Interpersonal Patterns Research Articles

Zelfopoffering, onderwerping en pleasing bij vrouwen met CVS in vergelijking met vrouwen met reumatoïde artritis: een observationele studie

Self-sacrifice, subjugation and approval-seeking in women with CFS in comparison to women with rheumatoid arthritis: an observational study CFS is a disorder with a multifactorial pathogenesis in which symptoms arise when precipitating factors combine with predisposing factors. An increasing body of research points to a dysfunction of the stress axis and finds evidence for a high prevalence of early childhood trauma, one of the most important vulnerability factors. Several pathways are conceivable through which early trauma may contribute to the vulnerability to or maintenance of the stress response and the symptoms. In this study, the authors used self-report questionnaires to identify maladaptive patterns that often stand out in clinical practice and may play both a predisposing and a maintaining role. These interpersonal patterns have often been adaptive in an early childhood context, but become harmful when they generalize and remain active in adult life. The authors investigated a group of 49 female CFS patients using 3 subscales of the Young Schema Questionnaire measuring the interpersonal styles of self-sacrifice, approval-seeking and subjugation. They included 45 women with a diagnosis of rheumatoid arthritis as a control group. The authors found significantly higher scores in the CFS group for the 3 variables, with a large effect size for each. The present findings have implications for the further research and treatment. These interpersonal patterns are usually very rigid and serve to protect self-esteem and sense of security. The standard treatment of graded exercise and a limited number of sessions of psychoeducation and cognitive behavioral therapy is often insufficient to allow recovery and prevent relapse. Further research is required to substantiate which is the most optimal treatment strategy to mitigate these patterns.

The smartphone as a “significant other”: interpersonal dependency and attachment in maladaptive smartphone and social networks use

Smartphones are increasingly widespread throughout the world and, although smartphones provide various benefits, excessive and maladaptive use is often reported. Given the penetration of smartphones in the individual’s daily life, it is relevant to identify the mechanisms sustaining their use, including the affective bond that the owner may develop with the device. The aim of the current study is to test a novel model to explain smartphone and Social Network Sites (SNS) use from an interpersonal perspective. We hypothesized that adult attachment style and interpersonal patterns (i.e., features of interpersonal dependency) generalize to the emotional bond with the mobile device, interacting with psychological correlates and background factors to predict smartphone and SNS consumption. 341 nonclinical adults (57.2% females; age M = 35.5, SD = 14.6) completed a battery consisting of the Attachment Style Questionnaire, the Relationship Profile Test, the Rosenberg Self-Esteem Scale, the Toronto Alexithymia Scale, the Young Adult Attachment to Phone Scale, and the Social Network Intensity and Social Network Access via Mobile phone Applications. A multi-mediation model supported the hypothesis regarding the influence of interpersonal style in the relationship of the individual with their smartphone and use of SNS. A parallel between attachment style and the emotional bond with the smartphone emerged, with anxious attachment style and destructive overdependence being potential risk factors for maladaptive smartphone use especially in individuals involved in a romantic relationship. Findings are discussed in terms of theoretical implications and intervention strategies towards smartphone dependency.

Specificity of training future teachers of a foreign language and literature for cross-cultural education within multicultural educational environment of institutions of general secondary education

