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Norman UA, Truijens F, Desmet M, De Smet M, Meganck R. Impact of personality style changes on CBT and PDT treatment responses in major depression. Acta Psychol (Amst) 2024; 246:104295. [PMID: 38701624 DOI: 10.1016/j.actpsy.2024.104295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Revised: 04/23/2024] [Accepted: 04/24/2024] [Indexed: 05/05/2024] Open
Abstract
This study examines the influence of depressive personality styles on treatment responses in patients with major depression receiving cognitive behavioural therapy and psychodynamic therapy. We assessed changes in personality styles, including dependency, self-criticism, sociotropy, and autonomy, and their association with treatment response. Both treatment modalities led to significant reductions in self-criticism and sociotropy scores. Depressive symptom severity decreased overall, with a more pronounced reduction observed in the cognitive behavioural therapy group. Notably, reduced self-criticism and sociotropy were associated with better treatment outcomes in the cognitive behavioural therapy group. Our findings highlight the role of personality styles in influencing treatment outcomes for major depression. The study suggests an association between changes in personality styles and the reduction of symptoms. Our results support the idea that unique pathways of change are activated depending on the therapeutic intervention. These insights are critical in tailoring treatments to individual needs, addressing the central question of 'what works for whom'.
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Affiliation(s)
| | - Femke Truijens
- Department of Psychology, Education & Child Studies/Clinical Psychology, Erasmus University Rotterdam, Netherlands
| | - Mattias Desmet
- Department of psychoanalysis and clinical consulting, Ghent University, Ghent, Belgium
| | - Melissa De Smet
- Department of Methodology, Tilburg School of Social and Behavioural Sciences, Tilburg University
| | - Reitske Meganck
- Department of psychoanalysis and clinical consulting, Ghent University, Ghent, Belgium
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Pinus M, Lassri D, Rahamim O, Schiller M, Soffer-Dudek N, Shahar G. Identifying state self-criticism subscales within the Brief Symptoms Inventory: Analyses of data from Israeli young adults. PERSONALITY AND INDIVIDUAL DIFFERENCES 2023. [DOI: 10.1016/j.paid.2022.111989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Klim-Conforti P, Levitt AJ, Cheung AH, Loureiro R, Fefergrad M, Schaffer A, Niederkrotenthaler T, Sinyor M, Zaheer J. Youth voices and experiences regarding a school-based cognitive behavioral therapy skills intervention: lessons for future engagement and adaptation. BMC Public Health 2022; 22:1709. [PMID: 36076231 PMCID: PMC9461107 DOI: 10.1186/s12889-022-14058-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 08/22/2022] [Indexed: 11/26/2022] Open
Abstract
Background The Cognitive Behavioral Therapy Skills Intervention (or CBTSI) aims to build mental health literacy and knowledge, allowing youth to build resilience and improve mental health broadly. In Ontario, Canada, youth voice is scant and European studies have largely reported on youth factors supporting stigma reduction, help-seeking intentions and overall satisfaction with a given intervention. Process evaluations and implementation that underpin what youth require to embrace mental health literacy interventions, particularly those that embed key learning principles in the everyday curriculum, have not been broached. The goal of this study is to understand both barriers and facilitators to engagement with the CBTSI (an intervention novel in itself because of the combined mental health plus cognitive behavior therapy (CBT) skills principles embedded in literacy) and the resources and structures that students report requiring, to fully engage with such an intervention. Methods Student focus groups were conducted utilizing qualitative interviews that were analyzed thematically. Analysis was informed using principles of pragmatism and analyzed inductively using thematic analysis (Braun and Clarke, Qual Res Psychol 3:77–101, 2006), first looking at the whole and then coding for themes, within an interpretivist framework. Youth were in middle school (grade 7 and 8) in Toronto, Canada who had received the CBTSI. Face to face interview guides with iterative questioning were conducted in February of 2020, and these interviews were audio-recorded and professionally transcribed. Teachers randomly chose a subset of youth whose parents consented to the research to ensure ethno-racial similarity to classroom demographics. Results There were eight groups with sixty students who participated. Students were 12 to 14 years of age. Major themes were identified: maximizing the opportunities for involvement and self-determination created an atmosphere where confidence and self-compassion could flourish, signalling to the students that they understood and were able to deploy the strategies they were taught; students expressed that the intervention needs to be adapted to enhance personal dignity, respecting both individual wishes and goals in light of the variability in student reported mental health. A model explains the structures and adaptations required to maximize learning based on youth feedback. Interpretation Mental health literacy incorporating CBT is a promising population-based health promotion intervention. Future adaptations and implementation decisions regarding the CBTSI need to address the wishes and experiences of these youth. Youth voice in this study explored factors that prevent and promote the uptake of the key lessons within the context of existing variability in student mental health that is often found within the context of a regular classroom. The results should be used to adapt the CBTSI as it is disseminated more broadly.
