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Meehan KB, Cain NM, Roche MJ, Fertuck EA, Sowislo JF, Clarkin JF. Evaluating Change in Transference, Interpersonal Functioning, and Trust Processes in the Treatment of Borderline Personality Disorder: A Single-Case Study Using Ecological Momentary Assessment. J Pers Disord 2023; 37:490-507. [PMID: 37903025 DOI: 10.1521/pedi.2023.37.5.490] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2023]
Abstract
Transference-focused psychotherapy (TFP) is an empirically supported treatment for borderline personality disorder (BPD) that improves functioning via targeting representations of self affectively relating to others, particularly as evoked in the therapeutic relationship. If change in TFP operates as theorized, then shifts in patterns of "self affectively relating to others" should be observed in the transference prior to shifts in daily relationships. Using ecological momentary assessment (EMA), a patient with BPD rated daily interpersonal events for 2-week periods during 18 months of TFP; at 9 and 18 months these ratings included interactions with the therapist. Results suggest that positive perceptions of her therapist that ran counter to her negatively biased perception in other relationships preceded changes in her perceptions of others. EMA shifts corresponded to improvements in self-reported symptoms, interview-based personality functioning, and therapist assessments. Implications for assimilation of a trusting experience with the therapist as a mechanism of change in TFP are discussed.
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Affiliation(s)
- Kevin B Meehan
- Long Island University - Brooklyn, NY
- Weill Medical College of Cornell University, New York, New York
| | | | | | - Eric A Fertuck
- The City College and Graduate Center of CUNY, New York, New York
| | - Julia F Sowislo
- Weill Medical College of Cornell University, New York, New York
| | - John F Clarkin
- Weill Medical College of Cornell University, New York, New York
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Liu H, Chen B, Wang Y, Zhao X, Hu J. Social affiliation moderates the link between depressive symptoms and heart rate variability in healthy middle-aged and older individuals: An intensive ecologic momentary assessment study. Psychophysiology 2021; 59:e13958. [PMID: 34687474 DOI: 10.1111/psyp.13958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Revised: 09/30/2021] [Accepted: 10/06/2021] [Indexed: 11/28/2022]
Abstract
Depressive symptoms have been associated with lower cardiac autonomic control, thus contributing to cardiovascular diseases, especially among older adults. Interpersonal factors have been found to attenuate physiologic stress responses, but little is known about whether these factors (e.g., perceived affiliation) would moderate the relation of depressive symptoms and cardiovascular activation. The present research aimed to investigate the interplay of depressive symptoms and momentary-assessed interpersonal perceptions on cardiac vagal tone as indexed by heart rate variability (HRV). The sample consisted of 78 late middle-aged and older community-dwelling participants (48.7% male, mean age = 59.15 years). Participants reported on depressive symptoms and other personal characteristics by questionnaire. Perceptions of interpersonal affiliation, ambulatory HRV, and contextual variables were recorded using ecologic momentary assessment and portable electrocardiogram (ECG) monitoring device throughout 1 week (with a maximum of seven times daily). Multilevel analyses found that depressive symptoms were correlated with lower HRV, whereas momentary interpersonal perceptions of higher affiliation were associated with elevated HRV. A significant association was revealed between depressive symptoms and momentary affiliation perceptions on HRV. When individuals were involved in social interactions with higher affiliation, the effect of depressive symptoms on reducing HRV was attenuated. These findings suggested that the effects of subthreshold depressive symptoms on vagal control of the heart could be altered by the quality of interpersonal experiences.
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Affiliation(s)
- Huiying Liu
- Department of Sociology, Central South University, Changsha, China.,Sau Po Centre on Ageing, The University of Hong Kong, Hong Kong, Hong Kong
| | - Beizhuo Chen
- Department of Sociology, Central South University, Changsha, China
| | - Yao Wang
- Fuwai Hospital National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences & Peking Union Medical College Fuwai Hospital, Beijing, China
| | - Xinyi Zhao
- School of Health Humanities, Peking University, Beijing, China
| | - Jian Hu
- Department of Hematology, Xiangya Hospital, Central South University, Changsha, China
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Hong RY, Sheng D, Yee WQ. Pathological personality, situations, and their joint influences on daily emotional symptoms. J Pers 2021; 90:426-440. [PMID: 34558664 DOI: 10.1111/jopy.12675] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 06/23/2021] [Accepted: 09/21/2021] [Indexed: 12/12/2022]
Abstract
OBJECTIVE The present research aims to advance current understanding on how individuals with pathological personality traits construe their day-to-day situational experiences. METHOD College students (N = 231) completed a measure of personality pathology, followed by six assessments of everyday situations and anxiety/depression symptoms over two weeks. RESULTS Multilevel analyses indicated that personality pathology was meaningfully associated with situational experiences. Major findings suggested that situations that entailed aggravations and interpersonal confrontations were associated with negative affectivity, antagonism, and psychoticism. Detached individuals were less likely to experience pleasant and social situations. Exploratory analyses suggested an amplification effect where individuals high on personality pathology were more anxious or depressed when they perceived certain situational features, compared to their low trait counterparts. However, such cross-level interactions constituted a small minority; most personality traits and situations exerted additive effects on symptoms. CONCLUSION Situational experiences appear to be driven in part by personality pathology. The exacerbation of daily negative symptoms can be attributed to the joint (largely additive) influence of the trigger situations and pathological personality traits.