According to the results of the study of methodological, didactic, scientific-theoretical, pedagogical literature, it is determined that the cross-cultural approach reveals the methodology of a multi-panoramic study of "a person at the intersection of cultures" as an innovative type of personality that adheres to planetary ethics and is characterized by cross-border thinking that goes beyond his/her own culture. It has been determined that cross-cultural learning is a consistent, purposeful interaction of teachers and students, within which there is an accumulation of background and cultural knowledge, the development of language and speech skills necessary for effective inter-linguistic and intercultural interaction with representatives of various linguistic and cultural communities. The study determined that the multicultural educational space is a spatial-subject area of interaction between subjects of the educational process, which is constructed on the basis of taking into account the invariance of universal human (planetary) values in combination with the variability of cultural intents (ethnocultural worldview, natiomental constants, historical-cultural artifacts, cultural-deterministic interpersonal patterns). The functioning of the multicultural educational space in institutions of general secondary education is characterized as a model for creating psychological and pedagogical conditions, algorithms, and technologies for the adaptation integration of the student's personality into the multicultural field of society through educational (didactic) mechanisms, in particular, cross-cultural learning. Based on the analysis of the scientific fund, it is determined that a teacher of a foreign language and literature is a highly qualified, competitive specialist-teacher, providing the educational needs of modern society in the field of foreign language education; ensures the organization of the educational (educational, developmental) process on the basis of preserving Ukrainian traditions, respectful attitude to the native language and historical past, on the principles of patriotism, humanism, democracy, tolerance and civic responsibility in the multicultural educational space. The training of future teachers of a foreign language and literature for cross-cultural learning within a multicultural educational space is interpreted as a pedagogical process, which is a structural component of the general, holistic, systematic professional training of the future teacher, aimed at: the awareness by future teachers of the importance of constructing a multicultural educational space at educational institutions on the basis of ethnic tolerance; formation of a complex of knowledge on cross-cultural didactics and skills in implementing culturally relevant means of teaching a foreign language; development of personal properties and worldview values of students as initiators and mediators of the dialogue of cultures. The readiness of future teachers of a foreign language and literature for cross-cultural learning within a multicultural educational space is a synthetic personal-deterministic and professionally-oriented construct that reflects the integrative unity of the desire of the teacher-dictionary to carry out the transmission of ethnocentrism into ethnorelativism (ethno-mental identification component); the ability to adapt and remodel situational didactic interactions within an environment of cross-cultural integration in a multicultural educational space (interactive-professional component); intention to transform professional knowledge into sociocultural intelligence (metacognitive information-centred component).

Specificity of training future teachers of a foreign language and literature for cross-cultural education within multicultural educational environment of institutions of general secondary education

According to the results of the study of methodological, didactic, scientific-theoretical, pedagogical literature, it is determined that the cross-cultural approach reveals the methodology of a multi-panoramic study of "a person at the intersection of cultures" as an innovative type of personality that adheres to planetary ethics and is characterized by cross-border thinking that goes beyond his/her own culture. It has been determined that cross-cultural learning is a consistent, purposeful interaction of teachers and students, within which there is an accumulation of background and cultural knowledge, the development of language and speech skills necessary for effective inter-linguistic and intercultural interaction with representatives of various linguistic and cultural communities. The study determined that the multicultural educational space is a spatial-subject area of interaction between subjects of the educational process, which is constructed on the basis of taking into account the invariance of universal human (planetary) values in combination with the variability of cultural intents (ethnocultural worldview, natiomental constants, historical-cultural artifacts, cultural-deterministic interpersonal patterns). The functioning of the multicultural educational space in institutions of general secondary education is characterized as a model for creating psychological and pedagogical conditions, algorithms, and technologies for the adaptation integration of the student's personality into the multicultural field of society through educational (didactic) mechanisms, in particular, cross-cultural learning. Based on the analysis of the scientific fund, it is determined that a teacher of a foreign language and literature is a highly qualified, competitive specialist-teacher, providing the educational needs of modern society in the field of foreign language education; ensures the organization of the educational (educational, developmental) process on the basis of preserving Ukrainian traditions, respectful attitude to the native language and historical past, on the principles of patriotism, humanism, democracy, tolerance and civic responsibility in the multicultural educational space. The training of future teachers of a foreign language and literature for cross-cultural learning within a multicultural educational space is interpreted as a pedagogical process, which is a structural component of the general, holistic, systematic professional training of the future teacher, aimed at: the awareness by future teachers of the importance of constructing a multicultural educational space at educational institutions on the basis of ethnic tolerance; formation of a complex of knowledge on cross-cultural didactics and skills in implementing culturally relevant means of teaching a foreign language; development of personal properties and worldview values of students as initiators and mediators of the dialogue of cultures. The readiness of future teachers of a foreign language and literature for cross-cultural learning within a multicultural educational space is a synthetic personal-deterministic and professionally-oriented construct that reflects the integrative unity of the desire of the teacher-dictionary to carry out the transmission of ethnocentrism into ethnorelativism (ethno-mental identification component); the ability to adapt and remodel situational didactic interactions within an environment of cross-cultural integration in a multicultural educational space (interactive-professional component); intention to transform professional knowledge into sociocultural intelligence (metacognitive information-centred component).

