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Psychodynamic Psychiatry最新文献

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When the Psychiatrist Morally Disapproves. 当精神科医生道德上不赞成时。
Psychodynamic Psychiatry Pub Date : 2023-03-01 DOI: 10.1521/pdps.2023.51.1.15
Keng Chuan Soh, Jocelyn Siling Liao, Yi Hang Tay
{"title":"When the Psychiatrist Morally Disapproves.","authors":"Keng Chuan Soh,&nbsp;Jocelyn Siling Liao,&nbsp;Yi Hang Tay","doi":"10.1521/pdps.2023.51.1.15","DOIUrl":"https://doi.org/10.1521/pdps.2023.51.1.15","url":null,"abstract":"<p><p>The understanding of concepts like moral distress and countertransference in mental health settings has advanced over time. While organizational constraints and the clinician's moral values are conventionally thought to play a part in evoking such responses, certain behavioral transgressions might be universally deemed as morally unacceptable. The authors present case scenarios that took place during forensic assessments and routine clinical care. Clinical interactions evoked a diverse range of negative emotional reactions, including anger, disgust, and frustration. The clinicians struggled with moral distress and negative countertransference, which resulted in difficulty mobilizing empathy. Such responses could affect a clinician's ability to best work with the individual and could even affect the clinician's well-being adversely. The authors put forth several suggestions on how to manage one's own negative emotional reactions in similar settings.</p>","PeriodicalId":38518,"journal":{"name":"Psychodynamic Psychiatry","volume":"51 1","pages":"15-20"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9506782","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Examining Anti-Racism Efforts in Psychiatry Residency Programs. 检视精神病学住院医师计划中的反种族主义努力。
Psychodynamic Psychiatry Pub Date : 2023-03-01 DOI: 10.1521/pdps.2023.51.1.6
Justin Reynard Smith
{"title":"Examining Anti-Racism Efforts in Psychiatry Residency Programs.","authors":"Justin Reynard Smith","doi":"10.1521/pdps.2023.51.1.6","DOIUrl":"https://doi.org/10.1521/pdps.2023.51.1.6","url":null,"abstract":"<p><p>High-profile instances of police and citizen brutality against Black people in the United States in 2020 spurred increased attention to longstanding racial injustice, leading to widespread adoption of anti-racism concepts, discussions, and efforts. Due to the relative infancy of anti-racism agendas on an organizational level, effective anti-racism strategies and best practices are still being developed. The author-a Black psychiatry resident-aims to contribute to the anti-racism efforts and discourse happening nationally within medicine and psychiatry. A personal account is given reviewing challenges and successes from recent anti-racism efforts on the organizational level of a psychiatry residency program.</p>","PeriodicalId":38518,"journal":{"name":"Psychodynamic Psychiatry","volume":"51 1","pages":"6-14"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9506785","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Psychosocial and Psychodynamic Considerations Informing Factitious Disorder. 关于人为障碍的社会心理和心理动力学考虑。
Psychodynamic Psychiatry Pub Date : 2023-03-01 DOI: 10.1521/pdps.2023.51.1.98
Anna L Dickerman, Xavier F Jiménez
{"title":"Psychosocial and Psychodynamic Considerations Informing Factitious Disorder.","authors":"Anna L Dickerman,&nbsp;Xavier F Jiménez","doi":"10.1521/pdps.2023.51.1.98","DOIUrl":"https://doi.org/10.1521/pdps.2023.51.1.98","url":null,"abstract":"<p><p>Factitious disorder is a condition in which patients deceitfully present themselves as injured or ill in the absence of obvious external reward. It is difficult to diagnose and treat, and little rigorous evidence exists in the literature. While larger studies have revealed some clinical and sociodemographic patterns, there is a lack of consensus on psychosocial factors and mechanisms contributing to factitious disorder. This in turn has led to conflicting recommendations on management. In this article, we review major psychopathological theories of factitious disorder, including the role of early trauma and subsequent development of interpersonal dysfunction, as well as maladaptive gratification obtained from assuming the sick role. Common themes of interpersonal disruptions in this patient population include a pathologic need for attention and care, as well as aggression and desire for dominance. In addition to psychodynamic and psychosocial etiologic models of factitious disorder, we also review associated treatment approaches. Finally, we offer clinical implications, including countertransference considerations, as well as directions for future research.</p>","PeriodicalId":38518,"journal":{"name":"Psychodynamic Psychiatry","volume":"51 1","pages":"98-113"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9506777","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A Preliminary Study of the Interactive Effect of Avoidant Personality Disorder Symptoms and Expressive Suppression on the Outcome of a Psychodynamically Oriented Day Treatment Program. 逃避型人格障碍症状和表达抑制对心理动力学导向的日间治疗方案结果交互作用的初步研究。
Psychodynamic Psychiatry Pub Date : 2023-03-01 DOI: 10.1521/pdps.2023.51.1.114
