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MDMA-Assisted Psychotherapy for Borderline Personality Disorder. MDMA辅助治疗边缘型人格障碍。
Focus (American Psychiatric Publishing) Pub Date : 2022-10-01 Epub Date: 2022-10-25 DOI: 10.1176/appi.focus.20220056
Jenna M Traynor, Daniel E Roberts, Stephen Ross, Richard Zeifman, Lois Choi-Kain
{"title":"MDMA-Assisted Psychotherapy for Borderline Personality Disorder.","authors":"Jenna M Traynor, Daniel E Roberts, Stephen Ross, Richard Zeifman, Lois Choi-Kain","doi":"10.1176/appi.focus.20220056","DOIUrl":"10.1176/appi.focus.20220056","url":null,"abstract":"<p><p>Borderline personality disorder is a complex psychiatric disorder with limited treatment options that are associated with large heterogeneity in treatment response and high rates of dropout. New or complementary treatments for borderline personality disorder are needed that may be able to bolster treatment outcomes. In this review, the authors comment on the plausibility for research on 3,4-methylenedioxymethamphetamine (MDMA) used in conjunction with psychotherapy for borderline personality disorder (i.e., MDMA-assisted psychotherapy [MDMA-AP]). On the basis of the promise of MDMA-AP in treating disorders overlapping with borderline personality disorder (e.g., posttraumatic stress disorder), the authors speculate on initial treatment targets and hypothesized mechanisms of change that are grounded in prior literature and theory. Initial considerations for designing MDMA-AP clinical trials to investigate the safety, feasibility, and preliminary effects of MDMA-AP for borderline personality disorder are also presented.</p>","PeriodicalId":73036,"journal":{"name":"Focus (American Psychiatric Publishing)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10187385/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9490145","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}
引用次数: 0
A Cognitive-Behavioral Formulation of Narcissistic Self-Esteem Dysregulation. 自恋型自尊失调的认知行为表述。
Focus (American Psychiatric Publishing) Pub Date : 2022-10-01 Epub Date: 2022-10-25 DOI: 10.1176/appi.focus.20220055
Erik C Nook, Adam C Jaroszewski, Ellen F Finch, Lois W Choi-Kain
{"title":"A Cognitive-Behavioral Formulation of Narcissistic Self-Esteem Dysregulation.","authors":"Erik C Nook, Adam C Jaroszewski, Ellen F Finch, Lois W Choi-Kain","doi":"10.1176/appi.focus.20220055","DOIUrl":"10.1176/appi.focus.20220055","url":null,"abstract":"<p><p>Narcissistic personality disorder (NPD) is a commonly encountered diagnosis, affecting approximately 1%-6% of the population, with no evidence-based treatments. Recent scholarship has focused on self-esteem dysregulation as a key component of NPD: Excessively high expectations for oneself and how one should be treated leads to brittle self-esteem and maladaptive reactions to self-esteem threats. The current article builds on this formulation, introducing a cognitive-behavioral model of narcissistic self-esteem dysregulation that clinicians can use in providing a relatable model of change for their patients. Specifically, symptoms of NPD can be seen as a set of cognitive and behavioral habits that serve to regulate difficult emotions emerging from maladaptive beliefs and interpretations of self-esteem threats. This perspective renders narcissistic dysregulation amenable to cognitive-behavioral therapy (CBT) in which patients learn skills that help them gain awareness around these habitual reactions, reshape cognitive distortions, and engage in behavioral experiments that serve to transform maladaptive belief systems that consequently free them from symptomatic reactions. Here, we provide a precis of this formulation and examples of how CBT skills can be used to treat narcissistic dysregulation. We also discuss future research that could provide empirical support for the model and test the efficacy of CBT approaches to NPD. Conclusions focus on the notion that narcissistic self-esteem dysregulation likely varies continuously in the population and transdiagnostically across disorders. Greater insight into the cognitive-behavioral mechanisms of self-esteem dysregulation could foster tools for ameliorating distress both in people with NPD and the general populace.</p>","PeriodicalId":73036,"journal":{"name":"Focus (American Psychiatric Publishing)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10187391/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9490151","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}
引用次数: 0
Five Failures and Five Challenges for Prevention and Early Intervention for Personality Disorder. 预防和早期干预人格障碍的五大失败和五大挑战。