Much ado about ontological nihilism

ABSTRACT According to ontological nihilism nothing exists. A recent argument purports to show that this view is indefensible, since its most plausible formulations are tacitly committed to quantificational claims that are inconsistent with the nihilist's view that there aren't any existents. I show that this objection begs the question against the nihilist. The objector's argument relies on an equivalence principle implying that claims which nihilists regard as non-quantificational should nonetheless be interpreted as equivalent to quantified claims, given that both kinds of assertion are assertible in the same contexts. This style of reasoning is supported by considerations of charity, which suggest that similarities in inter-personal patterns of language use provide evidence of similarity in the semantic content of speakers' utterances. However, related considerations also suggest that intra-personal patterns of language use constitute significant semantic evidence of the same kind. When we appreciate this and further recognize that nihilists are disposed to assert the negation of any positive, quantified claim, we see that it is too much to expect principles of semantic interpretation based on considerations of charity to decisively refute nihilism. This result has interesting metametaphysical implications concerning the role and scope of analogous arguments based on principles of interpretive charity.

A typology for the interpersonal affective focus in dynamic interpersonal therapy based on a contemporary interpersonal approach.

Dynamic Interpersonal Therapy (DIT) is a brief, time-limited psychodynamic individual therapy in which depressive and anxious symptoms are understood as responses to interpersonal difficulties. Problematic interpersonal representations of the self and others are conceptualized in DIT as the interpersonal affective focus (IPAF), a predominant and recurring interpersonal pattern that is connected to the symptoms and becomes the foundation of treatment. This article reports the development of a typology for classifying IPAFs, which characterizes the predominant style based on contemporary interpersonal approaches. If such a typology can be shown to have validity in a clinical setting, it could have multiple uses that would improve understanding of how DIT works and for whom it might be effective, for example, assisting the therapist in formulating the IPAF, allowing investigations of treatment outcome and process research, and informing training. An IPAF typology was developed by means of a hybrid method of qualitative analysis of transcriptions of audio recordings of DIT sessions using data from a randomized control and feasibility trial. Results revealed four themes, that is, patterns of relating, which could be described as hostile-dominant, hostile-submissive, friendly-dominant, or friendly-submissive. Limitations include the sample size and diversity, the impact of the inclusion and exclusion criteria of the pilot feasibility trial, and the clinical need to titrate the IPAF. Future research should focus on the reliability and validity of the typology and whether it can be employed in outcome and process research. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

An Enneagram Approach to Strategy

This conceptual paper examines how Enneagram as a personality typing system could be adopted as a meta-model across multiple domains. The enneagram strategy is a structural typology that many organisations and individuals use to effectively understand their business profiles and interpersonal patterns, despite scholars showing concerns about its robustness and dynamism. This paper extends the argument as to how the mechanics of the Enneagram are intrinsically interrelated with (a) organisational systems and networks, (b) organisational grammar, (c) supply chains, and (d) creativity. It also emphasizes the importance/close association of the Enneagram tool with interdependence, business model, networks, statics, and system dynamics. The paper uses a combination of research methods (theoretical, exploratory, and descriptive) to evaluate the adaptability of the enneagram. The findings demonstrate that enneagram as a strategy could be applied to various business phenomena but requires more cross-domain empirical research. The enneagram can also be used to develop meta-models/toy models that can relate to the organisational outcomes by integrating tangible and intangible process assets. This paper reliably lays a set of principles/foundations to launch the enneagram approach to a complex, broad, systematic, and creative scope.

