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Negri A, Mariani R, Tanzilli A, Fiorini Bincoletto A, Lingiardi V, Christian C. A Single Case Multimethod Assessment to Detect Significant Changes in the Psychoanalytic Treatment of Psychosomatic Disorders. J Pers Assess 2024; 106:696-707. [PMID: 38407092 DOI: 10.1080/00223891.2024.2312978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 01/23/2024] [Indexed: 02/27/2024]
Abstract
Mental disorders with body-centered symptoms, such as somatic, eating, and body dysmorphic disorders, present difficulties in psychotherapy because psychological suffering is manifested in the body rather than expressed verbally. The present study illustrates a single case multi-method investigation sensitive to detecting characteristic change manifestations in the treatment of these disorders. We investigated a treatment of a patient with body dysmorphic disorder. Computerized linguistic measures were applied to 86 sessions to assess changes in symbolic processing; out of the 86 sessions, 40 were analyzed to calculate the proportion of speech focused on bodily symptoms versus on relationships. Changes in personality were assessed using the SWAP-200 on nine sessions from different treatment stages. Measures of linguistic style, speech content, and personality showed marked changes over the treatment. The patient manifested schizoid and schizotypal personality traits that decreased over time, along with an increase in personality high-functioning dimension. The patient's ability to translate his emotional experience into words steadily increased, switching the primary focus of narratives from bodily symptoms to relationships. A multimethod assessment of the treatment of body dysmorphic disorder shows that improvement in personality functioning is accompanied by a shift from a focus on bodily experiences to a focus on relationships.
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Affiliation(s)
- Attà Negri
- Department of Human and Social Sciences, University of Bergamo, Italy
| | - Rachele Mariani
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Italy
| | - Annalisa Tanzilli
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Italy
| | - Alice Fiorini Bincoletto
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Italy
| | - Vittorio Lingiardi
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Italy
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Leung YW, Wouterloot E, Adikari A, Hong J, Asokan V, Duan L, Lam C, Kim C, Chan KP, De Silva D, Trachtenberg L, Rennie H, Wong J, Esplen MJ. Artificial Intelligence-Based Co-Facilitator (AICF) for Detecting and Monitoring Group Cohesion Outcomes in Web-Based Cancer Support Groups: Single-Arm Trial Study. JMIR Cancer 2024; 10:e43070. [PMID: 39037754 DOI: 10.2196/43070] [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: 10/03/2022] [Revised: 07/07/2023] [Accepted: 05/08/2024] [Indexed: 07/23/2024] Open
Abstract
BACKGROUND Commonly offered as supportive care, therapist-led online support groups (OSGs) are a cost-effective way to provide support to individuals affected by cancer. One important indicator of a successful OSG session is group cohesion; however, monitoring group cohesion can be challenging due to the lack of nonverbal cues and in-person interactions in text-based OSGs. The Artificial Intelligence-based Co-Facilitator (AICF) was designed to contextually identify therapeutic outcomes from conversations and produce real-time analytics. OBJECTIVE The aim of this study was to develop a method to train and evaluate AICF's capacity to monitor group cohesion. METHODS AICF used a text classification approach to extract the mentions of group cohesion within conversations. A sample of data was annotated by human scorers, which was used as the training data to build the classification model. The annotations were further supported by finding contextually similar group cohesion expressions using word embedding models as well. AICF performance was also compared against the natural language processing software Linguistic Inquiry Word Count (LIWC). RESULTS AICF was trained on 80,000 messages obtained from Cancer Chat Canada. We tested AICF on 34,048 messages. Human experts scored 6797 (20%) of the messages to evaluate the ability of AICF to classify group cohesion. Results showed that machine learning algorithms combined with human input could detect group cohesion, a clinically meaningful indicator of effective OSGs. After retraining with human input, AICF reached an F1-score of 0.82. AICF performed slightly better at identifying group cohesion compared to LIWC. CONCLUSIONS AICF has the potential to assist therapists by detecting discord in the group amenable to real-time intervention. Overall, AICF presents a unique opportunity to strengthen patient-centered care in web-based settings by attending to individual needs. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.2196/21453.
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Affiliation(s)
- Yvonne W Leung
- de Souza Institute, University Health Network, Toronto, ON, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- College of Professional Studies, Northeastern University, Toronto, ON, Canada
| | - Elise Wouterloot
- de Souza Institute, University Health Network, Toronto, ON, Canada
| | - Achini Adikari
- Centre for Data Analytics and Cognition, La Trobe University, Melbourne, Australia
| | - Jinny Hong
- de Souza Institute, University Health Network, Toronto, ON, Canada
| | - Veenaajaa Asokan
- de Souza Institute, University Health Network, Toronto, ON, Canada
| | - Lauren Duan
- de Souza Institute, University Health Network, Toronto, ON, Canada
| | - Claire Lam
- de Souza Institute, University Health Network, Toronto, ON, Canada
| | - Carlina Kim
- de Souza Institute, University Health Network, Toronto, ON, Canada
| | - Kai P Chan
- de Souza Institute, University Health Network, Toronto, ON, Canada
| | - Daswin De Silva
- Centre for Data Analytics and Cognition, La Trobe University, Melbourne, Australia
| | - Lianne Trachtenberg
- de Souza Institute, University Health Network, Toronto, ON, Canada
- Centre for Psychology and Emotional Health, Toronto, ON, Canada
| | - Heather Rennie
- de Souza Institute, University Health Network, Toronto, ON, Canada
- BC Cancer Agency, Vancouver, BC, Canada
| | - Jiahui Wong
- de Souza Institute, University Health Network, Toronto, ON, Canada
| | - Mary Jane Esplen
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
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Renzi A, Mariani R, Fedele F, Maniaci VG, Petrovska E, D’Amelio R, Mazzoni G, Di Trani M. Women's Narratives on Infertility as a Traumatic Event: An Exploration of Emotional Processing through the Referential Activity Linguistic Program. Healthcare (Basel) 2023; 11:2919. [PMID: 37998411 PMCID: PMC10671616 DOI: 10.3390/healthcare11222919] [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: 09/18/2023] [Revised: 10/25/2023] [Accepted: 11/06/2023] [Indexed: 11/25/2023] Open
Abstract
BACKGROUND the diagnosis of infertility and its related treatment can be traumatic, leading to profound psychological distress and a variety of psychopathological symptoms. The primary objective of this study is to contrast the linguistic features of narratives from women undergoing Assisted Reproductive Treatment with those of women not undergoing any fertility treatment. This study examines the speech of both groups of individuals as an indicator of their capacity to cope with current and past distressing experiences. METHOD 44 women (mean age 36.05; SD = 4.66) enrolled in a fertility medical center in Rome, and 43 control women (mean age 36.07; SD = 3.47) completed a socio-demographic questionnaire and a semi-structured interview designed to collect their memories of a neutral, a positive, and a negative event. This interview also aimed to investigate: (a) (for women with fertility difficulties) how they realized they and their partner had fertility problems and a description of an event when they talked about these difficulties with their partner; and (b) (for control group participants) the most difficult moment of their pregnancy and an event when they talked about it with their partner. The interviews were audio recorded and transcribed, and the text was analyzed using the referential process (RP) linguistic measures software. RESULTS Mann-Whitney non-parametric U tests for the independent samples showed several significant differences regarding the linguistic measures applied to the narratives of neutral, positive, negative, and difficult experiences in the form of a linguistic style, with more intellectualization and defenses in all the narratives associated with the women with fertility problems compared to the women in the control group. CONCLUSIONS the traumatic and painful experience of infertility and ART seems to characterize the whole mode of narrating life experiences. Present findings sustain the importance of helping women to elaborate on their experience and to understand and recognize the difficult feelings that are activated in relation to the difficulties of having a child.