Focus (American Psychiatric Publishing) Pub Date : 2022-10-01 Epub Date: 2022-10-25 DOI: 10.1176/appi.focus.22020016
Andrew M Chanen, Katie Nicol
{"title":"Five Failures and Five Challenges for Prevention and Early Intervention for Personality Disorder.","authors":"Andrew M Chanen,&nbsp;Katie Nicol","doi":"10.1176/appi.focus.22020016","DOIUrl":"10.1176/appi.focus.22020016","url":null,"abstract":"<p><p>Despite global consensus regarding the early detection of personality disorder, current approaches to early intervention have failed to deliver for the majority of young people. This only serves to reinforce the enduring effects of personality disorder on functioning, mental and physical health, resulting in a reduction of quality of life and life expectancy. Here, we describe five significant challenges facing prevention and early intervention for personality disorder: identification, access to treatment, research translation, innovation and functional recovery. These challenges highlight the need for early intervention to shift from niche programmes in specialist services for a select few young people to become established in mainstream primary care and specialist youth mental health services. Reprinted from <i>Curr Opin Psychol 2021; 37:134-138</i>, with permission from Elsevier. Copyright © 2021.</p>","PeriodicalId":73036,"journal":{"name":"Focus (American Psychiatric Publishing)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10187394/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9490144","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}
引用次数: 0
Ethical Challenges in the Treatment of Personality Disorders. 人格障碍治疗中的伦理挑战。
Focus (American Psychiatric Publishing) Pub Date : 2022-10-01 Epub Date: 2022-10-25 DOI: 10.1176/appi.focus.20220061
Jarrod A Marks, Jesse C Palermo, James L Knoll
{"title":"Ethical Challenges in the Treatment of Personality Disorders.","authors":"Jarrod A Marks,&nbsp;Jesse C Palermo,&nbsp;James L Knoll","doi":"10.1176/appi.focus.20220061","DOIUrl":"10.1176/appi.focus.20220061","url":null,"abstract":"","PeriodicalId":73036,"journal":{"name":"Focus (American Psychiatric Publishing)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10187390/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9490147","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}
引用次数: 0
Forging our Future: Innovations in Psychotherapy Spurred by the COVID-19 Pandemic. 打造我们的未来:COVID-19大流行推动的心理治疗创新。
Focus (American Psychiatric Publishing) Pub Date : 2022-07-01 DOI: 10.1176/appi.focus.20220048
Jordan E Cattie
{"title":"Forging our Future: Innovations in Psychotherapy Spurred by the COVID-19 Pandemic.","authors":"Jordan E Cattie","doi":"10.1176/appi.focus.20220048","DOIUrl":"https://doi.org/10.1176/appi.focus.20220048","url":null,"abstract":"","PeriodicalId":73036,"journal":{"name":"Focus (American Psychiatric Publishing)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10172518/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9725408","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}
引用次数: 0
Innovations in Psychotherapy. 心理治疗的创新。
Focus (American Psychiatric Publishing) Pub Date : 2022-07-01 DOI: 10.1176/appi.focus.22020008
{"title":"Innovations in Psychotherapy.","authors":"","doi":"10.1176/appi.focus.22020008","DOIUrl":"https://doi.org/10.1176/appi.focus.22020008","url":null,"abstract":"","PeriodicalId":73036,"journal":{"name":"Focus (American Psychiatric Publishing)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10172525/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9725412","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}
引用次数: 0
Implementing Cognitive Behavioral Therapy in Specialty Medical Settings. 在专业医疗环境中实施认知行为疗法。
Focus (American Psychiatric Publishing) Pub Date : 2022-07-01 DOI: 10.1176/appi.focus.22020011
Jessica F Magidson, Risa B Weisberg
{"title":"Implementing Cognitive Behavioral Therapy in Specialty Medical Settings.","authors":"Jessica F Magidson,&nbsp;Risa B Weisberg","doi":"10.1176/appi.focus.22020011","DOIUrl":"https://doi.org/10.1176/appi.focus.22020011","url":null,"abstract":"<p><p>This article is an introduction to the second issue of a two-part special series on integrating cognitive behavioral therapy (CBT) into medical settings. The first issue focused on integrating CBT into primary care, and this issue focuses on implementing CBT in other specialty medical settings, including cancer treatment, HIV care, and specialized pediatric medical clinics. Models for treatment delivery to improve ease of implementation are also discussed, including telehealth and home-delivered treatment. The six articles in this series provide examples of how to transport CBT techniques that are largely designed for implementation in outpatient mental health settings to specialized medical settings, and discuss unique considerations and recommendations for implementation. Reprinted from <i>Cogn Behav Pract,</i> Vol. 21:4, pp. 367-371, with permission from Elsevier. Copyright 2014.</p>","PeriodicalId":73036,"journal":{"name":"Focus (American Psychiatric Publishing)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10172516/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9731827","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}
