RESUMO
The concept of mentalizing-attending to mental states in oneself and others-provides an integrative conceptual framework to characterize the psychotherapeutic treatment of a patient with a history of attachment trauma and a comorbid schizoaffective disorder. The authors construe mentalizing failures in childhood attachment relationships as integral to the trauma and the promotion of mentalizing in the psychotherapy relationship as the cornerstone of healing. They employ mentalizing to conceptualize both the exposure-based interventions and the equally essential interruption of a problematic pattern of reenactment that continually fueled the patient's posttraumatic symptoms.
Assuntos
Terapia Cognitivo-Comportamental , Transtornos de Estresse Pós-Traumáticos/psicologia , Transtornos de Estresse Pós-Traumáticos/terapia , Adulto , Sobreviventes Adultos de Maus-Tratos Infantis/psicologia , Transtorno Bipolar/complicações , Transtorno Bipolar/terapia , Feminino , Humanos , Relações Interpessoais , Transtornos de Estresse Pós-Traumáticos/complicações , Tentativa de Suicídio , Resultado do TratamentoRESUMO
Self-report questionnaires designed to assess attachment in adulthood potentially confound global valence of relationships (e.g., liking and disliking) with attachment. The authors surveyed an international panel of experts to develop items for a new measure of attachment that systematically distinguishes between attachment and non-attachment aspects of relationships. The survey yielded a large set of items on which there is consensus in five domains: secure attachment, dismissing attachment, preoccupied attachment, positive non-attachment, and negative non-attachment. This report presents a content analysis of the core themes in each of these five domains and discusses implications of these results for conceptualizing and researching adult attachment.
Assuntos
Relações Interpessoais , Apego ao Objeto , Adulto , Afeto , Feminino , Humanos , MasculinoRESUMO
Using a community sample of 115 young adults, this study applied a range of statistical techniques to five measures of adult attachment to gain a better understanding of what they assess. First, we determined comparability of measures, using both categorical and dimensional approaches to model the association. Agreement among classifications was modest. Next, we examined the relation of attachment classifications and attachment measure subscale scores to criterion variables (i.e. dyadic adjustment, interpersonal sensitivity and severity of psychiatric symptoms). Classification predicted severity of psychological symptoms better than it predicted other measures of adjustment. Finally, using a principal components analysis, we mapped the relationship among underlying constructs, the subscales of the five measures and three criterion measures of psychological adjustment. We discuss our findings from the perspective of underlying constructs of attachment insecurity and strategy for coping with insecurity in relationships, noting implications for further research.
Assuntos
Transtornos de Adaptação/psicologia , Relações Interpessoais , Adaptação Psicológica , Transtornos de Adaptação/classificação , Transtornos de Adaptação/etiologia , Adulto , Feminino , Humanos , Masculino , Escalas de Graduação Psiquiátrica , Psicometria , Índice de Gravidade de DoençaRESUMO
The relationship between mentalization and Melanie Klein's concepts of depressive and paranoid-schizoid positions is noted, as well as commonalities between mentalization and narrative coherence. Two case examples are presented to illustrate the vicissitudes of mentalization as a psychotherapeutic tool and to explore the context in which mentalization can flourish.
Assuntos
Cognição , Psicoterapia/métodos , Autoimagem , Adulto , Feminino , Humanos , Processos MentaisRESUMO
The authors developed a psychoeducational protocol to help psychiatric patients review their patterns of interpersonal relationships. The conceptual framework is based on the Adult Personality Functioning Assessment (Hill, Fudge, Harrington, Pickles, & Rutter, 1995; Hill, Harrington, Fudge, Rutter, & Pickles, 1989). Seven domains of functioning are addressed: friendships, romantic relationships, family relationships, social contacts, therapeutic relationships, relationships with addictive substances and activities, and work. The intervention aims at fostering participants' reflectiveness about their relationships to enhance their capacity for social support. The introduction sets the protocol in context; an annotated version of patient materials includes commentary on each domain.
Assuntos
Identidade de Gênero , Relações Interpessoais , Educação de Pacientes como Assunto/métodos , Transtornos da Personalidade/diagnóstico , Feminino , Humanos , Entrevista Psicológica , Masculino , Determinação da Personalidade , Transtornos da Personalidade/psicologia , Psicoterapia de Grupo/métodos , Apoio SocialAssuntos
Adaptação Psicológica , Criança Institucionalizada/psicologia , Cuidados no Lar de Adoção/psicologia , Desenvolvimento da Personalidade , Transtornos de Estresse Pós-Traumáticos/psicologia , Adolescente , Adulto , Idoso , Criança , Maus-Tratos Infantis/psicologia , Abuso Sexual na Infância/psicologia , Pré-Escolar , Mecanismos de Defesa , Feminino , Humanos , Lactente , Recém-Nascido , Acontecimentos que Mudam a Vida , Masculino , Pessoa de Meia-Idade , Apego ao Objeto , Determinação da Personalidade , Psicopatologia , Apoio Social , Transtornos de Estresse Pós-Traumáticos/diagnósticoRESUMO
There has been an increasing interest in assessing object relations in individuals presenting with personality pathology. The present study describes the development of the Problematic Object Representation Scales (PORS), which were devised to assess dimensions of object representations through the Adult Attachment Interview protocol in an effort to integrate psychoanalytic and cognitive approaches. The results of this study have revealed that the PORS are able to distinguish patients with severe personality disorder both from patients with Axis I disorders and from healthy controls. Although the PORS have been shown to be a reliable and promising instrument, further validation of the scales is needed before they can become a valuable research tool for the assessment of object relations in personality pathology.