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Affiliation(s)
- Alessia Renzi
- Department of Dynamic and Clinical Psychology and Health Studies, Sapienza University of Rome, Via degli Apuli 1, 00185 Rome, Italy; (R.M.); (V.G.M.); (G.M.); (M.D.T.)
| | - Rachele Mariani
- Department of Dynamic and Clinical Psychology and Health Studies, Sapienza University of Rome, Via degli Apuli 1, 00185 Rome, Italy; (R.M.); (V.G.M.); (G.M.); (M.D.T.)
| | - Fabiola Fedele
- ART Italian National Register, National Centre for Diseases Prevention and Health Promotion, Italian National Health Institute, Viale Regina Elena 299, 00161 Rome, Italy;
| | - Vito Giuseppe Maniaci
- Department of Dynamic and Clinical Psychology and Health Studies, Sapienza University of Rome, Via degli Apuli 1, 00185 Rome, Italy; (R.M.); (V.G.M.); (G.M.); (M.D.T.)
| | - Elena Petrovska
- Derner School of Psychology, Adelphi University, Garden City, NY 11530-0701, USA;
| | - Renzo D’Amelio
- Department of Gynecologic-Obstetrical and Urologic Sciences, Umberto I Hospital, Sapienza University of Rome, 00185 Rome, Italy;
| | - Giuliana Mazzoni
- Department of Dynamic and Clinical Psychology and Health Studies, Sapienza University of Rome, Via degli Apuli 1, 00185 Rome, Italy; (R.M.); (V.G.M.); (G.M.); (M.D.T.)
| | - Michela Di Trani
- Department of Dynamic and Clinical Psychology and Health Studies, Sapienza University of Rome, Via degli Apuli 1, 00185 Rome, Italy; (R.M.); (V.G.M.); (G.M.); (M.D.T.)
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Mariani R, Marini I, Di Trani M, Catena C, Patino F, Riccioni R, Pasquini M. Emotional dysregulation and linguistic patterns as a defining feature of patients in the acute phase of anorexia nervosa. Eat Weight Disord 2022; 27:3267-3277. [PMID: 35939211 PMCID: PMC9358383 DOI: 10.1007/s40519-022-01456-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 07/20/2022] [Indexed: 01/06/2023] Open
Abstract
PURPOSE This research aims to analyze the relationship between emotional regulation and the symbolic process in autobiographical narratives of a group of individuals diagnosed with restrictive anorexia nervosa (AN), compared to a non-clinical group. The study is framed within multiple code theory (MCT) (Bucci, 1997; 2021), which considers mind-body integration. The purposes of this study are to investigate whether participants of the AN group will show greater alexithymia and emotional dysregulation than the non-clinical group; and whether the specific linguistic and symbolic features, such as somato-sensory words, affect words, and difficulty in the symbolizing process will predict the AN group. METHODS Twenty-nine female participants hospitalized with AN during an acute phase (mean age 19.8 ± 4.1) and 36 non-clinical female participants (mean age 21 ± 2.4) were selected through snow-ball sampling. The participants completed the Toronto Alexithymia Scale (TAS-20), the Profile of Mood of State (POMS), the Emotion Regulation Questionnaire (ERQ), and the Relationship Anecdotes Paradigm Interview (RAP). The RAP interview was audio-recorded and transcribed to apply the Referential Process (RP) Linguistic Measures. A T test for paired samples and a logistic binary regression was performed. RESULTS AN presented a significantly higher emotional dysregulation through the ERQ, TAS20 and POMS measures. Specifically, AN showed higher ER expression/suppression strategies, fewer functional cognitive strategies, higher alexithymia, and higher mood dysregulation. Specific linguistic features such as sensory-somatic, word affect, and difficulty in RP symbolizing predict the AN group (R2 = 0.349; χ2 = 27,929; df = 3; p = .001). CONCLUSIONS Emotional dysregulation is connected to AN symptoms and autobiographical narratives. The results can help a clinical assessment phase showing specific linguistic features in AN patients. LEVEL OF EVIDENCE Level II, controlled trial without randomization.
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Affiliation(s)
- Rachele Mariani
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Rome, Italy.
| | - Isabella Marini
- Azienda Ospedaliera-Universitaria, Policlinico Umberto I, Rome, Italy
| | - Michela Di Trani
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Rome, Italy
| | - Carlotta Catena
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Rome, Italy
| | - Francesca Patino
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Rome, Italy
| | | | - Massimo Pasquini
- Department of Human Neurosciences, Sapienza University, Rome, Italy
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Negri A, Castiglioni M, Caldiroli CL, Barazzetti A. Language and Intelligence: A Relationship Supporting the Embodied Cognition Hypothesis. J Intell 2022; 10:jintelligence10030042. [PMID: 35893273 PMCID: PMC9326655 DOI: 10.3390/jintelligence10030042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 07/01/2022] [Accepted: 07/12/2022] [Indexed: 11/16/2022] Open
Abstract
Cognitive science has gathered robust evidence supporting the hypothesis that cognitive processes do not occur in an amodal format but take shape through the activation of the sensorimotor systems of the agent body, which works as simulation system upon which concepts, words, and thought are based. However, studies that have investigated the relationship between language and cognitive processes, as both embedded processes, are very rare. In this study, we investigated the hypothesis that intelligence is associated with referential competence, conceived as the ability to find words to refer to our subjective and perceptual experience, and to evoke understanding of this experience in the listener. We administered the WAIS-IV test to 32 nonclinical subjects and collected autobiographical narratives from them through the Relationship Anecdotes Paradigm Interview. The narratives were analyzed linguistically by applying computerized measures of referential competence. Intelligence scores were found to correlate with the use in narratives of words related to somatic and sensory sensations, while they were not associated with other measures of referential competence related to more abstract domains of experience or based on vivid or reflective dimensions of language style. The results support the hypothesis that sensorimotor schemas have an intrinsic role in language and cognition.
