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Carone N, Muzi L, Benzi IMA, Cacioppo M, Parolin LAL, Santona AMR, Fontana A. The Influence of Childhood Emotional Abuse and Neglect on Love Addiction: The Indirect Effect of Vulnerable Narcissism Among Female and Male Emerging Adults. JOURNAL OF INTERPERSONAL VIOLENCE 2024:8862605241285879. [PMID: 39364662 DOI: 10.1177/08862605241285879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/05/2024]
Abstract
Childhood maltreatment is a key precursor to vulnerable narcissism since it likely lead to a narcissistic injury that triggers defenses against rage and abandonment. In later life, this pattern may contribute to a maladaptive model of love relationships. The present study explored the association between different types of childhood maltreatment (i.e., emotional, physical, and sexual abuse; physical and emotional neglect) and love addiction via vulnerable narcissism in a community sample of 505 cisgender emerging adults (M = 24.90, SD = 2.67; 76.6% assigned female at birth (AFAB); 68.5% heterosexual) residing in Italy. Data collection relied on self-report questionnaires administered online through the Qualtrics platform, and study hypotheses were tested using structural equation modeling. The results showed that childhood emotional abuse and emotional neglect directly influenced love addiction, while physical and sexual abuse, as well as physical neglect, showed no significant effects. Greater childhood emotional abuse and neglect were associated with increased vulnerable narcissism, leading to higher levels of love addiction. Gender differences emerged, with the indirect effect of vulnerable narcissism on the relationship between emotional neglect and love addiction significant only for AFAB. The findings emphasize the risk of love addiction in emerging adults with a history of childhood emotional abuse and neglect, highlighting the importance of addressing childhood emotional maltreatment and vulnerable narcissistic personality traits in interventions to treat this condition.
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Gullslett MK, Kristiansen E, Nilsen ER. Therapists' Experience of Video Consultation in Specialized Mental Health Services During the COVID-19 Pandemic: Qualitative Interview Study. JMIR Hum Factors 2021; 8:e23150. [PMID: 34096505 PMCID: PMC8284340 DOI: 10.2196/23150] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 10/27/2020] [Accepted: 06/06/2021] [Indexed: 01/20/2023] Open
Abstract
Background As part of political and professional development with increased focus on including service users within mental health services, these services are being transformed. Specifically, they are shifting from institutional to noninstitutional care provision with increased integration of the use of electronic health and digitalization. In the period from March to May 2020, COVID-19 restrictions forced rapid changes in the organization and provision of mental health services through the increased use of digital solutions in therapy. Objective The aim of this study was to develop and advance comprehensive knowledge about how therapists experience the use of video consultation (VC). To reach this objective, we evaluated therapists’ experiences of using VC in specialized mental health services in the early phase of COVID-19 restrictions. The following questions were explored through interviews: Which opportunities and challenges appeared when using VC during the period of COVID-19 restrictions? In a short-term care pathway, for whom does VC work and for whom does it not work? Methods This study employed a qualitative approach based on an abductive strategy and hermeneutic-phenomenological methodology. Therapists and managers in mental health departments in a hospital were interviewed via Skype for Business from March to May 2020, using a thematic interview guide that aimed to encourage reflections on the use of VC during COVID-19 restrictions. Results Therapists included in this study experienced advantages in using VC under circumstances that did not permit face-to-face consultations. The continuity that VC offered the service users was seen as a valuable asset. Various negative aspects concerning the therapeutic environment such as lack of safety for the most vulnerable service users and topics deemed unsuitable for VC lowered the therapists’ overall impression of the service. The themes that arose in the data analysis have been categorized in the following main topics: (1) VC—“it’s better than nothing”; (2) VC affects therapists’ work situation—opportunities and challenges in working conditions; and (3) challenges of VC when performing professional assessment and therapy on the screen. Conclusions Experiences with VC in a mental health hospital during COVID-19 restrictions indicate that there are overall advantages to using VC when circumstances do not permit face-to-face consultations. Nevertheless, various negative aspects in the use of VC lowered the therapists’ overall impression of VC. Further qualitative research is needed, and future studies should focus on service users’ experiences, cocreation between different stakeholders, and how to scale up the use of VC while ensuring that the service provided is appropriate, safe, and available.
