Psychopathology Practice Research Articles

A Process-Based Approach to Transtheoretical Clinical Research and Training.

The science and practice of psychopathology and psychological intervention of today is more like an island archipelago than it is a single land mass, and connections between different traditions are both limited and fraught with misunderstanding. Our analysis and solution to the problem is process-based therapy (PBT). PBT defines psychopathology as failed adaptation processes to a given context. Therapy involves adaptation through context-dependent or context-altering applications of biopsychosocial strategies that allows a goal to be met. This coherent approach to more transtheoretical and integrative concepts of clinical training and practice provides a firm foundation by targeting biopsychosocial processes of change, analyzing these processes using an idiographic complex network analytic approach, and organizing findings on the intellectual agora of multi-dimensional and multi-level evolutionary science. PBT is a new empirical form of functional analysis, resulting in interventions and trainings that are built on elements or kernels of direct relevance to client's specific needs. In PBT, case formulation continues as long as treatment persists.

Describing disorder: The importance and advancement of compositional explanations in psychopathology

Understanding the makeup of mental disorders has great value for both research and practice in psychopathology. The richer and more detailed our compositional explanations of mental disorder—that is, comprehensive accounts of client signs and symptoms—the more information we have to inform etiological explanations, classification schemes, clinical assessment, and treatment. However, at present, no explicit compositional explanations of psychopathology have been developed and the existing descriptive accounts that could conceivably fill this role—DSM/ICD syndromes, transdiagnostic and dimensional approaches, symptom network models, historical accounts, case narratives, and the Research Domain Criteria (RDoC)—fall short in critical ways. In this article, we discuss what compositional explanations are, their role in scientific inquiry, and their importance for psychopathology research and practice. We then explain why current descriptive accounts of mental disorder fall short of providing such an explanation and demonstrate how effective compositional explanations could be constructed.

Carl Jung and Alcoholics Anonymous: is a Theistic Psychopathology Feasible?

The reputed success in rehabilitating so-called “hopeless” alcoholics through the Alcoholics Anonymous (A.A.) program depends in large measure to convincing the members of the group or community that they are totally helpless in changing themselves through their own efforts, but that God can do it when they give themselves and their lives over to God. This theistic approach and method may influence future theory and practice in psychopathology and psychiatry, as this aspect of Carl Jung’s psychology [1] becomes the focus of attention.

Training in Psychopathology in Europe: Results From a Survey

Introduction Recently the need for modern psychiatrists to have strong psychopathological bases has been repeatedly affirmed. Objectives To provide a general overview on the current status of training and practice in psychopathology across Europe. Aims 1) to describe the current status of training on psychopathology;2)to identify the unmet needs of European residents in psychiatry;3)to suggest future perspectives of training in psychopathology. Methods An online survey, promoted by the EPA Section on Philosophy and Psychiatry, was carried out during the period July-December 2013. Forty-one representatives of early career psychiatrists of their national associations were invited to participate. Each respondent was asked to provide the collective feedback of the association rather than that of any of its individual officer or member. Results Thirty-two associations returned the questionnaire out of the 41 contacted (response rate: 78%). All respondents recognize psychopathology as a core component of training in psychiatry. The primary aims of psychopathology are to assess psychiatric symptoms, to understand patients' abnormal experiences, and to make nosographical diagnoses. A formal training course in psychopathology is available in almost all surveyed countries. In most countries:1)there is not a defined number of hours dedicated to psychopathology;2)teaching is mainly theoretical;3)a structured training on psychopathological rating scales is missing. At the end of the training, about half of respondents is not satisfied with received training in psychopathology. Conclusions European early career psychiatrists clearly recognize the need to rediscover psychopathology, which represents the heritage of European Psychiatry. Initiatives to improve training and practice of psychopathology should be addressed by national and international psychiatric organizations.

Quelques éléments en faveur d’une réflexion psychopathologique sur la psychopathie : seconde partie

ObjectivesThe objectives of this study are to offer some clinical and semiological considerations for a psychopathological conception of psychopathy. In the first part, the author provides a history of this diagnosis (see Introduction of this paper) and a description of the current trends in the international literature: the contributions of R.D. Hare and the PCL-R, D.J. Cooke and the Comprehensive Assessment of Psychopathic Personality (CAPP) and T.H. Pham for French-speaking validations (subtitle 2 of this paper). After that, the author proposes a definition of psychopathology in the sense of Minkowski and Jaspers proposals (i.e. these latter come from the principles of the continental phenomenology) (subtitle 3 of this paper). Patients and methodsThis theoretical essay is improved by clinical situations. The psychopaths were interviewed in prison or in forensic centers. The method used was a psychopathological analysis from the clinical material, as well as references to the phenomenological psychopathology (continental phenomenology) and the philosophy of J.-P. Sartre, M. Foucault and P. Ricœur. ResultsThis study shows that it is useful to consider a psychopathological reflection on psychopathy and this approach gives a framework for the clinical investigations. Regarding that, the author proposes a first comparison between the binswangerian conception of mania and the psychopathic functioning (subtitle 4 of this paper). By this way, we can understand why many studies show a positive correlation between the scoring in the PCL-R and the scale of the MMPI mania. The behavior is similar but the difference is about the dialectic between the “ego” and the “alter ego”. The maniac has a fundamental crisis of the “ego”, which the psychopath does not have. A second finding of our investigations concerns emotions and the dimension of the adaptive psychopathic disorder (subtitle 5 of this paper). An epistemological discussion of the concept of emotions allows us to say that the psychopath is competent in the management of emotional stimuli, which confers a psychological advantage to him. In addition, fundamental research on the management of the emotional stimuli in the psychopath seems to confirm our hypothesis of an adaptive dimension for the psychopathic disorder. The last point we discuss is about “morality” and “ethics” for the psychopath (these notions are from the concepts of empathy and sympathy). On the basis of Foucault's distinction between these two concepts, it becomes possible to study these dimensions and integrate them in the practice of psychopathology. This proposal enables to introduce the concept of narrativity. This observation prompts the clinician to listen to the patient and to pay attention to how he has to tell himself. ConclusionsOur contribution shows that it is possible to conduct a study about the psychopathology of psychopathy. Our study is not intended to be complete and irrefutable. Our goal is rather to give some evidence for a psychopathological consideration on psychopathy (as indicated by the title of this paper). Finally, we offered some thoughts on the practice of psychotherapy by integrating the adaptive dimension of this disorder which, when it is missed, can lead to a psychotherapeutic stalemate.