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Affiliation(s)
- Paula Klim-Conforti
- Institute of Medical Science, Temerty Faculty of Medicine, University of Toronto, 1 King's College Circle, Medical Sciences Building, Toronto, Ontario, M5S 3H2, Canada. .,Member of the College of Psychologists of Ontario, Toronto, Ontario, Canada. .,Member of the College of Registered Psychotherapists of Ontario, Toronto, Ontario, Canada.
| | - Anthony J Levitt
- Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Amy H Cheung
- Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Raisa Loureiro
- Member of the College of Registered Psychotherapists of Ontario, Toronto, Ontario, Canada
| | - Mark Fefergrad
- Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Ayal Schaffer
- Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Thomas Niederkrotenthaler
- Unit Suicide Research and Mental Health Promotion, Department of Social and Preventive Medicine, Centre for Public Health, Medical University of Vienna, Kinderspitalgasse 15, A-1090, Vienna, Austria.,Wiener Werkstaette for Suicide Research, Vienna, Austria
| | - Mark Sinyor
- Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Juveria Zaheer
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.,Institute for Medical Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
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Tsur N, Najjar AA, Katz C. "Explode into small pieces": Suicidal ideation among child sexual abuse survivors. CHILD ABUSE & NEGLECT 2022; 131:105780. [PMID: 35803028 DOI: 10.1016/j.chiabu.2022.105780] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 06/19/2022] [Accepted: 06/30/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Child sexual abuse (CSA) has been acknowledged as predisposing survivors to an increased risk of suicidal ideation and attempts. Despite this risk being widely recognized, the study of suicidality has mainly focused on psychopathology, while less attention has been given to survivors' experiences and perceptions. OBJECTIVE This study aims to uncover the experiences and perceptions of suicidality among adult CSA survivors. PARTICIPANTS AND SETTINGS The sample consisted of 41 adult CSA survivors' written narratives of abuse that included references to suicide. METHODS Written narratives of CSA experiences were collected from 41 adult participants as part of the Israeli Independent Public Inquiry on CSA to change public policy. An inductive thematic analysis guided the exploration of the stories. RESULTS The findings portrayed several main themes regarding the survivors' experiences before, during and after suicidal thoughts and behaviors. These themes elucidated their motivations leading to suicidal attempts, including the wish to end one's self and suffering, self-blame, communicate the abuse and the request for recognition. Additionally, the survivors' stories illuminated their experiences following the suicidal attempts, depicting inadequate treatment and difficulties with the psychiatric labeling of a mental health disorder. CONCLUSIONS The findings of this study uncover new insights regarding the link between trauma, posttraumatic suffering, and suicidality within a social interaction context. Furthermore, these findings call medical and psychosocial health practitioners to view post-CSA suffering as trauma-related rather than personal psychopathology and to adjust practices to adapt to survivors' experiences and needs.
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Affiliation(s)
- Noga Tsur
- Bob Shapell School of Social Work, Tel Aviv University, Tel Aviv, Israel.
| | | | - Carmit Katz
- Bob Shapell School of Social Work, Tel Aviv University, Tel Aviv, Israel
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Ross V, Mathieu S, Hawgood J, Turner K, Stapelberg NJC, Welch M, Davies A, Sveticic J, Walker S, Kõlves K. Consumer and Carer Perspectives of a Zero Suicide Prevention Program: A Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:10634. [PMID: 34682380 PMCID: PMC8535550 DOI: 10.3390/ijerph182010634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 10/05/2021] [Accepted: 10/05/2021] [Indexed: 11/17/2022]
Abstract
This study explored the experiences of healthcare consumers who had recently attempted suicide, and their carers, following placement on a Suicide Prevention Pathway based on the Zero Suicide framework. Qualitative interviews were conducted with 10 consumers and 5 carers using a semi-structured interview schedule. Interviews were transcribed and thematic analysis was applied to identify prominent themes and sub-themes. Three interrelated themes were identified. The first theme was 'Feeling safe and valued' with the associated sub-theme pertaining to perceived stigmatizing treatment and self-stigma. The second was 'Intersection of consumer and staff/organizational needs' with a related sub-theme of time pressure and reduced self-disclosure. The final theme was 'Importance of the 'whole picture', highlighting the relevance of assessing and addressing psychosocial factors when planning for consumer recovery. Overall, consumers and their carers reported a favorable experience of the Suicide Prevention Pathway; however, there were several areas identified for improvement. These included reconciling the time-pressures of a busy health service system, ensuring consumers and carers feel their psychosocial concerns are addressed, and ensuring that adequate rapport is developed. Key to this is ensuring consumers feel cared for and reducing perceptions of stigma.