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Affiliation(s)
- Monika K Gullslett
- Norwegian Center for E-Health Research, University Hospital of North Norway, Tromsø, Norway
| | - Eli Kristiansen
- Norwegian Center for E-Health Research, University Hospital of North Norway, Tromsø, Norway
| | - Etty R Nilsen
- School of Business and Economics, University of Tromsø (UiT), Alta, Norway
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Solmi M, Dragioti E, Croatto G, Radua J, Borgwardt S, Carvalho AF, Demurtas J, Mosina A, Kurotschka P, Thompson T, Cortese S, Shin JI, Fusar-Poli P. Risk and Protective Factors for Personality Disorders: An Umbrella Review of Published Meta-Analyses of Case-Control and Cohort Studies. Front Psychiatry 2021; 12:679379. [PMID: 34552513 PMCID: PMC8450571 DOI: 10.3389/fpsyt.2021.679379] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 07/06/2021] [Indexed: 12/26/2022] Open
Abstract
The putative risk/protective factors for several personality disorders remain unclear. The vast majority of published studies has assessed personality characteristics/traits rather than disorders. Thus, the current umbrella review of meta-analyses (MAs) aims to systematically assess risk or protective factors associated with personality disorders. We searched PubMed-MEDLINE/PsycInfo databases, up to August 31, 2020. Quality of MAs was assessed with AMSTAR-2, while the credibility of evidence for each association was assessed through standard quantitative criteria. Out of 571 initial references, five meta-analyses met inclusion criteria, encompassing 56 associations of 26 potential environmental factors for antisocial, dependent, borderline personality disorder, with a median of five studies per association, and median 214 cases per association. Overall, 35 (62.5%) of the associations were nominally significant. Six associations met class II (i.e., highly suggestive) evidence for borderline personality disorder, with large effect sizes involving childhood emotional abuse (OR = 28.15, 95% CI 14.76-53.68), childhood emotional neglect (OR = 22.86, 95% CI 11.55-45.22), childhood any adversities (OR = 14.32, 95% CI 10.80-18.98), childhood physical abuse (OR = 9.30, 95% CI 6.57-13.17), childhood sexual abuse (OR = 7.95, 95% CI 6.21-10.17), and childhood physical neglect (OR = 5.73, 95% CI 3.21-10.21), plus 16 further associations supported by class IV evidence. No risk factor for antisocial or dependent personality disorder was supported by class I, II, and III, but six and seven met class IV evidence, respectively. Quality of included meta-analyses was rated as moderate in two, critically low in three. The large effect sizes found for a broad range of childhood adversities suggest that prevention of personality disorders should target childhood-related risk factors. However, larger cohort studies assessing multidimensional risk factors are needed in the field.
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Affiliation(s)
- Marco Solmi
- Department of Psychiatry, University of Ottawa, Ottawa, ON, Canada.,Department of Mental Health, The Ottawa Hospital, Ottawa, ON, Canada.,Early Psychosis: Interventions and Clinical-Detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology, London, United Kingdom.,Faculty of Environmental and Life Sciences, Center for Innovation in Mental Health, School of Psychology, University of Southampton, Southampton, United Kingdom.,Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Elena Dragioti
- Pain and Rehabilitation Centre, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | | | - Joaquim Radua
- Early Psychosis: Interventions and Clinical-Detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology, London, United Kingdom.,Imaging of Mood- and Anxiety-Related Disorders (IMARD) Group, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), CIBERSAM, Barcelona, Spain.,Department of Clinical Neuroscience, Centre for Psychiatric Research and Education, Karolinska Institutet, Solna, Sweden
| | - Stefan Borgwardt
- Department of Psychiatry, Medical Faculty, University of Basel, Basel, Switzerland.,Department of Psychiatry, Psychosomatics and Psychotherapy, University of Lübeck, Lübeck, Germany
| | - Andre F Carvalho
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.,Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Jacopo Demurtas
- Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena, Italy
| | - Anna Mosina
- Clienia AG, Wetzikon Psychiatric Centre, Wetzikon, Switzerland
| | - Peter Kurotschka
- Department of General Practice, University Medical Center Würzburg, Würzburg, Germany
| | - Trevor Thompson
- Faculty of Education and Health, University of Greenwich, London, United Kingdom
| | - Samuele Cortese
- Faculty of Environmental and Life Sciences, Center for Innovation in Mental Health, School of Psychology, University of Southampton, Southampton, United Kingdom.,Clinical and Experimental Sciences (CNS and Psychiatry), Faculty of Medicine, University of Southampton, Southampton, United Kingdom.,Solent NHS Trust, Southampton, United Kingdom.,Hassenfeld Children's Hospital at NYU Langone, New York University Child Study Center, New York, NY, United States.,Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Jae Il Shin
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, South Korea
| | - Paolo Fusar-Poli
- Early Psychosis: Interventions and Clinical-Detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology, London, United Kingdom.,Department of Brain and Behavioural Sciences, University of Pavia, Pavia, Italy.,Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom.,Outreach and Support in South London (OASIS) Service, South London and Maudsley NHS Foundation Trust, London, United Kingdom