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Affiliation(s)
- Attà Negri
- Department of Human and Social Sciences, University of Bergamo, 24129 Bergamo, Italy;
- Correspondence:
| | - Marco Castiglioni
- Department of Human Sciences for Education, University of Milano-Bicocca, 20126 Milan, Italy; (M.C.); (C.L.C.)
| | - Cristina Liviana Caldiroli
- Department of Human Sciences for Education, University of Milano-Bicocca, 20126 Milan, Italy; (M.C.); (C.L.C.)
| | - Arianna Barazzetti
- Department of Human and Social Sciences, University of Bergamo, 24129 Bergamo, Italy;
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Rocco D, Rizzi L, Dell'Arciprete G, Perrella R. The Functional Psychotherapy Approach: A Process-Outcome Multiple Case Study. Front Psychol 2022; 12:727497. [PMID: 35069311 PMCID: PMC8777224 DOI: 10.3389/fpsyg.2021.727497] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 12/07/2021] [Indexed: 11/25/2022] Open
Abstract
Objective: The present work aims to conduct the first naturalistic empirical investigation of the process and outcome assessment of functional psychotherapy (FP) treatment. The FP model of psychotherapy is rooted in psychoanalysis and integrates the verbal communication approach founded on transference and countertransference dynamics with the analysis of bodily processes. Method: The study sample included ten patients recruited on a voluntary basis and treated by clinicians in their private practices. Each patient received FP with an average duration of 40 h (min 35 and max 42). Therapies had weekly sessions, were audio-recorded with the patient’s written consent, and lasted for an average of 10 months (min 9 and max 12). Outcome and process tools included the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) and the Luborsky’s the Core Conflictual Relationship Theme (CCRT), used to assess therapeutic benefit, and the Metacognition Assessment Scale (MAS) and the Italian Discourse Attributes Analysis Program (IDAAP) system, used to evaluate therapeutic benefit and process. The MMPI-2 was used also in the follow-up assessment. Results: Results show that FP had a positive therapeutic outcome on the patients assessed in this study, and that the therapeutic benefits were maintained over time. Some specific features of the FP approach were found to contribute more than others to the observed therapeutic benefits. Conclusion: The current investigation constitutes a first step toward assessment of the therapeutic effectiveness of FP. Future developments should apply the methodology to a larger sample, possibly introducing different methodologies to enable detection of specific bodily oriented processes and techniques.
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Affiliation(s)
- Diego Rocco
- Department of Developmental and Social Psychology, University of Padua, Padua, Italy
| | - Luca Rizzi
- Associazione Centro di Psicologia e Psicoterapia Funzionale, Istituto SIF, Padua, Italy
| | - Gaia Dell'Arciprete
- Department of Developmental and Social Psychology, University of Padua, Padua, Italy
| | - Raffaella Perrella
- Department of Psychology, University of Campania "Luigi Vanvitelli", Caserta, Italy
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Mariani R, Musetti A, Di Monte C, Danskin K, Franceschini C, Christian C. Maladaptive Daydreaming in Relation to Linguistic Features and Attachment Style. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 19:ijerph19010386. [PMID: 35010644 PMCID: PMC8751151 DOI: 10.3390/ijerph19010386] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 12/24/2021] [Accepted: 12/28/2021] [Indexed: 01/09/2023]
Abstract
(1) Background: Maladaptive daydreaming (MD) is a concept that describes a significant imaginary activity that replaces human engagement and/or interferes with academic, interpersonal, or vocational functioning. We explored the interaction between attachment style, reflective functioning (RF), and the narrative dimension of MD. (2) Methods: 414 adults completed an online survey, including socio-demographic variables, the 16-item Maladaptive Daydreaming Scale, the Symptom Checklist-90-Revised, Relationship Questionnaire, and Reflective Functioning Questionnaire. Participants were asked to write a short description of the most representative episodes of their daydreams. Eighty-four participants were identified as maladaptive daydreamers (MDers). (3) Results: A set of t-tests between MDers and non-MDers group showed differences in attachment dimensions, RF, and linguistic measures. A linear regression model with Global Severity Index (GSI) of the revised Symptom Checklist-90 as the dependent variable, and psychological scales as independent variables showed that the MD score was the strongest predictor of GSI. Regarding differences between the two groups in linguistic measures, the MDers showed more use of reflection and sensory-somatic words, and a smaller number of affective words. (4) Conclusions: These results support the idea that the MD is a process connected to psychopathological mechanisms, probably to a sub-symbolic activation, and to dysfunctional self-other relational patterns that are difficult to integrate.
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Affiliation(s)
- Rachele Mariani
- Department of Dynamic and Clinical Psychology and Health Studies “Sapienza”, University of Rome, Via degli Apuli 1, 00185 Rome, Italy;
- Correspondence:
| | - Alessandro Musetti
- Department of Humanities, Social Sciences and Cultural Industries, University of Parma, 43125 Parma, Italy;
| | - Cinzia Di Monte
- Department of Dynamic and Clinical Psychology and Health Studies “Sapienza”, University of Rome, Via degli Apuli 1, 00185 Rome, Italy;
| | - Kerri Danskin
- Licensed Psychologist in Private Practice, Princeton, NJ 08544, USA;
| | | | - Christopher Christian
- Department of Psychology, City College, City University of New York, 160 Convent Avenue, New York, NY 10031, USA;
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Andreassi S, Monaco S, Salvatore S, Sciabica GM, De Felice G, Petrovska E, Mariani R. 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. Healthcare (Basel) 2021; 9:healthcare9121754. [PMID: 34946480 PMCID: PMC8701455 DOI: 10.3390/healthcare9121754] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 12/09/2021] [Accepted: 12/17/2021] [Indexed: 12/23/2022] Open
Abstract
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.
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Affiliation(s)
- Silvia Andreassi
- Department of Dynamic and Clinical Psychology and Health Studies Sapienza, University of Rome, 00185 Rome, Italy; (S.M.); (S.S.); (G.M.S.); (R.M.)
- Correspondence:
| | - Silvia Monaco
- Department of Dynamic and Clinical Psychology and Health Studies Sapienza, University of Rome, 00185 Rome, Italy; (S.M.); (S.S.); (G.M.S.); (R.M.)
| | - Sergio Salvatore
- Department of Dynamic and Clinical Psychology and Health Studies Sapienza, University of Rome, 00185 Rome, Italy; (S.M.); (S.S.); (G.M.S.); (R.M.)
| | - Gaetano Maria Sciabica
- Department of Dynamic and Clinical Psychology and Health Studies Sapienza, University of Rome, 00185 Rome, Italy; (S.M.); (S.S.); (G.M.S.); (R.M.)
| | - Giulio De Felice
- Xenophon College London, University of Chichester, Chichester PO19 6PE, UK;
| | - Elena Petrovska
- Derner School of Psychology, Adelphi University, Garden City, New York, NY 11530-0701, USA;
| | - Rachele Mariani
- Department of Dynamic and Clinical Psychology and Health Studies Sapienza, University of Rome, 00185 Rome, Italy; (S.M.); (S.S.); (G.M.S.); (R.M.)
