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Bipolar Disorder and PTSD
Affect Regulation-Self Esteem-Expecting Best-Preparing for Worst
Bipolar Disorder and Trauma
Bipolar Disorder DSM-IV
Bipolar I Disorder
Bipolar II Disorder
Cingulate Gyrus and Trauma
Circadiam Rhythm and PTSD
Circadian Rhythm and REM Behavior Disorder
Circadian Rhythm and Sleepwalking
Circadian Rhythm and Trauma
Circadian Rhythm DSM-IV
Corpus Callosum and PTSD
Cortisol and Dissociation
Cortisol and Trauma
Dissociation and Affect Dysregulation
Fornix and Trauma
Hippocampus Trauma and PTSD
Hypothalamus and PTSD
Limbic System and Trauma
MRI and Trauma
Neocortex and Trauma
NeuroImaging and DID
NeuroImaging and Trauma
NMRI and PTSD
Prefrontal Lobe and Trauma
ADHD and PTSD
ADHD and EMDR
ADHD and Dissociation
ADHD and DID
ADHD and Trauma
Affect Regulation
Attachment and Relational Trauma II
Affect Development and Attachment
Affect Regulation: Mentalization and the Development of the Self
Attachment and Affect Development
AffectDysregulation and Dissociation
Affect Dysregulation and Disorders of the Self
Affect Regulation and Attachment
Affect Dysregulation and Disorders of the Self
Affect Regulation and Attachment I
Affect Regulation and Attachment II
Affect Dysregulation
Affect Regulation and PTSD
Affect Regulation and Binge Drinking
Affect Regulation in Married Styles
Affect Regulation and Trauma
Affect Regulation-Delayed memories of Childhood
Affect Regulation-Mentalization and Development of The Self
Affect Regulaqtion-Recurrent Abortiona in Bulimics
Affect Regulation-Social Context on Childrens Affect Regulation
Affect Regulation-the Development of Psychopathology
Amygdala and Fear
Amygdala and PTSD
Aspergers Disorder and Adolescence
Aspergers Disorder and Childhood
Aspergers Disorder and Development
Aspergers Disorder and Infancy
Aspergers Disorder DSM-IV
Basal Ganglia and PTSD
Basal Ganglia and Trauma
Bipolar Disorder and DID
Sleepwalking and Trauma
Sleepwalking and PTSD
Sleep Disorders and PTSD
Sleep Disorders and Trauma
Sleep Disorders DSM-IV-R
Circadian Rhythm DSMIV-R
Sleep Terror Disorder
Self-Mutilization and Trauma
Self-Mutilization and Resilience
Self-Mutilization and PTSD
Self-Mutilization and DID
Human Stress Continuum

Psychological

and Physiological

Trauma Research

 

 

Seize Your Journeys

 

_______________________

Traumatic stress is found in many competent, healthy, strong, good people.  No one can completely protect themselves from traumatic experiences.  Many people have long-lasting problems following exposure to trauma.  Up to 8% of persons will have PTSD at some time in their lives. People who react to traumas are not going crazy.  What is happening to them is part of a set of common symptoms and problems that are connected with being in a traumatic situation, and thus, is a normal reaction to abnormal events and experiences.  Having symptoms after a traumatic event is NOT a sign of personal weakness.  Given exposure to a trauma that is bad enough, probably all people would develop PTSD.

By understanding trauma symptoms better, a person can become less fearful of them and better able to manage them. By recognizing the effects of trauma and knowing more about symptoms, a person will be better able to decide about getting treatment.

_______________________

 

Sleep Disorders DSMIV-R

 

            “The sleep disorders are organized into four major sections according to presumed etiology. 

 

Primary Sleep Disorders are those in which none of the etiologies listed below (i.e., another mental disorder, a general medical condition, or a substance) is responsible.  Primary Sleep Disorders are presumed to arise from endogenous abnormalities in sleep-wake generating or timing mechanisms, often complicated by conditioning factors.  Primary Sleep Disorders in turn are divided into Dyssomnias (characterized by abnormalities in the amount, quality, or timing of sleep) and Parasomnias (characterized by abnormal behavioral or physiological events occurring in association with sleep, specific sleep stages, or sleep-awake transitions).