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Affiliation(s)
- Ryan Y Hong
- Department of Psychology, National University of Singapore, Singapore, Singapore
| | - Dan Sheng
- Department of Psychology, National University of Singapore, Singapore, Singapore
| | - Wan Qi Yee
- Department of Psychology, National University of Singapore, Singapore, Singapore
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Hannah Lee J. Perceptions towards an interaction partner predict social anxiety: an ecological momentary assessment study. Cogn Emot 2021; 35:1479-1498. [PMID: 34455927 DOI: 10.1080/02699931.2021.1969339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Social anxiety occurs in everyday social interactions, yet the real-world factors that shape the moment-to-moment experience of social anxiety have not been fully explored. Using ecological momentary assessments (smartphone-based, five signals a day for 21 days), the present study examined the associations between state social anxiety (SSA) and characteristics of interaction partners in varied contexts, and how these momentary associations differed with trait social anxiety (TSA). Ninety-two participants (54% female, age from 18 to 34) completed 4185 momentary reports. Results from multilevel models showed that perceived judgmentalness and unfamiliarity of interaction partners were positively associated with SSA, and the associations were stronger for the high TSA group (n = 30) compared to a control group (n = 62). Exploratory analyses with various types of interaction partners and social settings revealed noticeable group differences in how the types were associated with SSA (e.g. acquaintance, close friend/romantic partner) and how they influenced the effect of judgmentalness and unfamiliarity on SSA (e.g. authority, work/school). Overall, the findings highlight the role of contextual associations in social anxiety, and the benefits and the need for more comprehensive approaches with EMA in studying social anxiety, particularly its contextual aspects.
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Affiliation(s)
- J Hannah Lee
- Department of Psychology, Indiana University Northwest, Gary, IN, USA
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Comparing Signal-Contingent and Event-Contingent Experience Sampling Ratings of Affect in a Sample of Psychotherapy Outpatients. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2021; 42:13-24. [PMID: 33664551 DOI: 10.1007/s10862-019-09766-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
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 landscapes via the Earth Mover's Distance (EMD) metric. We found that event-contingent schedules, relative to signal-contingent schedules, captured higher average levels of pleasant valence and emotional arousal ratings. Moreover, signal-contingent schedules captured greater variability within and between individuals on arousal-valence landscapes compared to event-contingent schedules. Altogether, findings suggest that the two assessment schedules should not be treated interchangeably in the assessment of affect over time. Researchers must be cautious in generalizing results across studies utilizing different experience sampling assessment schedules.
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Heinonen E, Pos AE. The role of pre-treatment interpersonal problems for in-session emotional processing and long-term outcome in emotion-focused psychotherapy. Psychother Res 2019; 30:635-649. [DOI: 10.1080/10503307.2019.1630778] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Affiliation(s)
- Erkki Heinonen
- National Institute for Health and Welfare, Helsinki, Finland
- Department of Psychology, York University, Toronto, ON, Canada
- Department of Psychology and Logopedics, University of Helsinki, Finland
| | - Alberta E. Pos
- Department of Psychology, York University, Toronto, ON, Canada
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Rejection Sensitivity and Self-Regulation of Daily Interpersonal Events. JOURNAL OF CONTEMPORARY PSYCHOTHERAPY 2019. [DOI: 10.1007/s10879-019-09424-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Yang X, Ram N, Gest SD, Lydon-Staley DM, Conroy DE, Pincus AL, Molenaar PC. Socioemotional Dynamics of Emotion Regulation and Depressive Symptoms: A Person-Specific Network Approach. COMPLEXITY 2018; 2018:5094179. [PMID: 30613129 PMCID: PMC6319954 DOI: 10.1155/2018/5094179] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Socioemotional processes engaged in daily life may afford and/or constrain individuals' emotion regulation in ways that affect psychological health. Recent findings from experience sampling studies suggest that persistence of negative emotions (emotion inertia), the strength of relations among an individual's negative emotions (density of the emotion network), and cycles of negative/aggressive interpersonal transactions are related to psychological health. Using multiple bursts of intensive experience sampling data obtained from 150 persons over one year, person-specific analysis, and impulse response analysis, this study quantifies the complex and interconnected socioemotional processes that surround individuals' daily social interactions and on-going regulation of negative emotion in terms of recovery time. We also examine how this measure of regulatory inefficiency is related to interindividual differences and intraindividual change in level of depressive symptoms. Individuals with longer recovery times had higher overall level of depressive symptoms. As well, during periods where recovery time of sadness was longer than usual, individuals' depressive symptoms were also higher than usual, particularly among individuals who experienced higher overall level of stressful life events. The findings and analysis highlight the utility of a person-specific network approach to study emotion regulation, how regulatory processes change over time, and potentially how planned changes in the configuration of individuals' systems may contribute to psychological health.