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Mariani R, Gennaro A, Monaco S, Di Trani M, Salvatore S. Narratives of Dreams and Waking Thoughts: Emotional Processing in Relation to the COVID-19 Pandemic. Front Psychol 2021; 12:745081. [PMID: 34795615 PMCID: PMC8593037 DOI: 10.3389/fpsyg.2021.745081] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 10/12/2021] [Indexed: 12/12/2022] Open
Abstract
The Coronavirus-19 (COVID-19) pandemic posed a significant challenge to the physical, mental, and emotional well-being of each individual. It also brought the importance of daily emotional management for survival to the forefront of every human being. Our study aims to explore whether emotional processes perform different functions during waking thoughts and night dreams during the first lockdown in Italy. Utilizing Multiple Code Theory (MCT), our goal is to verify whether waking thoughts facilitate a functional disconnection in order to manage the trauma caused by COVID-19. Two online forms were distributed to random participants in the general population, presenting a total of 49 reports of night dreams (23 males; mean age 33.45 ds. 10.12; word mean 238.54 ds. 146.8) and 48 reports of waking thoughts (25 males; mean age 34.54 ds. 12.8; word mean M. 91 words ds. 23). The Referential Process linguistic measures and Affect Salience Index were utilized. It was found that Affect Salience is present in both dreams and in waking thoughts; however, Referential Activity was higher in dreams and Reflection and Affect words were higher in waking thoughts. Two different processes of emotional elaboration emerged. The results highlight the use of greater symbolization processes during dreams and a higher emotional distance in waking thoughts. These results confirm that during the nocturnal processes, there is greater contact with the processing of trauma, while during the diurnal processes, defensive strategies were activated to cope with and manage life via a moment of the defensive disruption of daily activities.
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Affiliation(s)
- Rachele Mariani
- Department of Dynamic and Clinical Psychology, and Health Studies, University of Sapienza, Rome, Italy
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Putting into Words the COVID-19 Lockdown Experience: Psychological Symptoms and the Referential Process. Healthcare (Basel) 2021; 9:healthcare9091100. [PMID: 34574874 PMCID: PMC8464981 DOI: 10.3390/healthcare9091100] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Revised: 08/23/2021] [Accepted: 08/23/2021] [Indexed: 11/17/2022] Open
Abstract
The coronavirus pandemic is a unique collective event which has affected the physical and psychological health of all individuals. Restrictions imposed by governments to counteract this situation have represented risk factors for developing psychopathological symptoms. This study aims to explore the relationship between psychological symptoms and the referential process (RP). Forty-eight healthy participants (25 males, mean age = 39.3; SD = 16.6) completed a demographic questionnaire and the Symptom Checklist-90-Revised (SCL-90-R) through an online platform and wrote about their experience 3 weeks after the imposition of the lockdown. Different linguistic measures of the RP were applied to the narratives. The logical functions expressed through written narratives (The Italian Reflection Dictionary score, IREF) showed significant positive correlations with the SCL-90-R General Score Index (GSI) and different SCL-90-R subscales (depression, anxiety, obsessive-compulsiveness, interpersonal sensitivity, hostility, and paranoid ideation). On the contrary, the reorganization and reflection function related to emotional events (The Italian Weighted Reflection and Reorganization List score, IWRRL) showed significant negative correlations with the SCL-90-R’s GSI and different subscales (obsessive-compulsiveness, depression, anxiety). The results highlight the relationship between psychological symptoms and complex defense mechanisms based on the intellectualization of negative emotions and a positive strategy of reorganization based on emotional elaboration. These results suggest the importance of supporting collective elaborations of citizens in the context of the pandemic.
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Mariani R, Monaco S, Christian C, Di Trani M. Dreaming in quarantine: linguistic analysis of referential process of dreams during COVID-19 pandemic lockdown. RESEARCH IN PSYCHOTHERAPY (MILANO) 2021; 24:537. [PMID: 34568106 PMCID: PMC8451209 DOI: 10.4081/ripppo.2021.537] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 04/24/2021] [Indexed: 11/26/2022]
Abstract
The spread of coronavirus disease 2019 (COVID-19) became a collective trauma adversely affecting physical and psychological health. The impact of this trauma made itself manifest in a myriad of ways, including through dreams. This study aimed to explore the Referential Process (RP, Bucci, 2021) of dreams reported during quarantine. Dream samples were collected through a social blog. Linguistic analysis and clinical evaluation were conducted to explore the group's collective elaboration of a shared traumatic experience. Sixty-eight people (22 males; mean age 26.16 ds. 7.68) contributed to a social-blog, writing their dreams. 91 dreams were collected and transcribed using transcription rules for the Discourse Attributes Analysis Program (DAAP). Linguistic measures of RP were applied and a statistical cluster analysis was performed. In addition, each dream was evaluated by trained judges on three specific qualities of the RP (Arousal, Symbolizing, and Reflection/Reorganizing). Clinical judges in a double-blinded method reached reliable scoring (Arousal α.874 ICC 0.701; Symbolizing α.783 ICC 0.671; Reflection/reorganization α.884 ICC 0.758). Cluster Analysis yielded three dream clusters. 26 dreams fell under a cluster defined as a symbolizing process (Cluster A); 16 into a cluster defined as arousal of emotional activation (Cluster B); and 49 dreams fell into a cluster defined as Reflection/Reorganizing elaboration (Cluster C). Each cluster showed specific linguistic features. The dreams collected through a blog showed a Referential Process that is similar to that found in psychotherapy process. Results suggests that writing dreams can play different functions in processing and integrating social traumatic experience.