            Sleep Disorder Related to Another Mental Disorder involves a prominent complaint of sleep disturbance that results from a diagnosable mental disorder (often a Mood Disorder or Anxiety Disorder) but that is sufficiently severe to warrant independent clinical attention.  Presumably, the pathophysiological mechanisms responsible for the mental disorder also affect sleep-awake regulation. 

            Sleep Disorder Due to a General Medical Condition involves a prominent complaint of sleep disturbance that results from the direct physiological effects of a general medical condition on the sleep-wake system.

            Substance-Induced Sleep Disorder involves prominent complaints of sleep disturbance that result from the concurrent use, or recent discontinuation of use, of a substance (including medications).

            That systematic assessment in individuals who present with prominent complaints of sleep disturbance includes an evaluation of the specific type of sleep complaint and a consideration of concurrent mental disorders, general medical conditions, and substance (including medication) use that may be responsible for the sleep disturbance.

            Five distinct sleep stages can be measured by polysomnography:  rapid eye movement (REM) sleep and four stages of non-rapid eye movement (NREM) sleep (stages 1, 2, 3, and 4).  Stage 1 NREM sleep is a transition from wakefulness to sleep and occupies about 5% of time spent asleep in healthy adults.  Stage 2 NREM sleep, which is characterized by specific EEG waveforms (sleep spindles and K complexes), occupies about 50% of time spent asleep.  Stages 3 and 4 NREM sleep (also known collectively as slow-wave sleep) are the deepest levels of sleep and occupy about 10%-20% of sleep time.  REM sleep, during which the majority of typical storylike dreams occur, occupies about 20%-25% of total sleep.

            These sleep stages have a characteristic temporal organization across the night.  NREM stages 3 and 4 tend to occur in the first one-third to one-half of the night and increase in duration in response to sleep deprivation.  REM sleep occurs cyclically throughout the night, alternating with NREM sleep about every 80-100 minutes.  REM sleep periods increase in duration toward the morning.  Human sleep also varies characteristically across the life span.  After relative stability with large amounts of slow-wave sleep in childhood and early adolescence, sleep continuity and depth deteriorate across the adult age range.  This deterioration is reflected by increased wakefulness and stage 1 sleep and decreased stages 3 and 4 sleep.  Because of this, age must be considered in the diagnosis of a Sleep Disorder in any individual.

            Polysomnography is the monitoring of multiple electrophysiological parameters during sleep and generally includes measurement of EEG activity, electroculographic activity, and electromyographic activity.  Additional polysomnographic measures may include oral or nasal airflow, respiratory effort, chest and abdominal wall movement, oxyhemoglobin saturation, or exhaled carbon dioxide concentration; these measures are used to monitor respiration during sleep and to detect the presence and severity of sleep apnea.  Measurement of peripheral electromyographic activity may be used to detect abnormal movements during sleep.  Most polysomnographic studies are conducted during the person’s usual sleeping hours—that is, at night.  However, daytime polysomnographic studies also are used to quantify daytime sleepiness.  The most common daytime procedure is the Multiple Sleep Latency Test (MSLT), in which the individual is instructed to lie down in a dark room and not resist falling asleep; this protocol is repeated fives times during the day.  Sleep latency (the amount of time required to fall asleep) is measured on each trial and is used as an index of physiological sleepiness.  The converse of the MSLT is also used:  In the Repeated Test of Sustained Wakefulness (RTSW), the individual is placed in a quiet, dimly lit room and instructed to remain awake; this protocol is repeated several times during the day.  Again, sleep latency is measured, but is it used here as an index of the individual’s ability to maintain wakefulness.

            Standard terminology for polysomnographic measures is used throughout the test in this section.  Sleep continuity refers to the overall balance of sleep and wakefulness during a night of sleep.  “Better” sleep continuity indicates consolidated sleep and wakefulness; “worse” sleep continuity indicates disrupted sleep with more wakefulness.  Specific sleep continuity measures include sleep latency—the amount of time required to fall asleep (expressed in minutes); intermittent wakefulness—the amount of awake time after initial sleep onset (expressed in minutes); and sleep efficiency—the ratio of actual time spent asleep to time spent in bed (expressed as a percentage, with higher numbers indicating better sleep continuity).  Sleep architecture refers to the amount and distribution of specific sleep stages.  Sleep architecture measures include absolute amount of REM sleep and each NREM sleep stage (in minutes), relative amount of REM seep and NREM sleep stages (expressed as a percentage of total sleep time), and latency between sleep onset and the first REM period (REM latency).