The Burden of Keeping Things to Yourself: Self-Concealment and Suicidality

ABSTRACT Suicide is a critical concern for psychologists given the complexity of suicide risk and fatal consequences. Using self-determination theory (SDT) as a framework, we examined the relationships between self-concealment, basic psychological needs, collectivism, and suicidality in a sample of adults in the United States (n = 199). Self-concealment is an interpersonal pattern of hiding sensitive personal information from others and has been correlated with increased suicidality. We tested a model whereby unmet basic psychological needs (i.e. autonomy, competence, and relatedness) mediated the relationship between self-concealment and suicidality. We also included collectivist cultural orientation as a moderator. We found that greater self-concealment was associated with more dissatisfaction with all three basic needs. However, only dissatisfaction with the relatedness need was associated with more suicidality. The effect of relatedness need dissatisfaction on suicidality was moderated by collectivism such that the effect was stronger for participants who were higher in collectivism. We found support for SDT as a framework for theory driven exploration of self-concealment and suicidality. The significant moderating effect of collectivism also highlights the importance of including cultural variables in future research. We include a discussion of implications for research, intervention, and prevention.

Patient personality dimensions, relational patterns and therapeutic alliance in clinical practice: An empirical investigation.

Transference (meant in this context, as the patient relational patterns expressed towards the clinician) and therapeutic alliance play a crucial role in the treatment of personality pathology. To date, no empirical study examined the association between these two dimensions of the clinical relationship and patients' personality maladaptive traits in psychotherapy. A national sample of therapists (N = 100) of different theoretical orientations assessed dysfunctional personality features of a patient in their care using a comprehensive and empirically grounded dimensional diagnostic approach from the Shedler-Westen Assessment Procedure-200 (SWAP-200). Moreover, they filled in the Psychotherapy Relationship Questionnaire (PRQ) to identify interpersonal patterns expressed early in treatment by the patients and the Working Alliance Inventory (WAI-T) to evaluate quality of therapeutic alliance. Overall, the most severe and maladaptive dimensions of patients' personality were associated with more negative clinician-patient dynamics and poorer levels of therapeutic alliance in statistically significant and clinically relevant ways. Notably, the hostile transference was predicted by both SWAP Hostility and Psychopathy, whereas the SWAP Narcissism was the strongest predictor of the special/entitled transference. The latter was also predicted by SWAP Emotional Dysregulation; conversely, the SWAP Dysphoria was the most robust predictor of anxious/preoccupied pattern. The SWAP Schizoid Orientation and Psychopathy predicted avoidant/dismissing attachment pattern; moreover, they were strongly and negatively related to the SWAP Psychological Health that was the best predictor of positive transference and alliance. Findings support that therapists' careful understanding of patients' interpersonal ways during early treatment stages may meaningfully inform diagnostic and therapeutic processes.

Efficacy of Cognitive Therapy for Body Dysmorphic Disorder: A Randomized Controlled Pilot Trial

Dysfunctional cognitive processes and maladaptive interpersonal patterns have been postulated to maintain body dysmorphic disorder (BDD). The present trial evaluated CT for BDD (CT-BDD), which includes modules targeting maladaptive cognitive processing in BDD, as well as elements of schema therapy related to interpersonal problems. We investigated whether (a) CT-BDD is effective, as compared with a wait-list (WL) group at Week 12; (b) outcome of CT-BDD is maintained at posttreatment and 3- and 6-months follow-up; and (c) whether changes in shame and insight mediate changes in BDD symptom severity. Forty adults with BDD were randomized to 36 weeks immediate CT-BDD (n = 21), or to 12-week WL (n = 19). At Week 12, immediate CT-BDD was significantly superior to WL in clinician-rated BDD symptom severity, insight, self-reported BDD symptoms, shame, depression, general symptomatology, and life satisfaction. Changes in outcomes were associated with moderate to large effect sizes at Week 12. Reductions in shame and increase in insight separately mediated changes in BDD symptom severity during treatment at Week 12. From baseline to posttreatment, significant improvements occurred within CT-BDD in clinician-rated symptom severity, insight, depression, global functioning, self-reported BDD symptoms, shame, depression, general symptomatology, and life satisfaction. At posttreatment, improvements were associated with large effect sizes and were maintained at 3- and 6-month follow-up. Preliminary results support the efficacy of CT-BDD. Addressing interpersonal problems in addition to cognitive dysfunctions may increase the benefit of CBT for BDD patients.

Multigenerational patterns of parenting-at-risk: A test of interpersonal specificity using copy process theory.