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Affiliation(s)
- Victoria Ross
- Australian Institute for Suicide Research and Prevention, School of Applied Psychology, Griffith University, 176 Messines Ridge Rd, Brisbane, QLD 4122, Australia; (S.M.); (J.H.); (K.K.)
| | - Sharna Mathieu
- Australian Institute for Suicide Research and Prevention, School of Applied Psychology, Griffith University, 176 Messines Ridge Rd, Brisbane, QLD 4122, Australia; (S.M.); (J.H.); (K.K.)
| | - Jacinta Hawgood
- Australian Institute for Suicide Research and Prevention, School of Applied Psychology, Griffith University, 176 Messines Ridge Rd, Brisbane, QLD 4122, Australia; (S.M.); (J.H.); (K.K.)
| | - Kathryn Turner
- Mental Health and Specialist Services, Gold Coast Hospital and Health Services, 1 Hospital Blvd, Southport, QLD 4215, Australia; (K.T.); (N.J.C.S.); (M.W.); (A.D.); (J.S.); (S.W.)
| | - Nicolas J. C. Stapelberg
- Mental Health and Specialist Services, Gold Coast Hospital and Health Services, 1 Hospital Blvd, Southport, QLD 4215, Australia; (K.T.); (N.J.C.S.); (M.W.); (A.D.); (J.S.); (S.W.)
| | - Matthew Welch
- Mental Health and Specialist Services, Gold Coast Hospital and Health Services, 1 Hospital Blvd, Southport, QLD 4215, Australia; (K.T.); (N.J.C.S.); (M.W.); (A.D.); (J.S.); (S.W.)
| | - Angela Davies
- Mental Health and Specialist Services, Gold Coast Hospital and Health Services, 1 Hospital Blvd, Southport, QLD 4215, Australia; (K.T.); (N.J.C.S.); (M.W.); (A.D.); (J.S.); (S.W.)
| | - Jerneja Sveticic
- Mental Health and Specialist Services, Gold Coast Hospital and Health Services, 1 Hospital Blvd, Southport, QLD 4215, Australia; (K.T.); (N.J.C.S.); (M.W.); (A.D.); (J.S.); (S.W.)
| | - Sarah Walker
- Mental Health and Specialist Services, Gold Coast Hospital and Health Services, 1 Hospital Blvd, Southport, QLD 4215, Australia; (K.T.); (N.J.C.S.); (M.W.); (A.D.); (J.S.); (S.W.)
| | - Kairi Kõlves
- Australian Institute for Suicide Research and Prevention, School of Applied Psychology, Griffith University, 176 Messines Ridge Rd, Brisbane, QLD 4122, Australia; (S.M.); (J.H.); (K.K.)
