Alberto Stefana, Paolo Fusar-Poli, Joshua Langfus, Eduard Vieta, Eric Youngstrom
{"title":"Development and preliminary validation of the Clinician Affective REsponse (CARE) scale.","authors":"Alberto Stefana, Paolo Fusar-Poli, Joshua Langfus, Eduard Vieta, Eric Youngstrom","doi":"10.4081/ripppo.2024.736","DOIUrl":"10.4081/ripppo.2024.736","url":null,"abstract":"<p><p>The present study reports on the development and validation of the clinician affective response (CARE) scale. The CARE scale was designed as a self-report measure of therapists' patterns of thoughts, feelings, and behaviors toward the patient during an individual psychotherapy session. An initial pool of 116 items was generated, and its quality was evaluated by subject matter experts. Validation data were gathered from licensed psychotherapists (n=554). We used exploratory factor analysis and item response theory-graded response modeling to select items, confirmatory factor analysis to test how well the factor structure fit the data, and k-fold cross-validation to ascertain the robustness of the model. Criterion validity was evaluated by correlating the scores of the scale with the characteristics of therapists, patients, and treatment. The selected model consists of 15 items and a 3-factor structure, which showed excellent model fit, good internal consistency, and evidence of criterion validity. The CARE scale, short and quick to complete, enables therapists to reflect on and recognize their inner experiences and quantify these experiences in ways conducive to statistical analysis and research. Furthermore, the monitoring of these affective reactions toward their patients can guide therapeutic interventions and inform clinical supervisors.</p>","PeriodicalId":44262,"journal":{"name":"Research in Psychotherapy-Psychopathology Process and Outcome","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11064772/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140319464","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Victoria Klimkowski, Sofia McRae, Alexia Blick, Laurence Beaulieu, J Reese S Handley, Anara A Hopley, Caroline A Hyde, Devika M Jain, Sylvia Kolodziejczyk, Josiane Laliberté, Alexa Lévesque, Lara M Masri, Anya M Monet, Reagan S Nediu, Rachel Valihrach, Giorgio Tasca
{"title":"Models of practice and training in psychotherapy: cross-national perspectives from Italy and Canada.","authors":"Victoria Klimkowski, Sofia McRae, Alexia Blick, Laurence Beaulieu, J Reese S Handley, Anara A Hopley, Caroline A Hyde, Devika M Jain, Sylvia Kolodziejczyk, Josiane Laliberté, Alexa Lévesque, Lara M Masri, Anya M Monet, Reagan S Nediu, Rachel Valihrach, Giorgio Tasca","doi":"10.4081/ripppo.2024.732","DOIUrl":"10.4081/ripppo.2024.732","url":null,"abstract":"<p><p>Internationally, there is ongoing concern about accessibility to mental health care and training. The goal of this study was to explore commonalities and differences within models of clinical psychology and psychotherapy in Ontario, Canada, and Lombardia, Italy, respectively, to inform improvements to the accessibility of mental health care and training. Using key informant sampling, we recruited ten students and professionals in Italy and Canada who study or work in psychology for semi-structured interviews. We analyzed the interview content using an inductive approach for thematic analysis within countries and meta-theme analysis across countries. The findings indicated three cross-national meta-themes: the need to integrate evidence with practice, the limited accessibility of training for students and treatment for patients, and the importance of the quality of training programs. Despite some differences regarding the amount of scientific training, personal therapy for trainees, and the prominence of cultural diversity training, Canadian and Italian psychology professionals and students shared experiences of psychotherapy practice and clinical psychology training. The three cross-national meta-themes indicate which issues in training and practice may be relevant worldwide and where to focus resources. The findings can inform international collaborations regarding training model structures that may increase access to psychology training and may increase consensus on professional recognition standards to improve mobility for professionals. These changes could reduce barriers to mental healthcare services for patients.</p>","PeriodicalId":44262,"journal":{"name":"Research in Psychotherapy-Psychopathology Process and Outcome","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11064771/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140144300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Therapist self-awareness and perception of actual performance: the effects of listening to one recorded session.","authors":"Raquel Pereira, António Pazo Pires, David Neto","doi":"10.4081/ripppo.2024.722","DOIUrl":"10.4081/ripppo.2024.722","url":null,"abstract":"<p><p>Research in psychotherapy has emphasized the relevance of the therapist's role, particularly the impact of deliberate practice and self-awareness (SA). This study aims to explore how SA is presented in the accounts of psychotherapists and assess the impact of attending to actual performance. Twenty cognitive behavioral therapy psychotherapists in training were interviewed before and after listening to their session recordings. The interview was based on five domains of self-awareness: recognition of emotional experience, assessment of personal skills, recognition of prejudices and implicit biases, and awareness of personal values. Results show that SA is frequently attained in skills identification and emotional experience. Recognizing the influence of personal values and bias, and emotional regulation was less frequently identified. There were minor differences before and after listening to the recording. There is an increase of SA in identifying the therapist's personal skills, and aspects such as our prejudices and biases are more internalized and difficult to change. This article suggests the importance of deliberate practice strategies to promote SA and increase the effectiveness of psychotherapy.