Quelques éléments en faveur d’une réflexion psychopathologique sur la psychopathie : première partie

ObjectivesThe objectives of this study are to offer some clinical and semiological considerations for a psychopathological conception of psychopathy. In the first part, the author provides a history of this diagnosis (see Introduction of this paper) and a description of the current trends in the international literature: the contributions of R.D. Hare and the PCL-R, D.J. Cooke and the Comprehensive Assessment of Psychopathic Personality (CAPP) and T.H. Pham for French-speaking validations (subtitle 2 of this paper). After that, the author proposes a definition of psychopathology in the sense of Minkowski and Jaspers proposals (i.e. these latter come from the principles of the continental phenomenology) (subtitle 3 of this paper). Patients and methodsThis theoretical essay is improved by clinical situations. The psychopaths were interviewed in prison or in forensic centers. The method used was a psychopathological analysis from the clinical material, as well as references to the phenomenological psychopathology (continental phenomenology) and the philosophy of J.-P. Sartre, M. Foucault and P. Ricœur. ResultsThis study shows that it is useful to consider a psychopathological reflection on psychopathy and this approach gives a framework for the clinical investigations. Regarding that, the author proposes a first comparison between the binswangerian conception of mania and the psychopathic functioning (subtitle 4 of this paper). By this way, we can understand why many studies show a positive correlation between the scoring in the PCL-R and the scale of the MMPI mania. The behavior is similar but the difference is about the dialectic between the “ego” and the “alter ego”. The maniac has a fundamental crisis of the “ego”, which the psychopath does not have. A second finding of our investigations concerns emotions and the dimension of the adaptive psychopathic disorder (subtitle 5 of this paper). An epistemological discussion of the concept of emotions allows us to say that the psychopath is competent in the management of emotional stimuli, which confers a psychological advantage to him. In addition, fundamental research on the management of the emotional stimuli in the psychopath seems to confirm our hypothesis of an adaptive dimension for the psychopathic disorder. The last point we discuss is about “morality” and “ethics” for the psychopath (these notions are from the concepts of empathy and sympathy). On the basis of Foucault's distinction between these two concepts, it becomes possible to study these dimensions and integrate them in the practice of psychopathology. This proposal enables to introduce the concept of narrativity. This observation prompts the clinician to listen to the patient and to pay attention to how he has to tell himself. ConclusionsOur contribution shows that it is possible to conduct a study about the psychopathology of psychopathy. Our study is not intended to be complete and irrefutable. Our goal is rather to give some evidence for a psychopathological consideration on psychopathy (as indicated by the title of this paper). Finally, we offered some thoughts on the practice of psychotherapy by integrating the adaptive dimension of this disorder which, when it is missed, can lead to a psychotherapeutic stalemate.

Performing Taxometric Analysis to Distinguish Categorical and Dimensional Variables

A fundamental question facing clinical scientists is whether the constructs they are studying are categorical or dimensional in nature. The taxometric method was developed expressly to answer this question and is being used by a growing number of investigators to inform theory, research, and practice in psychopathology. The current paper provides a practical introduction to the method, updating earlier tutorials based on the findings of recent methodological studies. We offer revised guidelines for data requirements, indicator selection, parameter estimation, and procedure selection and implementation. We illustrate our recommended approach to taxometric analysis using idealized data sets as well as data sets representative of those found in clinical research. We close with advice to help newcomers get started on their own taxometric analyses.

Publication Opportunity in the Journal of Psychopathology and Behavioral Assessment

This issue marks the beginning of the third year and volume of Journal of Psychopathology and Behavioral Assessment. The journal remains committed to the presentation of key developments in the science and practice of psychopathology and assessment, broadly conceived. As the journal has progressed, there has been new knowledge put forth on the general psychometric properties of existing measures. Moreover, new measures have been developed and introduced to the broader community of psychologists and mental health professionals via the journal. A great deal of knowledge has been acquired on psychopathology, assessment and its treatment. All of these studies have provided rich journal content. The journal remains dedicated to promoting the dissemination of knowledge of diverse facets of the profession of psychopathology and assessment. The journal is also committed to research on the treatment of psychopathology and especially articles that pertain to the measurement of change (i. e., reductions in psychopathology). It remains a goal of the journal to reflect the mastery of the assessment, psychopathology, and treatment areas for which authors are studying. In order to continue the flow of high quality manuscripts that have been submitted to the journal, I highlight several issues that I am hopeful will remain an important focus of the journal.