This study tests ways in which the perception of intergenerational continuity in parenting behaviors among child-maltreatment (CM) and non-CM families conform to Benjamin's (2006) Copy Process Theory, which considers three copy processes: Identification (be like him/her), Recapitulation (behave as if he/she is still present and in charge), and Introjection (treat myself as he/she treated me). Across two home visits and a laboratory session, 171 mothers of preschoolers (M = 3.7 years) completed the SASB Intrex Questionnairerelative to herself, her history with her parents, and her present relationship with her child. Mothers' retrospective reports of her interactions with caregivers were correlated with the quality of self-reported parenting processes in interactions with her preschooler. Analyses indicated high rates of intergenerational copying in both samples for each copy process. While copying in general was observed in nearly all mothers (roughly 80%-90%) and emphasized warm, securely attached patterns, the copying of hostility and/or lack of affiliation occurred in copied profiles for about one-third of mothers. About the more problematic profiles, CM mothers tended to rate themselves as being in the child-like position they experienced in their own childhood, with themes involving hostile control perceived from their child. By contrast, non-CM mothers copied disaffiliative themes primarily in relation to themselves. Findings verify that interpersonal patterns and internalized relational histories are important keys for understanding CM risk. The use of a method that offers interpersonal specificity at the level of individual profiles has application to clinical practice with at-risk parents.

Characteristics of implicit schemas in patients with major depressive disorder

BackgroundMany psychotherapy theories emphasise the importance of self-schema and other-schema, but most previous studies focused on the explicit self-schema in major depressive disorder (MDD). However, the limited studies of implicit...

Individual goals interact with dyad goals to constrain and facilitate the formation of interpersonal patterns of coordination

Two experiments were undertaken to examine the spontaneous and intentional formation of interpersonal coordination patterns within dyads. In both experiments, each individual in a dyad was given a pre-set amplitude goal of tracing a 3cm or 15cm line to maintain over a trial. Smaller amplitudes were associated with faster movement frequencies compared to larger amplitudes in both experiments. All trials started with the partners in the dyads not seeing each other, and at the half-way point within a trial vision of the partner was provided. In experiment 1, each individual was told to watch their partners hand in the view segment, yet maintain the amplitude goal. The pre-set amplitude goals limited the emergence of spontaneous interpersonal coordination in the form of frequency-locking and phase-entrainment. In experiment 2, the individuals in the dyad were told to intentionally coordinate at either a defined in-phase or anti-phase pattern of coordination when entering the view segment of a trial. All dyads formed the required coordination patterns at a 1:1 frequency-locking across 90% of trials when entering the view segment. However, the pre-set amplitudes still influenced performance of individuals in terms of movement amplitude and frequency modulations when intentionally forming the required coordination patterns. The proposed hypotheses and the interpretation of the results are framed within the coordination dynamics theory of perception-action processes.

An Interpersonal Approach to the Treatment of Social Anxiety Disorder (Social Phobia): A Component Analysis.

Most treatments of social anxiety disorder aim at anxiety reduction. To what extent this leads to improved social functioning remains unclear. An effective alternative aiming primarily at social functioning- the Interpersonal Approach- is available. The present study sought to identify its active ingredients. This is a randomized controlled study; 102 social anxiety disorder individuals were randomly assigned to 3 versions of the Interpersonal Approach. A total of 76 patients completed treatment and 67, a 1-year follow-up. The patients met Diagnostic and Statistical Manual of Mental Disorders, fourth edition criteria for social anxiety disorder. The study was carried out in an experimental clinic for the treatment of social anxiety disorder at the Research Center of Louis-H. Lafontaine Hospital in Montreal, Canada. No clinically meaningful change occurred during the waiting list. A significant and equivalent improvement was obtained in all treatment conditions in social functioning, anxiousness, and general psychopathology, maintaining over a 12-month follow-up. Remission rates improved progressively with 54% remission at 1-year follow-up. All variants of the Interpersonal Approach resulted in similar improvements. The Interpersonal Approach in all its versions has proved to be effective in reducing anxiety complaints and improving social functioning. The combined improvement in these 2 outcomes accounts for the significant remission rates seen at 1-year follow-up. Two active features were common to all: (1) targeting and ultimately dissolving long-standing habits of self-protection across various spheres of life and (2) fostering participatory interpersonal patterns of behavior, enacted by patients systematically and repeatedly between sessions.