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Affiliation(s)
- Rachele Mariani
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Rome, Italy
| | - Silvia Monaco
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Rome, Italy
| | | | - Michela Di Trani
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Rome, Italy
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Maskit B. Overview of Computer Measures of the Referential Process. JOURNAL OF PSYCHOLINGUISTIC RESEARCH 2021; 50:29-49. [PMID: 33464426 DOI: 10.1007/s10936-021-09761-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/29/2020] [Indexed: 06/12/2023]
Abstract
The Referential Process (RP) has three functions or processes, called Arousal, Symbolizing, and Reflecting/Reorganizing. Taken together, these provide a framework within which to address the question: how do people connect nonverbal experience and verbal forms. The purpose of this paper is to describe the Discourse Attributes Analysis Program (DAAP), which uses certain dictionaries or word lists to produce measures that model the referential process functions. These dictionaries are also described. The referential process may occur in any type of discourse context and the DAAP computer system may be applied to any type of verbal data. The focus in this paper is on transcripts of psychotherapy sessions. DAAP provides numeric and graphic data at several levels of discourse including word-by-word data concerning dictionary matches; average data for each turn of speech; average data for each speaker for each session; numeric data and graphic images for each session; and overall session data for each treatment. Graphic images of the ebb and flow of these computer generated functions of the referential process over the course of a therapy session are presented and interpreted. There are also discussions of new relational measures, as well as the referential process data base, which currently contains numerical data for 22 treatments, and presentations of several applications.
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Affiliation(s)
- Bernard Maskit
- Mathematics Department, Stony Brook University, Stony Brook, NY, 11794-3651, USA.
- , New York, USA.
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Zhang X, Bucci W. Locating Nodal Moments Within Psychotherapy Sessions: A Mixed-Methods Study Using a Computerized Measure and Therapist Comments. JOURNAL OF PSYCHOLINGUISTIC RESEARCH 2021; 50:223-230. [PMID: 33543380 DOI: 10.1007/s10936-021-09772-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/12/2021] [Indexed: 06/12/2023]
Abstract
A computerized linguistic measure, the Weighted Referential Activity Dictionary (WRAD), was applied to locate nodal turns of speech in psychotherapy, defined here as significant moments of patient emotional communication that are likely to reveal important themes. Two published demonstration sessions conducted by a senior clinician, who made extensive comments on this material, were utilized to illustrate the method. The WRAD, defined in the context of referential process theory, was developed and has been validated as assessing the vividness and immediacy of language. Segments of patient speech (turns of speech) were classified based on WRAD level and sufficient length. The themes of the therapist's clinical comments concerning high WRAD segments were coded using a category system developed for this study, and were compared to themes of comments for the remaining segments. Results showed a significant difference in the therapist's comments between the two groups of segments using Fisher's exact test. In particular, the therapist's comments on the nodal turns showed more focus on the emotional effects of the patient's utterances on him, as well as identification of unexpected disclosures in these utterances. The implications and limitations of this method are discussed.
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Affiliation(s)
- Xinyao Zhang
- Department of Counseling & Clinical Psychology, Columbia University, New York, NY, USA.
- The Pacella Research Center, New York Psychoanalytic Society and Institute, New York, NY, USA.
- Department of Educational Psychology, University of Utah, 1721 E. Campus Center Dr., SAEC 3220, Salt Lake City, UT, 84112, USA.
| | - Wilma Bucci
- Derner School of Psychology, Adelphi University, Garden City, NY, USA
- The Pacella Research Center, New York Psychoanalytic Society and Institute, New York, NY, USA
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Mariani R, Hoffman L. Analytic Process and Linguistic Style: Exploring Analysts' Treatment Notes in the Light of Linguistic Measures of the Referential Process. JOURNAL OF PSYCHOLINGUISTIC RESEARCH 2021; 50:193-206. [PMID: 33528713 PMCID: PMC7940265 DOI: 10.1007/s10936-021-09771-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 01/12/2021] [Indexed: 06/12/2023]
Abstract
This paper presents a comparison between a clinical evaluation and a computerized linguistic analysis of the treatment notes of the first two years of an analysis conducted four sessions a week with the patient lying on a couch. Clinical notes had been written as part of the analyst's standard practice after every session, some years prior to the planning of this study. The notes describe the analytic interchange and the analyst's internal thoughts. The linguistic analysis focuses on two analytically relevant linguistic variables: Referential Activity (RA), a measure of the degree of connection between emotional processing and language, and Reflection, the use of words referring to thoughts. The examination of the linguistic measures point to overlooked parts of sessions which may be clinically significant. In particular, the examination of the clinical material during the nodal points of the first summer break, where significant changes in the linguistic measures were seen, provided clinical understanding of the analytic work that was not explicitly noted at the time of treatment. This method has the potential to be utilized in ongoing treatments and to improve the supervisory process.
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Affiliation(s)
- Rachele Mariani
- Department of Dynamic and Clinical Psychology, Sapienza University, Rome, Italy.
| | - Leon Hoffman
- Pacella Research Center, New York Psychoanalytic Society and Institute, New York City, NY, USA
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15
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Negri A, Ongis M. Stimulus Features of the Object Relations Technique Affecting the Linguistic Qualities of Individuals' Narratives. JOURNAL OF PSYCHOLINGUISTIC RESEARCH 2021; 50:65-83. [PMID: 33481158 PMCID: PMC7940262 DOI: 10.1007/s10936-021-09764-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/06/2021] [Indexed: 06/12/2023]
Abstract
Previous studies on projective techniques have investigated the effects of variation in stimulus features on individuals' response behavior. In particular, the influence of chromatic colors and form definition on the images elicited by the stimuli has been tested. Most studies have focused on the Rorschach and TAT and have examined effects in terms of variables such as reality testing and reactions to perceptual details. This is the first study to examine the effects of variation in visual stimuli as represented in features of the Object Relations Technique (ORT) cards on linguistic indicators of connection to emotional experience using measures of the referential process. The ORT was administered to 207 Italian non-clinical participants to explore effects of color, form and content variation on language style. The sample was stratified by age, gender, marital status and education to be representative of the Italian population. The stories told in response to the card images were rated using computerized linguistic measures, including the Weighted Referential Activity Dictionary-Italian version (IWRAD) which indicates the degree to which language is connected to nonverbal experience, and the Weighted Reflection/Reorganization List-Italian version (IWRRL) which detects a linguistic style of personal re-elaboration of emotional experience. The results provide support for the color-affect and form-reality testing hypotheses. Cards with better form definition, including color definition, and with fewer silhouettes of people elicited responses that were higher in IWRAD and lower in IWRRL, and also higher in the degree to which the two measures varied together. Implications of the results for use of ORT in clinical assessment and intervention are discussed.