引用次数: 9
Scale Up Task-Sharing of Psychological Therapies. 扩大心理治疗的任务分担。
Focus (American Psychiatric Publishing) Pub Date : 2022-07-01 DOI: 10.1176/appi.focus.22020010
Vikram Patel
{"title":"Scale Up Task-Sharing of Psychological Therapies.","authors":"Vikram Patel","doi":"10.1176/appi.focus.22020010","DOIUrl":"https://doi.org/10.1176/appi.focus.22020010","url":null,"abstract":"<p><p>(Reprinted from Lancet, Vol. 399, pp. 343-345, Copyright (c) 2021, with permission from Elsevier).</p>","PeriodicalId":73036,"journal":{"name":"Focus (American Psychiatric Publishing)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10172522/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9725409","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}
引用次数: 0
The Rapid Evolution of Crisis Mental Health Services in Utah: Opportunities and Challenges as a Result of the Global Pandemic. 危机心理健康服务在犹他州的快速演变:机遇和挑战作为全球大流行的结果。
Focus (American Psychiatric Publishing) Pub Date : 2022-07-01 DOI: 10.1176/appi.focus.20220047
Dave Eldredge, Scott A Langenecker, Rachel Kay Lucynski, Mindy Westlund Schreiner
{"title":"The Rapid Evolution of Crisis Mental Health Services in Utah: Opportunities and Challenges as a Result of the Global Pandemic.","authors":"Dave Eldredge,&nbsp;Scott A Langenecker,&nbsp;Rachel Kay Lucynski,&nbsp;Mindy Westlund Schreiner","doi":"10.1176/appi.focus.20220047","DOIUrl":"https://doi.org/10.1176/appi.focus.20220047","url":null,"abstract":"<p><p>Our country is facing a resurgence of behavioral health crises from over the past 30 years, further illuminated and exacerbated by the global COVID-19 pandemic. Increasing suicide crises among youths over recent decades, untreated anxiety and depression, and serious mental illness are signs of the need for improvements in accessible, affordable, timely, and comprehensive behavioral health services. Against the backdrop of high suicide rates and low behavioral health services in Utah, statewide collaborators aligned with a common goal: deliver crisis services to anyone, anytime, and anywhere. After its initiation in 2011, the integrated behavioral health crisis response system continued to expand and excel, ultimately improving access and referral to services, flattening suicide rates, and reducing stigma. The global pandemic further motivated the expansion of Utah's crisis response system. This review focuses on the unique experiences of the Huntsman Mental Health Institute as a catalyst and partner in these changes. Our goals are to: inform about unique Utah partnerships and actions in the crisis mental health space, describe initial steps and outcomes, highlight continuing challenges, discuss pandemic-specific barriers and opportunities, and explore the long-term vision to improve quality and access to mental health resources.</p>","PeriodicalId":73036,"journal":{"name":"Focus (American Psychiatric Publishing)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10172528/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9725415","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}
引用次数: 1
Behavioral Medicine in the COVID-19 Era: Dawn of the Golden Age. COVID-19时代的行为医学:黄金时代的黎明。
Focus (American Psychiatric Publishing) Pub Date : 2022-07-01 DOI: 10.1176/appi.focus.22020012
John M Ruiz, Tracey A Revenson
{"title":"Behavioral Medicine in the COVID-19 Era: Dawn of the Golden Age.","authors":"John M Ruiz,&nbsp;Tracey A Revenson","doi":"10.1176/appi.focus.22020012","DOIUrl":"https://doi.org/10.1176/appi.focus.22020012","url":null,"abstract":"<p><p>(Reprinted from Ann Behav Med 2020; 54:541-543, with permission from Oxford University Press).</p>","PeriodicalId":73036,"journal":{"name":"Focus (American Psychiatric Publishing)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10172527/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9725414","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}
引用次数: 0
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