Dynamic-relational treatment of perfectionism: An illustrative case study.

OBJECTIVE: Perfectionism has been described as a multidimensional core vulnerability factor in various forms of dysfunction and disorders. Recently, we described our empirically supported-dynamic-relational treatment for perfectionism. This treatment integrates psychodynamic and interpersonal principles to reduce perfectionism and symptoms and enhance relationships with others and self by focusing on underlying relational patterns. METHOD: We discuss this approach and present Azure, a 27-year-old woman who completed our group treatment and subsequent individual therapy as a follow-up. RESULTS: Azure underwent a comprehensive psychological pretreatment assessment, the results of which were used to develop a working formulation that guided the group and individual psychotherapy. A description of the formulation and her experience in therapy are discussed and pre- and post-treatment data illustrate changes in Azure's perfectionism and symptoms. CONCLUSIONS: We discuss changes that occurred over the course of treatment.

Perfectionistic traits and self-presentation are associated with negative attitudes and concerns about seeking professional psychological help.

Numerous factors influence whether an individual is able and willing to seek professional help for psychological difficulties. One of these may be perfectionism, a multidimensional personality construct that has been linked to poor psychological adjustment. The current study investigated whether perfectionism traits and self-presentational facets were associated with negative help-seeking attitudes and concerns about psychotherapy. Samples of university (N = 299) and community (N = 77) men and women completed the Multidimensional Perfectionism Scale, Perfectionistic Self-Presentation Scale, Attitudes Towards Seeking Professional Help Scale, and Thoughts About Psychotherapy Survey. Various components of perfectionism were associated with both negative help-seeking attitudes and concerns about psychotherapy. The findings suggest that perfectionistic behaviour may be an important dispositional factor that interferes with seeking and obtaining help for psychological difficulties. Theoretical and clinical implications are discussed.

Dual Control Model in a Cross-Cultural Context: Role of Sexual Excitation in Sexual Response and Behavior Differences Between Chinese and Euro-Caucasian Women in Canada.

Chinese women in Western nations frequently report less engagement with sexuality, such as lower sexual response and behaviors, and more restrictive sexual attitudes, than their Euro-Caucasian peers. This difference is likely related to sexual conservatism within traditional Chinese culture, though the mechanisms underlying how culture influences sexual responding are not well understood. The current study investigated if these differences were consistent with the dual control model, a well-established model for understanding regulation of sexual response. Chinese and Euro-Caucasian women (N = 471; age M = 20.7 years, SD = 3.3) residing in Canada from a university sample completed self-report questionnaires on sexual excitation and inhibition, sexual attitudes, and various sexual response and behavior measures. Sexual excitation was significantly lower in Chinese than Euro-Caucasian women and was significantly associated with sexual response in both groups. Structural equation modeling showed that sexual response variables were associated with a latent sexual excitation factor and that sexual attitudes partially mediated the relationship between this latent factor and ethnicity. The findings showed that sexual excitation and sexual attitudes contribute to cross-cultural differences in women's sexual responding. Theoretical and clinical considerations are discussed.

Sexual Functioning in Young Women and Men: Role of Attachment Orientation.

Prior research has documented various ways in which adult attachment styles are characteristic of differential behavioral and cognitive patterns within romantic relationships and sexuality. However, few studies have examined the direct influence of anxious or avoidant attachment orientation on sexual function. The aim of the present study was to assess the impact of insecure attachment on sexual function. Undergraduate students completed questionnaires measuring attachment style and sexual functioning. Among women, attachment avoidance tended to be associated with impairments in all aspects of sexual function, whereas anxious attachment tended to be associated with declines in arousal, satisfaction, and ability to achieve orgasm. A different trend was seen in men: Anxious attachment tended to be associated with multiple facets of sexual dysfunction, while avoidant attachment did not correlate with any sexual function deficits and was associated with superior physiological competence. These results suggest that both anxious and avoidant attachment styles are important yet differential predictors of sexual function in men and women.

Specific formulation feedback in dynamic-relational group psychotherapy of perfectionism.

In this article, we describe how individualized feedback, in the form of a clinical formulation, is used in our dynamic-relational group treatment of perfectionism (Hewitt et al., 2015), a core vulnerability or transdiagnostic personality factor. The authors discuss briefly their conceptualization and assessment of perfectionism as well as other aspects of patients' functioning, and the use of both psychodynamic and interpersonal models to derive, for individual patients, their unique formulation or idiosyncratic model of their perfectionistic and related behavior. Moreover, we describe the process of providing the formulation feedback to each patient in preparation for group psychotherapy and, finally, provide an illustrative case. (PsycINFO Database Record

Insecure Attachment Style and Dysfunctional Sexual Beliefs Predict Sexual Coercion Proclivity in University Men.

INTRODUCTION: Past studies have shown an association between low sexual functioning and engaging in sexually coercive behaviors among men. The mechanism of this relationship is not well understood. Moreover, most studies in this area have been done in incarcerated sex offenders. AIMS: The aim of the current study was to investigate the role of potential distal predictors of sexual coercion, including insecure attachment style and dysfunctional sexual beliefs, in mediating the relationship between sexual functioning and sexual coercion. The study also seeks to extend past findings to a novel non-forensic population. METHODS: Male university students (N = 367) anonymously completed online questionnaires. MAIN OUTCOME MEASURES: Participants completed the Sexual Experiences Survey, Improved Illinois Rape Myth Acceptance Scale, Hostility Towards Women Scale, Likelihood of Rape Item, Experiences in Close Relationships Scale, Dysfunctional Sexual Beliefs Scale, and Brief Sexual Functioning Questionnaire. RESULTS: Sexual functioning was not significantly associated with sexually coercive behaviors in our sample (r = 0.08, P = 0.247), though a significant correlation between sexual functioning and rape myth acceptance was found (r = 0.18, P = 0.007). Path analysis of all variables showed that the likelihood of rape item was the strongest correlate of sexually coercive behaviors (ß = 0.34, P < 0.001), while dysfunctional sexual beliefs appeared to mediate the association between anxious attachment and likelihood of rape item score. Anxious (r = -0.27, P = 0.001) and avoidant (r = -0.19, P = 0.004) attachment also correlated significantly with lower sexual functioning. CONCLUSIONS: These findings suggest the relationship between sexual functioning and sexual coercion may be less robust than previously reported, and may be due to a shared association with other factors. The results elaborate on the interrelation between attachment style and dysfunctional sexual beliefs as predictors of sexual coercion proclivity, suggesting avenues for further research.

Minireview: Endocannabinoids and gonadal hormones: bidirectional interactions in physiology and behavior.

Endocannabinoids act as a major neuromodulatory system in a variety of physiological and behavioral functions. Three major lines of evidence suggest that the endocannabinoid system interacts with gonadal hormones. First, the endocannabinoid system is implicated in behaviors and physiological functions that are known to be regulated in part by gonadal hormones. Second, receptors and metabolic enzymes of the endocannabinoid system are localized extensively on structures in the hypothalamic-pituitary-gonadal axis. Third, changes in levels of gonadal hormones alter endocannabinoid signaling. Here we reviewed and summarized the current evidence regarding the interaction between the endocannabinoid system and androgens, estrogens, and progesterone. Overall, it appears that bidirectional interactions characterize the relationship between endocannabinoids and gonadal hormones, with endocannabinoids down-regulating hypothalamic-pituitary-gonadal activity and gonadal hormones modulating protein expression in the endocannabinoid system. An understanding of these interactions will have implications for elucidating the neuroendocrine mechanisms underlying a number of behavioral and physiological functions as well as potential pharmaceutical treatments for disorders of these functions.