John S Ogrodniczuk, David Kealy, Daniel W Cox, Michał Mielimąka, Anthony S Joyce
{"title":"A Preliminary Study of the Interactive Effect of Avoidant Personality Disorder Symptoms and Expressive Suppression on the Outcome of a Psychodynamically Oriented Day Treatment Program.","authors":"John S Ogrodniczuk,&nbsp;David Kealy,&nbsp;Daniel W Cox,&nbsp;Michał Mielimąka,&nbsp;Anthony S Joyce","doi":"10.1521/pdps.2023.51.1.114","DOIUrl":"https://doi.org/10.1521/pdps.2023.51.1.114","url":null,"abstract":"<p><p><i>Introduction:</i> Patients with avoidant personality disorder (AvPD) pathology tend to have poor prognosis in psychotherapy, yet there has been little research conducted to better understand why their outcomes are limited, making it difficult to improve treatments for them. Expressive suppression is a dysfunctional emotion regulation strategy that may exacerbate avoidant tendencies, further complicating the therapeutic process. <i>Methods:</i> Using data from a naturalistic study (<i>N</i> = 34) of a group-based day treatment program, we examined whether there was an interactive effect of AvPD symptoms and expressive suppression on treatment outcome. <i>Results:</i> Findings revealed a significant moderating effect of expressive suppression on the association between AvPD symptoms and treatment outcome. The outcome for patients with more severe AvPD symptoms was particularly poor when they engaged in high levels of expressive suppression. <i>Discussion:</i> The findings suggest that the combination of significant AvPD pathology and high expressive suppression is associated with poorer responsiveness to treatment.</p>","PeriodicalId":38518,"journal":{"name":"Psychodynamic Psychiatry","volume":"51 1","pages":"114-123"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9491381","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
From Mourning and Melancholia to Neurobiology in an Era of Global Warming, Pandemic Disease, and Social Chasms: Grief as a Requisite for Change. 从哀悼和忧郁症到全球变暖、流行病和社会鸿沟时代的神经生物学:悲伤是变革的必要条件。
Psychodynamic Psychiatry Pub Date : 2023-03-01 DOI: 10.1521/pdps.2023.51.1.45
Joanna E Chambers
{"title":"From Mourning and Melancholia to Neurobiology in an Era of Global Warming, Pandemic Disease, and Social Chasms: Grief as a Requisite for Change.","authors":"Joanna E Chambers","doi":"10.1521/pdps.2023.51.1.45","DOIUrl":"https://doi.org/10.1521/pdps.2023.51.1.45","url":null,"abstract":"<p><p>We find ourselves in a unique time in history with the confluence of a pandemic, global warming, and social chasms felt throughout the world. In this article, it is suggested that the grieving process is necessary for progress. The article addresses grief from a psychodynamic lens and progresses through the neurobiological changes that occur in the grieving process. The article discusses grief as both a result of and a necessary response to COVID-19, global warming, and social unrest. It is argued that grief is a vital process in order to fully change as a society and move forward. The role of psychiatry, and specifically psychodynamic psychiatry, is integral in paving the way to this new understanding and a new future.</p>","PeriodicalId":38518,"journal":{"name":"Psychodynamic Psychiatry","volume":"51 1","pages":"45-62"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9506784","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Abortion: Perspectives from an APA Past-President. 堕胎:来自APA前任主席的观点。
Psychodynamic Psychiatry Pub Date : 2023-03-01 DOI: 10.1521/pdps.2023.51.1.1
Nada L Stotland
{"title":"Abortion: Perspectives from an APA Past-President.","authors":"Nada L Stotland","doi":"10.1521/pdps.2023.51.1.1","DOIUrl":"10.1521/pdps.2023.51.1.1","url":null,"abstract":"<p><p>The United States Supreme Court's decision in <i>Dobbs v. Jackson Women's Health Organization,</i> eliminating the national right to abortion, poses challenges to psychiatrists and patients. Abortion laws now vary widely from state to state and are constantly changing and being challenged. The laws affect both patients and health care professionals; some prohibit not only the performance of abortion but efforts to inform and assist patients seeking abortion. Patients may become pregnant during and/or because of episodes of clinical depression, mania, or psychosis, and recognize that their current circumstances will not allow them to become adequate parents. Some laws allowing abortion to protect a woman's life or health explicitly exclude mental health risks; many prohibit transfer of a patient to a permissive venue. Psychiatrists working with patients contemplating abortion can convey the scientific evidence that abortion does not cause mental illness and help them identify and work through their own beliefs, values, and likely responses to the decision. Psychiatrists will also have to decide whether medical ethics or state laws will govern their own professional behavior.</p>","PeriodicalId":38518,"journal":{"name":"Psychodynamic Psychiatry","volume":"51 1","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9506779","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Reflections on Losing My Office during the Pandemic. 大流行期间失去办公室的思考。
Psychodynamic Psychiatry Pub Date : 2023-03-01 DOI: 10.1521/pdps.2023.51.1.21