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Affiliation(s)
- Attà Negri
- Department of Human and Social Sciences, University of Bergamo, Piazzale S. Agostino 2, 24129, Bergamo, Italy.
| | - Martino Ongis
- The New School for Social Research, New York, NY, USA
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Fertuck EA, Dambreville N, Diamond D, Duggal D, Erbe JK. Referential Activity Differentially Mediates Expression of Positive and Negative Emotions in Borderline Personality Disorder. JOURNAL OF PSYCHOLINGUISTIC RESEARCH 2021; 50:155-167. [PMID: 33566312 DOI: 10.1007/s10936-021-09767-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/06/2021] [Indexed: 06/12/2023]
Abstract
Borderline Personality Disorder (BPD) is a high risk and prevalent personality disorder that is associated with increased negative emotions, decreased positive emotions, and impairments in symbolization and impaired reflective functioning. These dimensions, while they may impact one another, have not been investigated concurrently from qualitative, linguistic narratives. We hypothesized a BPD group would have lower expression of positive emotions and greater expression of negative emotions and less reflective function than healthy controls. Additionally, we explored the role of referential activity (an index of symbolic capacity) between BPD and healthy controls in the context of valenced emotional expression. An adult, female BPD group (n = 13) and a demographically matched healthy control group (n = 14) were recruited and administered the Adult Attachment Interview and/or the Object Relations Inventory. Computerized text analyses were used to assess positive emotion and negative emotion, the Weighted Referential Activity Dictionaries to assess referential activity, and the Computerized Reflective Function dictionary. On the Object Relations Inventory, the BPD group expressed more frequent negative emotions and less frequent positive emotions; on the Adult Attachment Interview, the BPD group exhibited less expression of positive emotions. There were no differences between BPD and controls on referential activity or reflective functioning on either interview. However, BPD status fully mediated the significant relationship between referential activity and negative emotion expression. The BPD group utilized more referential activity when expressing negative emotions than controls. Conversely, the control group utilized more referential activity when expressing positive emotions than controls. Referential activity seems to play an important role in explaining the BPD versus control difference in valenced linguistic emotional expression. Furthermore, these results suggest the object relations inventory elicits more robust linguistic features relevant to BPD.
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Affiliation(s)
- Eric A Fertuck
- Department of Psychology, The Graduate Center, City University of New York, New York, US.
- Department of Psychology, The City College of New York, 160 Convent Ave, New York, NY, 10031, US.
| | - Naomi Dambreville
- Department of Psychology, The Graduate Center, City University of New York, New York, US
- Department of Psychology, The City College of New York, 160 Convent Ave, New York, NY, 10031, US
| | - Diana Diamond
- Department of Psychology, The Graduate Center, City University of New York, New York, US
- Personality Disorders Institute, Weill Cornell Medical College, New York, NY, US
| | - Devika Duggal
- Department of Psychology, The Graduate Center, City University of New York, New York, US
- Department of Psychology, The City College of New York, 160 Convent Ave, New York, NY, 10031, US
| | - Jeffrey K Erbe
- Department of Psychology, The Graduate Center, City University of New York, New York, US
- Department of Psychology, The City College of New York, 160 Convent Ave, New York, NY, 10031, US
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Negri A, Andreoli G, Mariani R, De Bei F, Rocco D, Greco A, Bucci W. First Validation of the Referential Process Post-Session Scale - Therapist Version (RPPS-T). CLINICAL NEUROPSYCHIATRY 2020; 17:319-329. [PMID: 34909010 PMCID: PMC8662713 DOI: 10.36131/cnfioritieditore20200601] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Bucci's multiple code theory maintains that for a significant change the patient-therapist relationship should foster a referential process shaping in three alternating phases: arousal of emotion schemas, symbolizing/narrating emotional experiences, and reflecting/reorganizing the emotional meanings. Until now to monitor these phases clinicians and researchers have used several referential process computerized linguistic measures, which however need the sessions verbatim transcription. In order to have a less time-consuming method we developed and tested a therapist self-report questionnaire measuring the referential process phases. METHOD We asked eight psychotherapists in a first study and nine psychotherapists in a second study to complete the Referential Process Post-session Scale - Therapist version (RPPS-T) just after the end of their sessions. In a third study we transcribed 29 sessions conducted by three psychotherapists to calculate the correlations between the RPPS-T scores and the computerized linguistic measures of the referential process calculated on the session transcripts. RESULTS In the first study we collected 105 evaluations regarding 29 patients and an exploratory factor analysis revealed a four-factor pattern consistent with the hypothesized constructs. The analysis reduced the initial pool of 42 items to 12. In the second study 130 sessions with 25 different patients have been evaluated on the shortened version of the RPPS-T and a confirmatory factor analysis found that the four-factor model satisfactorily fitted the new data as well. In the third study we found that the factors of RPPS-T regarding the symbolizing phase correlated with the corresponding computerized linguistic measures calculated on the session transcripts. CONCLUSIONS The RPPS-T received a first validation as a concurrent measure of the referential process, especially for the symbolizing phase, and could be considered a useful instrument for research and supervision.
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Affiliation(s)
- Attà Negri
- Department of Human and Social Sciences, University of Bergamo, Bergamo, Italy
| | | | - Rachele Mariani
- Department of Dynamic and Clinical Psychology, “Sapienza” University of Rome, Rome, Italy
| | - Francesco De Bei
- Department of Dynamic and Clinical Psychology, “Sapienza” University of Rome, Rome, Italy
| | - Diego Rocco
- Department of Developmental and Social Psychology, University of Padua, Padua, Italy
| | - Andrea Greco
- Department of Human and Social Sciences, University of Bergamo, Bergamo, Italy
| | - Wilma Bucci
- New York Psychoanalytic Society and Institute, New York, NY, USA
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18
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Negri A, Andreoli G, Barazzetti A, Zamin C, Christian C. Linguistic Markers of the Emotion Elaboration Surrounding the Confinement Period in the Italian Epicenter of COVID-19 Outbreak. Front Psychol 2020; 11:568281. [PMID: 33071896 PMCID: PMC7531075 DOI: 10.3389/fpsyg.2020.568281] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Accepted: 08/28/2020] [Indexed: 01/08/2023] Open
Abstract
The expressive writing method has rarely been proposed in contexts of large-scale upheavals that affect large populations. In this study this method was applied as an intervention and tool of investigation during the confinement period in the Lombardy region, the Italian Epicenter of COVID-19 outbreak. Sixty-four participants took part in an online expressive writing project, and a total of 167 writings were collected together with some self-report evaluations on emotions and physical sensations. A linguistic analysis through two different sets of computerized linguistic measures was conducted on the collected writings in order to study the linguistic markers of emotion regulation and elaboration. Results indicated that online expressive writing has helped respondents to get more in touch with the intense emotions that were experienced following the upheavals they witnessed. Writing even only once or twice helped, particularly those respondents who had at least one COVID-19 patient among close friends or relatives. Their writings showed an intense emotional involvement together with the ability to reflect and reorganize the personal meaning of the events and emotions experienced. This study shows that expressive writing can be used in the context of a psychological emergency, both as a powerful instrument to investigate and detect the complex psychodynamic processes underpinning the distress, and as a useful intervention to reduce the negative impact of traumatic events.
