Specificities of Mental Functioning and Referential Process in Body Dysmorphic Disorder: A Single Case Study Using the Psychodynamic Diagnostic Manual (PDM-2).

IF 1.6 2区 文学 Q1 LINGUISTICS
Christopher Christian, Alice Fiorini Bincoletto, Rachele Mariani, Attà Negri, Vittorio Lingiardi, Annalisa Tanzilli
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引用次数: 0

Abstract

This study aimed to accurately diagnose a patient with body dysmorphic disorder (BDD) and explore challenges to symbolization in the early and middle stages of psychotherapy through an analysis of language used by both therapist and patient. The patient was assessed using the Psychodynamic Chart in the Psychodynamic Diagnostic Manual and the Referential Process language measures, which were applied to the early and middle treatment sessions. At the beginning of treatment, the patient presented with comorbid somatizing and schizoid personality disorders, and strong obsessive and anxiety-avoidant traits. He displayed significant impairments in capacity for mentalization; affective range; communication and understanding; self-esteem regulation; and relational intimacy. The patient met criteria for severe BDD. His speech showed a markedly abstract and intellectualized linguistic style that indicated great difficulty in connecting emotional experience to images and words. The therapist's interventions were adapted to this style and were characterized by continuous prompts and suggestions aimed at linking elements and supporting a symbolizing process in order to integrate emotional activation in narratives. This therapeutic action, which we labeled "aided symbolization" promoted a slow but significant process of change with improvement in overall mental functioning. The clinical implications of these results are discussed.

身体畸形障碍的心理功能和参考过程的特异性:使用心理动力学诊断手册(PDM-2)的单个案例研究。
本研究旨在通过对治疗师和患者使用的语言进行分析,以准确诊断身体畸形障碍(BDD)患者,并探讨在心理治疗的早期和中期阶段对符号化的挑战。使用心理动力学诊断手册中的心理动力学图表和参考过程语言测量对患者进行评估,这些测量应用于治疗的早期和中期。在治疗开始时,患者表现出躯体化和分裂样人格障碍的合并症,以及强烈的强迫和焦虑回避特征。他在心智化能力上有明显的缺陷;情感范围;沟通和理解;自尊调节;以及亲密关系。患者符合重度BDD的标准。他的演讲表现出一种明显的抽象和理智的语言风格,这表明他很难将情感体验与图像和文字联系起来。治疗师的干预适应了这种风格,其特点是持续的提示和建议,旨在连接元素并支持象征化过程,以便将情感激活整合到叙事中。这种治疗行为,我们称之为“辅助符码化”,促进了一个缓慢但重要的改变过程,改善了整体的心理功能。讨论了这些结果的临床意义。
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来源期刊
CiteScore
3.00
自引率
5.00%
发文量
92
期刊介绍: Journal of Psycholinguistic Research publishes carefully selected papers from the several disciplines engaged in psycholinguistic research, providing a single, recognized medium for communications among linguists, psychologists, biologists, sociologists, and others. The journal covers a broad range of approaches to the study of the communicative process, including: the social and anthropological bases of communication; development of speech and language; semantics (problems in linguistic meaning); and biological foundations. Papers dealing with the psychopathology of language and cognition, and the neuropsychology of language and cognition, are also included.
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