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Kotera Y, Dosedlova J, Andrzejewski D, Kaluzeviciute G, Sakai M. From Stress to Psychopathology: Relationship with Self-Reassurance and Self-Criticism in Czech University Students. Int J Ment Health Addict 2021; 20:2321-2332. [PMID: 33723485 PMCID: PMC7945603 DOI: 10.1007/s11469-021-00516-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/24/2021] [Indexed: 11/04/2022] Open
Abstract
Psychological stress has become a major concern, potentially leading to diverse health problems including psychopathology such as depression and anxiety. Transactional Model of Stress and Coping is an established model, conceptualizing stressful experiences via person–environment relationship. This cross-sectional study aimed to explore the pathway from stress to depression/anxiety, with a focus on self-criticism (inadequate-self and hated-self) and self-reassurance (reassured-self) in Czech students who suffered from high prevalence of mental health problems. Convenience sample of 119 undergraduates completed the Depression Anxiety and Stress Scale-21 and the Forms of the Self-Criticizing/Attacking & Self-Reassuring Scale. Correlation and path analyses were conducted. The Strengthening the Reporting of Observational Studies in Epidemiology guidelines were used to aid an accurate and complete report of the study. Depression, anxiety, and stress were positively associated with inadequate-self and hated-self while negatively associated with reassured-self. Both inadequate-self and hated-self partially mediated the stress–depression and stress–anxiety relationships, whereas reassured-self only partially mediated the stress–depression relationship. Inadequate-self had greater impact on the stress–depression/anxiety pathways than hated-self and reassured-self. Findings indicate that clinical treatment may benefit from targeting the feelings of inadequacy to prevent stress progressing to psychopathology. This is particularly relevant as stress levels are rising globally. Our findings offer developments to the Transactional Model, and help practitioners and educators identify solutions to protect mental health of Czech university students.
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Affiliation(s)
- Yasuhiro Kotera
- Human Sciences Research Centre, University of Derby, Derby, UK
| | | | | | | | - Makoto Sakai
- School of Psychology, Chukyo University, Nagoya, Japan
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Suicidality in Chronic Illness: An Overview of Cognitive–Affective and Interpersonal Factors. J Clin Psychol Med Settings 2020; 28:137-148. [DOI: 10.1007/s10880-020-09749-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/19/2020] [Indexed: 12/18/2022]
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Shahar G. The subjective-agentic personality sector (SAPS): Introduction to the special issue on self, identity, and psychopathology. J Pers 2019; 88:5-13. [PMID: 31206666 DOI: 10.1111/jopy.12497] [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: 06/10/2019] [Accepted: 06/11/2019] [Indexed: 10/26/2022]
Abstract
This special issue is predicated upon the premise that there exists a subjective-agentic personality sector (SAPS) that is crucially relevant to the understanding and treatment of psychopathology. SAPS is often overlooked by "trait" models in personality psychology. It is comprised of "hot" cognitions about one's self and identity as they unfold throughout the life span and are brought to bear on interpersonal relationships. There are four ways in which SAPS may be involved in psychopathology: (a) inherently, as a component of psychiatric disorders, (b) as a passive vulnerability dimension, namely by interacting with life stress, (c) as an active vulnerability dimension, that is, by propelling external situations that culminate in psychopathology, and (d) by constituting a central consequent of psychopathology (i.e., the scarring pattern, see below). In this Journal of Personality special issue, experts in personality and psychopathology demonstrate the centrality of SAPS in unipolar depression, anxiety disorders, bipolar spectrum disorder, eating disorders, posttraumatic stress disorder, complex trauma and borderline personality disorder, social anxiety disorder, suicidality in the context of mood disorders, and recovery from schizophrenia. A commentary by Dan McAdams, a leader in the study of self and identity, concludes this special issue.
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Affiliation(s)
- Golan Shahar
- Department of Psychology, Ben-Gurion University of the Negev, Beer Sheva, Israel
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McAdams DP. Psychopathology and the self: Human actors, agents, and authors. J Pers 2019; 88:146-155. [PMID: 31206660 DOI: 10.1111/jopy.12496] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Accepted: 06/08/2019] [Indexed: 12/24/2022]
Abstract
The articles included within this special issue of the Journal of Personality all conceptualize psychopathology as the result of problems in human selfhood. As such, they implicate a wide assortment of self-related constructs, from self-objectification to self-esteem, in the etiology and maintenance of psychopathology, and they point to interventions designed to alter these self-processes in order to alleviate suffering. In this commentary, I reinterpret and reorganize many of the ideas presented in the articles from the standpoint of a tripartite perspective on the reflexive human self. The self is first and foremost an inherent duality of I and Me. Psychologically speaking, the I/Me dynamic plays out in three different guises-the self as (1) social actor, (2) motivated agent, and (3) autobiographical author. Problems in human selfhood as they pertain to psychopathology may be profitably reconceived in terms of the corresponding performative styles expressed by social actors, the motivational agendas of values and goals that energize human striving and determine self-esteem, and the internalized life stories that human beings, as authors of the self, fashion and narrate to make sense of the reconstructed past and imagined future.
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Affiliation(s)
- Dan P McAdams
- Department of Psychology, Northwestern University, Evanston, Illinois
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