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Affiliation(s)
- Attà Negri
- Department of Human and Social Sciences, University of Bergamo, Bergamo, Italy
| | | | - Arianna Barazzetti
- Department of Human and Social Sciences, University of Bergamo, Bergamo, Italy
| | - Claudia Zamin
- Italian Society of Relationship Psychoanalysis, Milan, Italy
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19
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Renzi A, Mariani R, Di Trani M, Tambelli R. Giving words to emotions: the use of linguistic analysis to explore the role of alexithymia in an expressive writing intervention. RESEARCH IN PSYCHOTHERAPY (MILANO) 2020; 23:452. [PMID: 33024722 PMCID: PMC7513612 DOI: 10.4081/ripppo.2020.452] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Accepted: 04/21/2020] [Indexed: 12/02/2022]
Abstract
Expressive writing techniques are methods focusing on written emotional expression that require people to write about traumatic or difficult experiences, with the objective of promoting an elaboration of these events. The general aim of the study is to investigate the influence of alexithymia, a deficit in emotional regulation processes, on the effects of an expressive writing intervention, analyzing the writing protocols through the use of the Linguistic Inquiry and Word Count (LIWIC) and Referential Process (RP) linguistic measures via IDAAP software. Thirty-five women undergoing an assisted reproductive treatment participated in the study and filled out a sociodemographic questionnaire, the 20-item Toronto Alexithymia Scale. They also underwent three session of writing, following a request that they write about their emotions regarding their current situation. The women enrolled were divided into two groups: low alexithymia and high alexithymia, comprising individuals with a TAS-20 total score lower or higher than the mean, respectively. Analyses within the groups during the three writing sessions revealed that the women with low alexithymia reported a greater number of words expressing affectivity, sadness and future perspective, whereas no significances in the high alexithymia group emerged. Moreover, when analysing differences between the groups, high-alexithymia women reported lower scores in RP indexes and fewer words expressing sadness, future perspectives and we verbal. In conclusion, these preliminary findings may confirm the hypothesis that alexithymia affects the effectiveness of expressive writing through a difficulty in becoming involved in the writing process and a lack of symbolizing processes.
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Affiliation(s)
- Alesia Renzi
- Department of Dynamic and Clinical Psychology, "Sapienza" University of Rome, Rome, Italy
| | - Rachele Mariani
- Department of Dynamic and Clinical Psychology, "Sapienza" University of Rome, Rome, Italy
| | - Michela Di Trani
- Department of Dynamic and Clinical Psychology, "Sapienza" University of Rome, Rome, Italy
| | - Renata Tambelli
- Department of Dynamic and Clinical Psychology, "Sapienza" University of Rome, Rome, Italy
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20
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Mariani R, Di Trani M, Negri A, Tambelli R. Linguistic analysis of autobiographical narratives in unipolar and bipolar mood disorders in light of multiple code theory. J Affect Disord 2020; 273:24-31. [PMID: 32421609 DOI: 10.1016/j.jad.2020.03.170] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Revised: 02/21/2020] [Accepted: 03/29/2020] [Indexed: 11/16/2022]
Abstract
BACKGROUND Discriminating bipolar disorder (BD) from unipolar disorder (UD) is crucial in diagnosing mood disorders. Neurophysiological studies have identified different correlates of emotional regulation in BD and UD. According to the Multiple Code Theory, bodily modifications relate to linguistic styles, as highlighted by studies on the language of depression. Our purpose is to verify the existence in the Italian language of linguistic features of depression differentiating BD from UD to provide tools for clinicians to use beyond self-report measures. METHODS The sample included 20 BD, 20 UD (all diagnosed using DSM-5), and 20 Control Group (CG) participants. Participants completed the Profile of Mood States (POMS) and an audio-recorded Relationship Anecdotes Paradigm Interview, transcribed and analyzed by the Discourse Attributes Analysis Program for Referential Process Linguistic Measures. RESULTS One-way ANOVAs confirmed that specific linguistic features characterized BD, UD and CG. The use of Sensory-Somatic words was significantly different in the groups: higher in BD, intermediate in UD, and lower in CG. Individuals with BD produced higher scores on the Referential Activity Intensity Index and the use of singular pronoun "I". Negative Affect, as well as several POMS subscales, distinguished UD and BD from CG. LIMITATIONS Narrow sample size, use of a single self-report instrument and treatment effects on measures in the clinical groups are limitations of the study. CONCLUSION Individuals with UD and BD appear to use sensory-somatic language in predictably different patterns from each other and from the non-clinical population. Observation and assessment of linguistic features could improve diagnostic accuracy.
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Affiliation(s)
- R Mariani
- Department of Dynamic and Clinical Psychology, Sapienza University, Rome, Italy.
| | - M Di Trani
- Department of Dynamic and Clinical Psychology, Sapienza University, Rome, Italy
| | - A Negri
- Department of Human and Social Sciences, University of Bergamo, Bergamo, Italy
| | - R Tambelli
- Department of Dynamic and Clinical Psychology, Sapienza University, Rome, Italy
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21
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Bucci W. Il ruolo del linguaggio nella vita emotiva. PSICOTERAPIA E SCIENZE UMANE 2019. [DOI: 10.3280/pu2019-003001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Negri A, Christian C, Mariani R, Belotti L, Andreoli G, Danskin K. Linguistic features of the therapeutic alliance in the first session: a psychotherapy process study. RESEARCH IN PSYCHOTHERAPY (MILANO) 2019; 22:374. [PMID: 32913786 PMCID: PMC7451390 DOI: 10.4081/ripppo.2019.374] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Accepted: 03/04/2019] [Indexed: 11/23/2022]
Abstract
Critical aspects of the therapeutic alliance appear to be established as early as the first session. Specifically, the affective bond between the therapeutic dyad appears to develop early in treatment and tends to remain stable over time, while agreements on goals and tasks tend to fluctuate over the course of treatment. Are there distinguishable early signs of a strong therapeutic alliance? In this study, we examined how some linguistic measures indicative of joint emotional elaboration correlated with a measure of the therapeutic alliance assessed within a single session. Initial intake sessions with 40 patients with varying diagnoses were videotaped, transcribed, and analyzed using linguistic measures of referential process and then scored with the Segmented Working Alliance Inventory-Observer form. Results showed that patients who were rated as more emotionally engaged in relating their experiences and then reflecting on them by mid-session also had higher scores in the therapeutic alliance by the final part of that same session. An implication of this study is that the interpersonal factors facilitating elaboration of inner experience, including elements of warmth, safety, and analytic trust, are related to the development of early therapeutic alliance. These findings did not appear to be dependent on the patient's psychopathology. This study is one in a growing line of research exploring how patients speak rather than just the content of what they say.