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van IJzendoorn MH, Bakermans‐Kranenburg MJ, Coughlan B, Reijman S. Annual Research Review: Umbrella synthesis of meta-analyses on child maltreatment antecedents and interventions: differential susceptibility perspective on risk and resilience. J Child Psychol Psychiatry 2020; 61:272-290. [PMID: 31667862 PMCID: PMC7065145 DOI: 10.1111/jcpp.13147] [Citation(s) in RCA: 103] [Impact Index Per Article: 25.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/25/2019] [Indexed: 12/13/2022]
Abstract
Child maltreatment in the family context is a prevalent and pervasive phenomenon in many modern societies. The global perpetration of child abuse and neglect stands in stark contrast to its almost universal condemnation as exemplified in the United Nation's Convention on the Rights of the Child. Much work has been devoted to the task of prevention, yet a grand synthesis of the literature is missing. Focusing on two core elements of prevention, that is, antecedents for maltreatment and the effectiveness of (preventative) interventions, we performed an umbrella review of meta-analyses published between January 1, 2014, and December 17, 2018. Meta-analyses were systematically collected, assessed, and integrated following a uniform approach to allow their comparison across domains. From this analysis of thousands of studies including almost 1.5 million participants, the following risk factors were derived: parental experience of maltreatment in his or her own childhood (d = .47), low socioeconomic status of the family (d = .34), dependent and aggressive parental personality (d = .45), intimate partner violence (d = .41), and higher baseline autonomic nervous system activity (d = .24). The effect size for autonomic stress reactivity was not significant (d = -.10). The umbrella review of interventions to prevent or reduce child maltreatment showed modest intervention effectiveness (d = .23 for interventions targeting child abuse potential or families with self-reported maltreatment and d = .27 for officially reported child maltreatment cases). Despite numerous studies on child maltreatment, some large gaps in our knowledge of antecedents exist. Neurobiological antecedents should receive more research investment. Differential susceptibility theory may shed more light on questions aimed at breaking the intergenerational transmission of maltreatment and on the modest (preventive) intervention effects. In combination with family-based interaction-focused interventions, large-scale socioeconomic experiments such as cash transfer trials and experiments with vouchers to move to a lower-poverty area might be tested to prevent or reduce child maltreatment. Prevalence, antecedents, and preventive interventions of prenatal maltreatment deserve continuing scientific, clinical, and policy attention.
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Affiliation(s)
- Marinus H. van IJzendoorn
- Department of Psychology, Education, and Child StudiesErasmus University RotterdamRotterdamThe Netherlands
- Department of Public Health and Primary CareSchool of Clinical MedicineUniversity of CambridgeCambridgeUK
| | - Marian J. Bakermans‐Kranenburg
- Clinical Child and Family StudiesFaculty of Behavioural and Movement SciencesVrije Universiteit AmsterdamAmsterdamThe Netherlands
| | - Barry Coughlan
- Department of Public Health and Primary CareSchool of Clinical MedicineUniversity of CambridgeCambridgeUK
| | - Sophie Reijman
- Department of Public Health and Primary CareSchool of Clinical MedicineUniversity of CambridgeCambridgeUK
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Kane FA, Bornstein RF. Does interpersonal dependency affect therapeutic outcome? A meta-analytic review. Personal Ment Health 2019; 13:215-229. [PMID: 31364815 DOI: 10.1002/pmh.1463] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Revised: 06/14/2019] [Accepted: 06/21/2019] [Indexed: 11/07/2022]
Abstract
This study examined whether interpersonal dependency affects therapeutic outcome, using meta-analytic techniques to synthesize results from 31 studies (49 effect sizes; overall N = 3807). High levels of dependency were associated with more positive outcome in psychodynamic therapy (r = 0.11, p < 0.05), but not cognitive-behavioural therapy (r = -0.05, ns), and were associated with a less positive outcome in pharmacological treatment (r = -0.15, p < 0.001). Other predictors of outcome included patient diagnosis (high levels of dependency were linked with more positive outcome for patients with anxiety disorders but not those with depression), outcome measure (high levels of dependency were associated with significantly greater improvement in global functioning but not symptom reduction) and dependency measure (cognitive and cognitive-behavioural dependency scales yielded less positive results than other types of measures). These results contribute to a growing body of literature examining effects of personality on treatment process and outcome. © 2019 John Wiley & Sons, Ltd.
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Affiliation(s)
- Fallon A Kane
- Derner School of Psychology, Adelphi University Garden City, New York, USA
| | - Robert F Bornstein
- Derner School of Psychology, Adelphi University Garden City, New York, USA
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