov Transition Matrix showed how play profiles evolved over time. Entropy analyses comparing the first and the second half of therapy showed an increase in variability. Qualitative analyses indicated the importance of expression of the child's underlying fear, and its integration with overt anger in the generation of the new play profiles. The results indicate an increase in variability, and a destabilization of old play profiles that were used towards generating new play profiles.

The Non-linear Trajectory of Change in Play Profiles of Three Children in Psychodynamic Play Therapy.

Aim: Even though there is substantial evidence that play based therapies produce significant change, the specific play processes in treatment remain unexamined. For that purpose, processes of change in long-term psychodynamic play therapy are assessed through a repeated systematic assessment of three children's "play profiles," which reflect patterns of organization among play variables that contribute to play activity in therapy, indicative of the children's coping strategies, and an expression of their internal world. The main aims of the study are to investigate the kinds of play profiles expressed in treatment, and to test whether there is emergence of new and more adaptive play profiles using dynamic systems theory as a methodological framework. Methods and Procedures: Each session from the long-term psychodynamic treatment (mean number of sessions = 55) of three 6-year-old good outcome cases presenting with Separation Anxiety were recorded, transcribed and coded using items from the Children's Play Therapy Instrument (CPTI), created to assess the play activity of children in psychotherapy, generating discrete and measurable units of play activity arranged along a continuum of four play profiles: "Adaptive," "Inhibited," "Impulsive," and "Disorganized." The play profiles were clustered through K-means Algorithm, generating seven discrete states characterizing the course of treatment and the transitions between these states were analyzed by Markov Transition Matrix, Recurrence Quantification Analysis (RQA) and odds ratios comparing the first and second halves of psychotherapy. Results: The Markov Transitions between the states scaled almost perfectly and also showed the ergodicity of the system, meaning that the child can reach any state or shift to another one in play. The RQA and odds ratios showed two trends of change, first concerning the decrease in the use of "less adaptive" strategies, second regarding the reduction of play interruptions. Conclusion: The results support that these children express different psychic states in play, which can be captured through the lens of play profiles, and begin to modify less dysfunctional profiles over the course of treatment. The methodology employed showed the productivity of treating psychodynamic play therapy as a complex system, taking advantage of non-linear methods to study psychotherapeutic play activity.