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Holding Patients with Medication
Published in Paul Ian Steinberg, Psychoanalysis in Medicine, 2020
Our experience raises a question regarding to what extent psychotherapy helped these patients, and to what extent the patients’ improvements were attributable to neuroleptics. Future research regarding this might compare the results of psychotherapy alone with the results of neuroleptic medication alone, and the results of combined treatment. Clinical experience suggests that combined treatment is most beneficial. It seems very unlikely that treatment with the neuroleptic medication alone would be as effective as treatment with combined treatment in this population. Some disturbances of thinking, affect regulation, and impulse behavior might improve with medications alone. However, the interpersonal learning and the improvement in and development of the capacity for abstract thinking that can take place in DTP would not occur, and the patients’ improvement would be symptomatic only. There is no reason to believe that this improvement would be maintained if the neuroleptic medication were withdrawn. While it is possible that the environment might positively reinforce the more constructive behavior demonstrated while patients are taking neuroleptics, it appears more likely that this would be the case were the patient also to attend DTP. Ideally, patients who benefited from psychotherapy would build on their experience in DTP and continue to learn in interpersonal situations with or without ongoing psychotherapy. Eventually the neuroleptic medication might be withdrawn without a relapse of the symptoms prompting its prescription.
Posttraumatic Stress Disorder (PTSD)
Published in Judy Z. Koenigsberg, Anxiety Disorders, 2020
What are the factors that characterize posttraumatic stress disorder (PTSD) and individuals with PTSD? Posttraumatic stress disorder can be thought of as the lack of affect regulation after a traumatic incident (Seligowski, Lee, Bardeen, & Orcutt, 2015). The disorder can develop when threatening traumatic events that occur to an individual are not processed (Gilbert & Orlans, 2011). Gallegos and Hillbrand (2016) explain that individuals with trauma histories share the features of dysfunctional attachments, stressed relatedness, a maladaptive capacity to self-soothe, and impaired functioning.
Attention deficit hyperactivity disorder and substance use
Published in David B Cooper, Practice in Mental Health—Substance Use, 2018
Behavioural interventions such as bimanual coordination have been suggested.25 Tests of bimanual coordination show that this is decreased in patients with FASD compared to controls. Thus, there is the potential for bimanual exercises commenced in early childhood to be a potential treatment for FASD. The theory is that children with FASD would be able to complete more complex tasks progressively, demanding greater inter-hemispheric information transfer. The downstream effects would be less disruptive behaviour and improved executive control. Clinical trials are necessary to prove efficacy of this approach. The author’s novel affect regulation therapy approach could also be tested out on this clinical population.
A borderline focused Reflective Functioning measure – Interrater reliability of the Mentalization Breakdown Interview
Published in Nordic Journal of Psychiatry, 2023
Dag Anders Ulvestad, Merete Selsbakk Johansen, Elfrida Hartveit Kvarstein, Geir Pedersen, Theresa Wilberg
In borderline personality disorder (BPD), impaired mentalizing capacity is assumed to underlie core problems such as poor affect regulation, impulse control problems, and incoherent internal representations of self and others [6,7]. The mentalizing impairments in patients with BPD are characterized by significant fluctuations, primarily in attachment contexts, sometimes evolving into major mentalizing breakdowns. Such mentalizing breakdowns can lead to severe relational problems, self-destructive behavior, violence, or substance misuse and appear as obvious targets in therapy for this condition. For instance, Mentalization-Based Therapy (MBT) is an evidence-based manualized psychodynamic psychotherapy for patients with BPD which focuses specifically on the patients’ mentalizing difficulties [7].
Psychometric Evaluation of the Action Control Scale in Turkish Samples and the Relationship of Action–State Orientation with Emotional Labor
Published in Journal of Personality Assessment, 2022
We argue that action orientation is negatively related to surface acting and deep acting for two reasons. First, employees typically resort to surface acting and deep acting when there is incongruence between the felt and required emotions (Morris & Feldman, 1996). For example, emotional labor is required when an employee is in a bad mood but is required to display positive emotions to a customer. Theory and studies have shown that action orientation is closely related to regulation of affect. Specifically, action-oriented individuals are better than state-oriented individuals are at reducing negative affect and generating positive affect (Kazén & Quirin, 2018). Thus, it is likely that action-oriented individuals would more effectively adjust their emotions to be congruent with the emotional requirements of the work when necessary. Moreover, Kuhl (2000a) argued that affect regulation ability is shaped through early socialization practices that involve repeated associative learning experiences with the caregiver. Consequently, affect regulation gradually becomes well-practiced and integrated into the self, predisposing individuals to display effortless, fast, and effective emotion regulation across different situations, which in our case is emotion regulation in the workplace.
Emotions before and after loss of control eating
Published in Eating Disorders, 2018
Brittany L. Stevenson, Robert D. Dvorak, Stephen A. Wonderlich, Ross D. Crosby, Kathryn H. Gordon
Binge eating is currently defined as “eating, in a discrete period of time, an amount of food that is definitely larger than what most individuals would eat in a similar period of time under similar circumstances and is characterized by a sense of lack of control over eating,” according to The Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM–5; American Psychiatric Association, 2013). Binge eating is the cardinal symptom of the eating disorders bulimia nervosa (BN) and binge eating disorder (BED). This sense of lack of control over eating is associated with high rates of obesity, psychological distress, functional impairment, and negative emotions like guilt and shame (American Psychiatric Association, 2013; Mond et al., 2006; Vannucci et al., 2013). In fact, evidence has emerged that loss of control (LOC) eating that does not feature an objectively large amount of food is associated with functional impairment and distress consistent with objectively large binge eating (Mond et al., 2006; Vannucci et al., 2013). In light of this evidence, Uher and Rutter (2012) have proposed that the next version of the International Classification of Diseases eliminates the “objectively large” criterion. Because of these recent movements in the field, it is important for researchers to study how LOC eating fits within the framework of the theories that have been constructed to explain binge eating. One such model, the affect regulation model, is considered below.