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Affiliation(s)
| | - Nilam Ram
- Pennsylvania State University
- German Institute for Economic Research (DIW), Berlin
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Everyday social interactions and intra-individual variability in affect: A systematic review and meta-analysis of ecological momentary assessment studies. MOTIVATION AND EMOTION 2018. [DOI: 10.1007/s11031-018-9735-x] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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An interpersonal perspective on Criterion A of the DSM-5 Alternative Model for Personality Disorders. Curr Opin Psychol 2018; 21:11-17. [DOI: 10.1016/j.copsyc.2017.08.035] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Revised: 08/27/2017] [Accepted: 08/29/2017] [Indexed: 11/21/2022]
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Cain NM, Meehan KB, Roche MJ, Clarkin JF, De Panfilis C. Effortful Control and Interpersonal Behavior in Daily Life. J Pers Assess 2018; 101:315-325. [DOI: 10.1080/00223891.2018.1441151] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
| | - Kevin B. Meehan
- Department of Psychology, Long Island University
- Department of Psychiatry, Weill Medical College of Cornell University
| | - Michael J. Roche
- Department of Psychology, The Pennsylvania State University at Altoona
| | - John F. Clarkin
- Department of Psychiatry, Weill Medical College of Cornell University
| | - Chiara De Panfilis
- Department of Neuroscience, Unit of Psychiatry, University of Parma, Parma, Italy
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Ram N, Benson L, Brick TR, Conroy DE, Pincus AL. Behavioral Landscapes and Earth Mover's Distance: A New Approach for Studying Individual Differences in Density Distributions. JOURNAL OF RESEARCH IN PERSONALITY 2017; 69:191-205. [PMID: 28959082 PMCID: PMC5612642 DOI: 10.1016/j.jrp.2016.06.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Contemporary views of personality highlight intraindividual variability. We forward a general method for quantifying individual differences in behavioral tendencies based on Earth Mover's Distance. Using data from 150 individuals who reported on their and others' interpersonal behavior in 64,112 social interactions, we illustrate how this new approach can advance notions of personality as density distributions. Results provide independent confirmation and establish validity of existing representations of individual differences in interpersonal behavior, and identify new dimensions and profiles of personality and well-being. Benefits of the EMD method include freedom from assumptions about the shape and form of density distributions, generality of application to n-dimensional behavior captured in experience sampling studies, and natural integration of personality structure and dynamics.
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Affiliation(s)
- Nilam Ram
- Pennsylvania State University
- German Institute for Economic Research (DIW), Berlin
| | | | - Timothy R. Brick
- Pennsylvania State University
- Max Planck Institute for Human Development, Berlin
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Soundy A, Roskell C, Elder T, Collett J, Dawes H. The Psychological Processes of Adaptation and Hope in Patients with Multiple Sclerosis: A Thematic Synthesis. ACTA ACUST UNITED AC 2016. [DOI: 10.4236/ojtr.2016.41003] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Ambwani S, Roche MJ, Minnick AM, Pincus AL. Negative affect, interpersonal perception, and binge eating behavior: An experience sampling study. Int J Eat Disord 2015; 48:715-26. [PMID: 25946681 DOI: 10.1002/eat.22410] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/12/2015] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Etiological and maintenance models for disordered eating highlight the salience of negative affect and interpersonal dysfunction. This study employed a 14-day experience sampling procedure to assess the impact of negative affect and interpersonal perceptions on binge eating behavior. METHOD Young adult women (N = 40) with recurrent binge eating and significant clinical impairment recorded their mood, interpersonal behavior, and eating behaviors at six stratified semirandom intervals daily through the use of personal digital assistants. RESULTS Although momentary negative affect was associated with binge eating behavior, average levels of negative affect over the experience sampling period were not, and interpersonal problems moderated the relationship between negative affect and binge eating. Interpersonal problems also intensified the association between momentary interpersonal perceptions and binge eating behavior. Lagged analyses indicated that previous levels of negative affect and interpersonal style also influence binge eating. DISCUSSION The study findings suggest there may be important differences in how dispositional versus momentary experiences of negative affect are associated with binge eating. Results also highlight the importance of interpersonal problems for understanding relationships among negative affect, interpersonal perception, and binge eating behavior. These results offer several possibilities for attending to affective and interpersonal functioning in clinical practice.
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Affiliation(s)
- Suman Ambwani
- Psychology Department, Dickinson College, Carlisle, PA
| | | | - Alyssa M Minnick
- Perelman School of Medicine, Department of Psychiatry, University of Pennsylvania, Pennsylvania, Philadelphia
| | - Aaron L Pincus
- Department of Psychology, Pennsylvania State University, State College, PA
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