</p>","PeriodicalId":44262,"journal":{"name":"Research in Psychotherapy-Psychopathology Process and Outcome","volume":"27 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11064770/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139736321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Vera Békés, Claire J Starrs, J Christopher Perry, Tracy A Prout, Ciro Conversano, Mariagrazia Di Giuseppe
{"title":"Defense mechanisms are associated with mental health symptoms across six countries.","authors":"Vera Békés, Claire J Starrs, J Christopher Perry, Tracy A Prout, Ciro Conversano, Mariagrazia Di Giuseppe","doi":"10.4081/ripppo.2023.729","DOIUrl":"10.4081/ripppo.2023.729","url":null,"abstract":"<p><p>Defense mechanisms are adaptative processes that are related to mental health and psychological functioning and may play an important role in adaptation to distress, as well as in mental health interventions. The present study aimed to compare the use of defense mechanisms and their relationship to mental health symptoms across six countries. In a large-scale descriptive study, we collected data from community- based individuals (N=19,860) in the United States, Australia, Canada, Germany, Italy, and the United Kingdom about the use of defense mechanisms and experienced mental health symptoms during the early phase of the pandemic. We found that the use of defense mechanism categories was similar across countries. Moreover, lower defensive functioning, specifically, neurotic and immature defenses were related to experiencing higher distress across countries, whereas mature defenses were generally inversely related to symptoms. Furthermore, these findings were relatively similar across the six countries. Cross-cultural research on defense mechanisms and mental health has important clinical implications. Our results are consistent with the goal of promoting more adaptive defensive functioning to increase psychological well-being and mitigate the detrimental impact of situational stress.</p>","PeriodicalId":44262,"journal":{"name":"Research in Psychotherapy-Psychopathology Process and Outcome","volume":"26 3","pages":""},"PeriodicalIF":1.6,"publicationDate":"2023-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10849071/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139472033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Elena Ierardi, Marta Bottini, Emanuele Preti, Rossella Di Pierro, Fabio Madeddu, Cristina Riva Crugnola
{"title":"Attachment styles, mental health, and trauma during the first wave of COVID-19 pandemic in an Italian adult population.","authors":"Elena Ierardi, Marta Bottini, Emanuele Preti, Rossella Di Pierro, Fabio Madeddu, Cristina Riva Crugnola","doi":"10.4081/ripppo.2023.689","DOIUrl":"10.4081/ripppo.2023.689","url":null,"abstract":"<p><p>The COVID-19 pandemic has negatively impacted adults' mental health around the world. Various studies highlighted the role of sociodemographic risk factors, including age, gender, and level of education, in increasing this impact. Although insecure attachment styles are considered a vulnerability factor for psychopathology and difficulties in coping with stressful situations, few studies have examined the role of attachment styles in relation to psychological responses to the COVID-19 pandemic. This study aims to investigate the role of attachment styles in affecting psychopathological problems and post-traumatic symptoms during the COVID-19 pandemic in a sample of Italian adults (N=1548). During the first lockdown in Italy, the Attachment Style Questionnaire, the Impact of Event Scale-Revised, and Symptom Checklist 90-Revised were administered to the participants to assess attachment styles, trauma-related symptoms, and psychopathological problems. The results showed that 41% of the participants had symptoms of clinical and subclinical relevance during the pandemic. Anxious and avoidant insecure attachment styles predicted psychopathological problems and post-traumatic symptoms, whereas secure attachment style was a protective factor. Our results highlighted the significant role played by the quality of attachment styles on adult mental health during the pandemic, providing valuable elements for targeted psychological support interventions.</p>","PeriodicalId":44262,"journal":{"name":"Research in Psychotherapy-Psychopathology Process and Outcome","volume":"26 3","pages":""},"PeriodicalIF":1.6,"publicationDate":"2023-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10849074/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139467222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Attachment orientations and emotion regulation: new insights from the study of interpersonal emotion regulation strategies.","authors":"Irene Messina, Vincenzo Calvo, Alessandro Grecucci","doi":"10.4081/ripppo.2023.703","DOIUrl":"10.4081/ripppo.2023.703","url":null,"abstract":"<p><p>A crucial point for the understanding of the link between attachment and emotion regulation concerns the individual tendency in turning to others to alleviate distress. Most previous studies in this field have considered almost exclusively intra-personal forms of emotion regulation, neglecting the role of social interaction in emotion regulation processes. In the present study, instead, we focused on interpersonal emotion regulation. 