Addressing interpersonal patterns in patients with personality disorders partially explains psychotherapy outcome via changes in interaction patterns: A mediation analysis

ABSTRACT Objective Many patients with personality disorders (PDs) present with problematic interaction patterns. These may also manifest in the therapeutic relationship. For successful treatment, therapists must therefore find effective ways to address such problematic interaction patterns. Methods: A total of 382 patients with PDs were recruited within a naturalistic setting and received integrative cognitive–behavioral therapy (CBT). Two subscales of the observer-rated Process-Content-Relationship Scale were applied to sessions 15, 20, and 25 of treatment: one on patient interaction patterns and the other on therapist addressing these. Symptom severity was assessed at intake and discharge. Mediation analysis was applied. Results: We found significant main effects of (1) therapists’ addressing problematic interaction patterns in session 15 on patients’ changes in such patterns from session 15 to 25 and (2) patients’ changes in problematic interaction patterns on symptom severity at treatment termination. Further, the effect of therapists’ addressing problematic interaction patterns on outcome was mediated by changes in patients’ interaction patterns. Conclusion: The results indicate that therapists’ addressing of PD patients’ problematic interaction patterns may be particularly important to improve such patterns and thereby treatment outcome. Future research should identify in which patients the mechanism of addressing interaction patterns works best.

The Effect of Rejection Sensitivity on Fear of Intimacy in Emerging Adulthood

Abstract. Background: This research examined fear of intimacy during emerging adulthood. We attempted to determine whether rejection sensitivity has any effect on fear of intimacy through the mediational effect of interpersonal anxiety. We also assumed that remembered parental acceptance can have a buffering effect on the above relationships. Methods: The sample was composed of 679 (280 male and 399 female) university students. Data collection was accomplished through the use of self-report questionnaires, which measured rejection sensitivity, fear of intimacy, interpersonal anxiety, and remembered parental acceptance. Analyses of mediation and moderation effects variables were conducted through the use of the PROCESS statistical software. Results: Analysis showed that there is a partial meditational effect of interpersonal anxiety on the relationship of rejection sensitivity to fear of intimacy. Further, remembered maternal acceptance had a protective effect on the development of fear of intimacy in young women who are sensitive to rejection and have high interpersonal anxiety. Discussion: Rejection sensitivity seems to have an effect on the development of fear of intimacy through increasing interpersonal anxiety, especially in females. These relationships seem to be moderated by maternal acceptance. Conclusion: Student counselling would be beneficial to help students in this transitional period become aware of anxious interpersonal patterns and regulate their reactivity when facing perceived rejection cues in their interpersonal relationships.

The Cost-Effectiveness of Psychodynamic Therapy: The Obstacles, the Law, and a Landmark Lawsuit

ABSTRACT Psychotherapy, especially dynamic psychotherapy and psychoanalysis, has been poorly supported by insurance although the Mental Health Parity Act mandates benefits for mental health care at parity with other health care and The Affordable Care Act lists mental health care, including psychotherapy, as an Essential Health Benefit. Limiting insurance support for psychotherapy turns away very ill, especially poorer patients who forego treatment and incur increased medical costs and disability. Patients with personality disorders, chronic anxiety depression, chronic illness and comorbidity require extended, often intensive, psychotherapy for optimal recovery. Brief cognitive-behavioral therapy is seen as a “gold standard” and “most evidence-based” although its research protocols study subjects not typical of most patients and who achieve only short-lived improvements. Research finds psychodynamic therapies to be highly cost-effective, equal to other efficacious therapies in improving symptoms, and also superior in improving maladaptive interpersonal relationship patterns, a high-risk factor for mortality. Knowledgeable attorneys and expert witnesses were key to the 2019 successful class action lawsuit against United Behavioral Health for declining to cover research supported generally accepted standards for mental health care and for a subsequent California state law mandating sufficient insurance coverage. To defend it in legal and policy arenas, providers and advocates for psychodynamic psychotherapy should familiarize themselves with its supporting research and the laws that demand its provision.

Lessening of the pervasiveness of interpersonal patterns in borderline personality disorder explains symptom decrease after treatment: A process analysis.