Elizabeth Tillinghast
{"title":"Reflections on Losing My Office during the Pandemic.","authors":"Elizabeth Tillinghast","doi":"10.1521/pdps.2023.51.1.21","DOIUrl":"https://doi.org/10.1521/pdps.2023.51.1.21","url":null,"abstract":"<p><p>Reflections on loss, grief, and the possibility of recovery after losing my office, my analyst's office, and my analyst during the pandemic. The role of an office in consolidating a sense of analytic identity and the usefulness of sadness in catalyzing change are discussed.</p>","PeriodicalId":38518,"journal":{"name":"Psychodynamic Psychiatry","volume":"51 1","pages":"21-24"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9506780","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Mentalization Psychotherapy for Patients Presenting with a Psychotic Personality Structure: A Contemporary Approach. 精神化心理治疗对精神病性人格结构患者的治疗:一种当代方法。
Psychodynamic Psychiatry Pub Date : 2023-03-01 DOI: 10.1521/pdps.2023.51.1.76
Prometheas Constantinides, Julie Dauphin
{"title":"Mentalization Psychotherapy for Patients Presenting with a Psychotic Personality Structure: A Contemporary Approach.","authors":"Prometheas Constantinides,&nbsp;Julie Dauphin","doi":"10.1521/pdps.2023.51.1.76","DOIUrl":"https://doi.org/10.1521/pdps.2023.51.1.76","url":null,"abstract":"<p><p>Overt psychotic symptoms, currently understood as resulting from both neurobiological and developmental etiological factors, are also associated with deficits in mentalization in a subgroup of patients presenting with psychotic personality structure. Neurodevelopmental and traumatic impairments seen in this subtype of psychotic disorders create a pressure or need for what has been called a transformational mentalizing process. This specific form of mental elaboration focuses explicitly on finding words and images that help patients to grasp their emotional and mental states. It thus differs from mainstream mentalization treatment, which puts a greater emphasis on reflective functioning. A psychodynamically informed mentalization-based individual and group psychotherapy for this subgroup of patients was developed, aiming at augmenting the patient's psychological resources through explicit transformational mentalization, rather than primarily targeting symptom reduction. This program stimulates curiosity about one's mental states, progressively aiming to give shape to and explore affectively charged mental states, and is integrated with other treatment modalities. This article presents a psychological model of psychotic personality structure and its psychotherapeutic implications, as well as clinical illustrations. Preliminary findings from a pilot study provide encouraging support for the model, including emerging reflective capacities and symptom reduction, as well as overall improvement of social and occupational functioning.</p>","PeriodicalId":38518,"journal":{"name":"Psychodynamic Psychiatry","volume":"51 1","pages":"76-97"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9506781","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Reviewers for Psychodynamic Psychiatry 精神动力精神病学的评审员
Psychodynamic Psychiatry Pub Date : 2022-12-01 DOI: 10.1521/pdps.2022.50.4.719
{"title":"Reviewers for Psychodynamic Psychiatry","authors":"","doi":"10.1521/pdps.2022.50.4.719","DOIUrl":"https://doi.org/10.1521/pdps.2022.50.4.719","url":null,"abstract":"","PeriodicalId":38518,"journal":{"name":"Psychodynamic Psychiatry","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48456977","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Finding Psychodynamic Psychiatry's Lost Generation. 寻找精神动力精神病学失落的一代。
Psychodynamic Psychiatry Pub Date : 2022-06-01 DOI: 10.1521/pdps.2022.50.2.212
E. Plakun
{"title":"Finding Psychodynamic Psychiatry's Lost Generation.","authors":"E. Plakun","doi":"10.1521/pdps.2022.50.2.212","DOIUrl":"https://doi.org/10.1521/pdps.2022.50.2.212","url":null,"abstract":"This paper describes forces that have adversely affected the place of the psychodynamic perspective within psychiatric practice and training over the last generation. One effect of these forces has been to create a lost generation of psychiatrists with little knowledge or experience with psychodynamic treatment. The article addresses opportunities to reverse some of the detrimental effects of recent changes. The Residency Review Committee's introduction of a requirement that residents achieve a measurable level of competence in five schools of psychotherapy represents a major opportunity to influence psychiatric training and practice. The past and present work of the Committee on Psychotherapy by Psychiatrists (COPP) is summarized, including efforts to integrate and revise the five existing core competencies in psychotherapy into a \"Y\"-shaped model in a way that secures the future of psychodynamic therapy training in residencies. One existing unusual training opportunity with a central psychodynamic focus is described.","PeriodicalId":38518,"journal":{"name":"Psychodynamic Psychiatry","volume":"50 2 1","pages":"212-225"},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47610593","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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