630 adults were assessed for their attachment orientations, general difficulties in emotion regulation, and habitual intra-personal and interpersonal emotion regulation strategies. Results showed that the imbalance between the hyper-activation and deactivation of the attachment system, which characterize unsecure attachment, reflects a correspondent imbalance in the use of emotion regulation strategies, with an exaggerated dependence on other associated with attachment anxiety and pseudo-autonomy associated to attachment avoidance.</p>","PeriodicalId":44262,"journal":{"name":"Research in Psychotherapy-Psychopathology Process and Outcome","volume":"26 3","pages":""},"PeriodicalIF":2.7,"publicationDate":"2023-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10849076/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139467220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Marianna Liotti, Alice Fiorini Bincoletto, Fabiola Bizzi, Marta Tironi, Simone Charpentier Mora, Donatella Cavanna, Guido Giovanardi, Elliot Jurist, Anna Maria Speranza, Vittorio Lingiardi, Annalisa Tanzilli
{"title":"The catcher in the mind: validation of the brief-mentalized affectivity scale for adolescents in the Italian population.","authors":"Marianna Liotti, Alice Fiorini Bincoletto, Fabiola Bizzi, Marta Tironi, Simone Charpentier Mora, Donatella Cavanna, Guido Giovanardi, Elliot Jurist, Anna Maria Speranza, Vittorio Lingiardi, Annalisa Tanzilli","doi":"10.4081/ripppo.2023.709","DOIUrl":"10.4081/ripppo.2023.709","url":null,"abstract":"<p><p>The concept of mentalized affectivity (MA) encompasses the dimensions of identifying, processing, and expressing emotions and describes the process of making sense of and reevaluating one's affects in light of autobiographical memory. This construct was developed within the theoretical framework of mentalization and, due to its interpersonal nature, added further complexity to the emotion regulation construct. This research aimed to examine the factor structure and psychometric properties of the Brief-Mentalized Affectivity Scale for adolescents (B-MAS-A) on an Italian sample of young people (aged 13-19 years). Data were collected using non-probabilistic sampling and an online survey. Participants were asked to complete a large battery of instruments, including the B-MAS-A, the Toronto Alexithymia Scale, the Reflective Functioning Questionnaire, the Epistemic Trust, Mistrust, and Credulity Questionnaire, the Strengths and Difficulties Questionnaire, and the General Self-Efficacy Scale. In study 1, factor analyses carried out on a total sample of 566 adolescents identified 3 distinct dimensions of the same components of MA found in the adult population: i) identifying; ii) processing; iii) expressing emotions. The subscales showed excellent internal consistency. Study 2 (involving a subsample of 288 participants) demonstrated good levels of construct and criterion validity. These results confirm that the B-MAS-A represents a valid and robust instrument for assessing the complex and multifaceted characteristics of MA in adolescents. The B-MAS-A can make a significant contribution to clinical practice and research and encourage systematic studies on MA in psychotherapy, taking into account the developmental stage of adolescence.</p>","PeriodicalId":44262,"journal":{"name":"Research in Psychotherapy-Psychopathology Process and Outcome","volume":"26 3","pages":""},"PeriodicalIF":2.7,"publicationDate":"2023-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10849075/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139378497","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Gabriella Martino, Anna Viola, Carmelo Mario Vicario, Federica Bellone, Orlando Silvestro, Giovanni Squadrito, Peter Schwarz, Gianluca Lo Coco, Walter Fries, Antonino Catalano
{"title":"Psychological impairment in inflammatory bowel diseases: the key role of coping and defense mechanisms.","authors":"Gabriella Martino, Anna Viola, Carmelo Mario Vicario, Federica Bellone, Orlando Silvestro, Giovanni Squadrito, Peter Schwarz, Gianluca Lo Coco, Walter Fries, Antonino Catalano","doi":"10.4081/ripppo.2023.731","DOIUrl":"10.4081/ripppo.2023.731","url":null,"abstract":"<p><p>A comprehensive investigation of psychological features in chronic patients is very important for tailoring effective treatments. In this study we tested anxiety, depression, health related quality of life (HR-QoL), alexithymia, coping styles, and defense mechanisms, in eighty-four patients with Crohn disease (CD) and ulcerative colitis (UC). Participants reported low to moderate HRQoL and anxiety, apart from alexithymia. Women experienced lower QoL and higher levels of anxiety and depressive symptoms. Coping and defense strategies were related to distress symptoms and QoL. Positive attitude and principalization, showed negative associations with depression, anxiety and alexithymia and were also found to be associated with mental health. CD patients used significantly more turning against objects (p=0.02) and projections (p=0.01) and UC patients used more reversal (p=0.04). Elderly women showed higher anxiety symptoms and lower perceived QoL. Multiple regression analysis revealed anxiety and depression were independently associated with QoL. Significant differences emerged in defense styles among CD and UC. CD participants used more maladaptive coping and defense styles which were related to mental distress, depression and anxiety, together with higher level of alexithymia. Findings suggest that psychological aspects play a key role in mental health in patients suffering from inflammatory bowel diseases. A multi-integrated clinical strategy including psychotherapeutic interventions should be considered in treating CD and UC.