BackgroundProblematic interpersonal patterns, as defined by the core conflictual relationship theme (CCRT) method, are part of the clinical presentation of clients with borderline personality disorder (BPD). So far, we do not know whether the pervasiveness of interpersonal patterns changes and if this change explains therapy outcome.MethodsIn a secondary analysis of a randomized controlled trial on a brief version of psychiatric treatment for BPD, a treatment with a psychodynamic focus, the present study included N = 39 clients. One early session and one late session of the treatment were transcribed and analyzed using the CCRT method.ResultsIt appeared that pervasiveness of the predominant CCRT decreased over the course of the brief treatment; this effect was robust across treatment conditions. Change in pervasiveness in any CCRT component explained a small portion of variance of the decrease in borderline symptoms observed at the end of treatment.DiscussionLessening of pervasiveness of problematic in‐session interpersonal patterns may be hypothesized as potential mechanism of effective treatment for BPD which should be tested in controlled designs.

Interpersonal dynamics and therapeutic relationship in patients with functional somatic syndromes: A metasynthesis of case studies.

Patients with functional somatic syndromes (FSS) often display troubled relationships with health care providers, psychotherapists, and significant others. Research shows that patients' history of trauma, attachment disturbances, and mentalization deficits may result in the emergence of maladaptive interpersonal patterns, which may later contribute to the onset and maintenance of FSS, "doctor hopping," and dropout in psychotherapy. As the nature and therapeutic consequences of such maladaptive interpersonal patterns in FSS cannot be understood sufficiently by quantitative methods alone, there is a need for in-depth qualitative research. To address this issue, we conducted a metasynthesis of 23 published case studies of patients with FSS from various psychotherapeutic orientations. Results show that patients with FSS from our sample perceived others as unreliable, that is, unavailable, overcontrolling, and overprotective. To adapt to such unreliable others, patients attempted to please and to control them. Patients also suppressed their emotional awareness and expression. Although alexithymia could also play a role, the primary reason for emotional avoidance seemed to be interpersonal in nature, that is, patients were avoiding negative emotions in order to please and control the unreliable others. The onset and worsening of FSS were associated with both interpersonal and physical triggers. Showing signs of physical or emotional distress led to more rejection, overcontrol, and overprotection from unreliable others, which could create a "vicious circle." Our results suggest that offering a more interpersonal perspective on emotion regulation difficulties would be beneficial for patients with FSS, counselors, psychotherapists, and other health care professionals. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Using Interpersonal Dimensions of Personality and Personality Pathology to Examine Momentary and Idiographic Patterns of Alliance Rupture.

The Alternative Model of Personality Disorders (AMPD) integrates several theoretical models of personality functioning, including interpersonal theory. The interpersonal circumplex dimensions of warmth and dominance can be conceptualized as traits similar to those in AMPD Criterion B, but interpersonal theory also offers dynamic hypotheses about how these variables that change from moment to moment, which help to operationalize some of the processes alluded to in AMPD Criterion A. In the psychotherapy literature, dynamic interpersonal behaviors are thought to be critical for identifying therapeutic alliance ruptures, yet few studies have examined moment-to-moment interpersonal behaviors that are associated with alliance ruptures at an idiographic level. The current study examined the concurrent and cross-lagged relationships between interpersonal behaviors and alliance ruptures within each session in the famous Gloria films (“Three Approaches to Psychotherapy”). Interpersonal behaviors (warmth and dominance) as well as alliance ruptures (i.e., withdrawal and confrontation) were calculated at half minute intervals for each dyad. We identified distinct interpersonal patterns associated with alliance ruptures for each session: Gloria (patient)’s warmth was positively related with withdrawal ruptures concurrently in the session with Carl Rogers; Gloria’s dominance and coldness were related with increased confrontation ruptures in the session with Fritz Perls concurrently, while her coldness was also predicted by confrontation ruptures at previous moments; lastly, both Gloria’s dominance and Albert Ellis’s submissiveness were positively related with withdrawal ruptures. These interpersonal patterns demonstrated the promise of using AMPD dimensions to conceptualize momentary interpersonal processes related to therapy ruptures, as well as the clinical importance of attuning to repetitive, dyad-specific interpersonal cues of ruptures within each session.