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Affiliation(s)
- Atta Negri
- Department of Human and Social Sciences, University of Bergamo, Bergamo, Italy
| | | | | | - Luca Belotti
- Department of Human and Social Sciences, University of Bergamo, Bergamo, Italy
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Rocco D, Pastore M, Gennaro A, Salvatore S, Cozzolino M, Scorza M. Beyond Verbal Behavior: An Empirical Analysis of Speech Rates in Psychotherapy Sessions. Front Psychol 2018; 9:978. [PMID: 29962991 PMCID: PMC6014027 DOI: 10.3389/fpsyg.2018.00978] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Accepted: 05/28/2018] [Indexed: 11/13/2022] Open
Abstract
Objective: The present work aims to detect the role of the rate of speech as a mechanism able to give information on patient's intrapsychic activity and the intersubjective quality of the patient–therapist relationship. Method: Thirty clinical sessions among five patients were sampled and divided into idea units (N = 1276) according to the referential activity method. Each idea unit was rated according to referential activity method and in terms of speech rate (syllables per second) for both patient and therapist. A mixed-effects model was applied in order to detect the relationship between the speech rate of both the patient and the therapist and the features of the patient's verbal production in terms of referential activity scales. A Pearson correlation was applied to evaluate the synchrony between the speech rate of the patient and the therapist. Results: Results highlight that speech rate varies according patient's ability to get in touch with specific aspects detected through referential activity method: patient and the therapist speech rate get synchronized during the course of the sessions; and the therapist's speech rate partially attunes to the patient's ability to get in touch with inner aspects detected through RA method. Conclusion: The work identified speech rate as a feature that may help in the development of the clinical process in light of its ability to convey information about a patient's internal states and a therapist's attunement ability. These results support the intersubjective perspective on the clinical process.
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Affiliation(s)
- Diego Rocco
- Department of Developmental and Social Psychology, University of Padua, Padua, Italy
| | - Massimiliano Pastore
- Department of Developmental and Social Psychology, University of Padua, Padua, Italy
| | - Alessandro Gennaro
- Department of History, Society and Human Studies, University of Salento, Lecce, Italy
| | - Sergio Salvatore
- Department of History, Society and Human Studies, University of Salento, Lecce, Italy
| | - Mauro Cozzolino
- Department of Human, Philosophical and Educational Sciences, University of Salerno, Fisciano, Italy
| | - Maristella Scorza
- Department of Education and Human Sciences, University of Modena and Reggio Emilia, Modena, Italy
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24
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Di Trani M, Mariani R, Renzi A, Greenman PS, Solano L. Alexithymia according to Bucci's multiple code theory: A preliminary investigation with healthy and hypertensive individuals. Psychol Psychother 2018; 91:232-247. [PMID: 28972694 DOI: 10.1111/papt.12158] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Revised: 09/05/2017] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To evaluate the relation between alexithymia and Referential Activity (RA), a linguistic measure of the process by which non-verbal emotional experience is connected to language. METHODS The 20-Item Toronto Alexithymia Scale (TAS-20) and the Toronto Structured Interview for Alexithymia (TSIA) were administered to 20 postgraduate students and 15 outpatients with hypertension. The Weighted Referential Activity Dictionary (WRAD) and other linguistic measures (Reflection, Disfluency, and Somatic Sense) were applied to texts derived from the TSIA using the Discourse Attributes Analysis Program (DAAP). RESULTS Multiple linear regressions performed in the whole sample showed a relation between TSIA scores and Somatic Sense. Comparing the two groups, hypertensive subjects yielded higher scores on the TSIA than the young adult sample; no differences in DAAP measures emerged. A significant negative correlation was found between the TAS-20 Difficulty Describing Feelings score and the DAAP measure of references to body activations (Somatic Sense) both in the young adult sample and in hypertensives. In the young adult sample, negative relations emerged between different TSIA factors, WRAD score, and Somatic Sense; a positive relation with fragmented speech (Disfluency) and use of rationalization (Reflection) was also found. In hypertensive subjects, using the TSIA, a negative correlation between alexithymia and Somatic Sense and a positive correlation between alexithymia and the Mean High WRAD (a measure of intensity of engagement during the speech) were found. CONCLUSION The TSIA seems to be a more adequate instrument than the TAS-20 to explore relations between alexithymia and RA. Results appear to suggest a complex, nonlinear relation between alexithymia and RA, presumably influenced by subject-specific characteristics. PRACTITIONER POINTS A relation between alexithymia and RA has been proposed on theoretical grounds, but there has been minimal empirical investigation. This was the first study to employ both a self-report measure and a structured interview for measuring alexithymia in relation to RA. The results of this study suggest a complex, nonlinear relation between alexithymia and RA; this finding is essentially obtained with the structured interview measure of alexithymia. This relation is presumably influenced by subject-specific characteristics.
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Affiliation(s)
- Michela Di Trani
- Department of Dynamic and Clinical Psychology, Sapienza University, Rome, Italy
| | | | - Alessia Renzi
- Department of Dynamic and Clinical Psychology, Sapienza University, Rome, Italy
| | - Paul Samuel Greenman
- Department of Psychoeducation and Psychology, University of Quebec in Outaouais, Gatineau, Quebec, Canada
| | - Luigi Solano
- Department of Dynamic and Clinical Psychology, Sapienza University, Rome, Italy
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Esposito G, Savarese L, Squitieri B. Relation between referential and reflexive processes: an explorative study. COUNSELLING PSYCHOLOGY QUARTERLY 2018. [DOI: 10.1080/09515070.2018.1428528] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Giovanna Esposito
- Department of Humanities, University of Naples Federico II, Naples, Italy
| | - Livia Savarese
- Department of Humanities, University of Naples Federico II, Naples, Italy
| | - Barbara Squitieri
- Department of Humanities, University of Naples Federico II, Naples, Italy
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Gandino G, Di Fini G, Bernaudo A, Paltrinieri M, Castiglioni M, Veglia F. The impact of perinatal loss in maternity units: A psycholinguistic analysis of health professionals' reactions. J Health Psychol 2017; 25:640-651. [PMID: 28854811 DOI: 10.1177/1359105317727841] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Perinatal loss has a strong emotional impact on health professionals working in maternity units. We aimed to study the impact of this experience on health professionals' language. We analyzed the answers of 162 health professionals (physicians and non-medical staff) who described their reactions to perinatal loss. A linguistic analysis was performed using the Linguistic Inquiry and Word Count software. Associations between language and burnout were studied. Words typical of a psychological shock reaction were used more by non-medical staff than by physicians. Participants who used pronouns, optimistic words, future tense verbs, and cognitive words registered lower levels of burnout. Clinical implications of the results are discussed.
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Affiliation(s)
| | | | | | | | - Marco Castiglioni
- Riccardo Massa Department of Human Sciences and Education, University of Milano-Bicocca, Italy
| | - Fabio Veglia
- Department of Psychology, University of Turin, Italy
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