</p>","PeriodicalId":44262,"journal":{"name":"Research in Psychotherapy-Psychopathology Process and Outcome","volume":"26 3","pages":""},"PeriodicalIF":2.7,"publicationDate":"2023-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10849073/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139467226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Laura Parolin, Alberto Milesi, Giovanni Comelli, Francesca Locati
{"title":"The interplay of mentalization and epistemic trust: a protective mechanism against emotional dysregulation in adolescent internalizing symptoms.","authors":"Laura Parolin, Alberto Milesi, Giovanni Comelli, Francesca Locati","doi":"10.4081/ripppo.2023.707","DOIUrl":"10.4081/ripppo.2023.707","url":null,"abstract":"<p><p>Mentalization is the ability to interpret actions as caused by intentional mental states. Moreover, mentalization facilitates the development of epistemic trust (ET), namely, the ability to evaluate social information as accurate, reliable, and relevant. Recent theoretical literature identifies mentalization as a protective factor, contrasting psychopathology and emotional dysregulation. However, few investigations have explored the concurrent associations between mentalization, ET and emotion dysregulation in the context of internalizing problems in adolescence. In the present study, 482 adolescents from the general population aged between 12 and 19 were assessed with the epistemic trust mistrust credulity questionnaire, the reflective functioning questionnaire- youth, the difficulties in emotion regulation scale, and the youth self-report. We tested the relationship between the variables through serial mediation models. Results showed that mentalization reduces internalizing problems via emotional dysregulation; ET is positively associated with mentalization but not symptomatology. Finally, both epistemic mistrust and epistemic credulity are significantly associated with internalizing symptomatology; those effects are mediated differently by difficulties in emotional regulation. In conclusion, the present study confirms mentalization's role as a protective factor in developmental psychopathology. Nevertheless, exploring the role of the different epistemic stances guarantees a better understanding of psychopathological pathways in adolescence.</p>","PeriodicalId":44262,"journal":{"name":"Research in Psychotherapy-Psychopathology Process and Outcome","volume":"26 3","pages":""},"PeriodicalIF":1.6,"publicationDate":"2023-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10849069/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139378498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Elliot Jurist, David Greenberg, Marissa Pizziferro, Rozita Alaluf, Michael Perez Sosa
{"title":"Virtue, well-being, and mentalized affectivity.","authors":"Elliot Jurist, David Greenberg, Marissa Pizziferro, Rozita Alaluf, Michael Perez Sosa","doi":"10.4081/ripppo.2023.710","DOIUrl":"10.4081/ripppo.2023.710","url":null,"abstract":"<p><p>Virtue ethics, featuring the claim that virtue leads to wellbeing, has been imported by psychologists from philosophy. In the first part of the paper, we re-examine the source of virtue ethics in Aristotle's philosophy and question whether virtues can be the path to eudaimonistic well-being for us, given that contemporary society differs from ancient society in terms of a lack of consensus about virtues. We focus on the modulation of emotions as a good starting place for reconstruing virtue ethics, and we affirm a connection to well-being through the construct of \"mentalized affectivity\", which is a specific kind of emotion regulation. In the second half of this hybrid paper, we provide evidence for the link between mentalized affectivity and well-being, based upon an empirical study with an adult sample (N=558). Our study examined how the Mentalized Affectivity Scale (MAS) predicts subjective well-being compared to five commonly used and related measures: Difficulty with Emotion Regulation Scale; Emotion Regulation Questionnaire; Flexibility Regulation of Emotional Expression scale; Reflective Functioning Questionnaire; Toronto Alexithymia Scale. The most important finding is that the MAS and Difficulties in Emotion Regulation Scale are most predictive of satisfaction with life. A second finding, less relevant for the present paper, is that the MAS (namely, its components of Identifying and Processing) strongly predicted psychopathology, including anxiety and mood disorders. This suggests that the MAS is a valuable tool for research on emotion regulation, well-being, and psychopathology, and that mentalized affectivity ought to be regarded as a promising construct for re-describing and specifying the contemporary relevance of virtue ethics.</p>","PeriodicalId":44262,"journal":{"name":"Research in Psychotherapy-Psychopathology Process and Outcome","volume":"26 3","pages":""},"PeriodicalIF":2.7,"publicationDate":"2023-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10849072/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139378499","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}