            The text for each of the Sleep Disorders contains a section describing its relationship to corresponding disorders in The International Classification of Sleep Disorders:  (ICSD) diagnostic and Coding Manual, published in 1990 by the American Sleep Disorders Association.

FUNCTIONAL NEUROANATOMY

In order to best understand this atlas it is important to have a sense of the functional neuroanatomy of the brain. Over the next several pages there is a brief summary of the 5 major brain systems that relate to behavior, along with the general location seen on SPECT of these areas.


 

The Deep Limbic System


side active view


underside surface view


underside active view

Functions

  • sets the emotional tone of the mind

  • filters external events through internal states (emotional coloring)

  • tags events as internally important

  • stores highly charged emotional memories

  • modulates motivation

  • controls appetite and sleep cycles

  • promotes bonding

  • directly processes the sense of smell

  • modulates libido

Problems

  • moodiness, irritability, clinical depression

  • increased negative thinking

  • perceive events in a negative way

  • decreased motivation

  • flood of negative emotions

  • appetite and sleep problems

  • decreased or increased sexual responsiveness

  • social isolation

The Basal Ganglia System


left side active view


underside active view

Functions

  • integrates feeling and movement

  • shifts and smoothes fine motor behavior

  • suppression of unwanted motor behaviors

  • sets the body's idle or anxiety level

  • enhances motivation

  • pleasure/ecstasy

Problems

  • anxiety, nervousness

  • panic attacks

  • physical sensations of anxiety

  • tendency to predict the worst

  • conflict avoidance

  • Gilles de la Tourette's Syndrome/tics

  • muscle tension, soreness

  • tremors

  • fine motor problems

  • headaches

  • low or excessive motivation

The Prefrontal Cortex


dorsal lateral prefrontal cortex
outside view


inferior orbital prefrontal cortex
outside view


side surface view
dorsal lateral prefrontal area


inferior orbital prefrontal area
inside view


underside surface view
inferior orbital prefrontal area


top-down surface view
dorsal lateral prefrontal area

Functions

  • attention span

  • perseverance

  • judgment

  • impulse control

  • organization

  • self-monitoring and supervision

  • problem solving

  • critical thinking

  • forward thinking

  • learning from experience

  • ability to feel and express emotions

  • influences the limbic system

  • empathy

Problems

  • short attention span

  • distractibility

  • lack of perseverance

  • impulse control problems

  • hyperactivity

  • chronic lateness, poor time management

  • disorganization

  • procrastination

  • unavailability of emotions

  • misperceptions

  • poor judgement

  • trouble learning from experience

  • short term memory problems

  • social and test anxiety

The Cingulate Gyrus


inside side view


side active view


active top-down view


active front-on view

  • allows shifting of attention

  • cognitive flexibility

  • adaptability

  • helps the mind move from idea to idea

  • gives the ability to see options

  • helps you go with the flow

  • cooperation

Problems

  • worrying

  • holds onto hurts from the past

  • stuck on thoughts (obsessions)

  • stuck on behaviors (compulsions)

  • oppositional behavior, argumentative

  • uncooperative, tendency to say no

  • addictive behaviors (alcohol or drug abuse, eating disorders, chronic pain)

  • cognitive inflexibility

  • obsessive compulsive disorder

  • OCD spectrum disorders

  • eating disorders, road rage

The Temporal Lobes


side view


side surface view


underside surface view


active side view

Functions

Dominant Side (usually the left)

  • understanding and processing language

  • intermediate term memory

  • long term memory

  • auditory learning

  • retrieval of words

  • complex memories

  • visual and auditory processing

  • emotional stability

Problems

Dominant Temporal Lobe

  • aggression, internally or externally driven

  • dark or violent thoughts

  • sensitivity to slights, mild paranoia

  • word finding problems

  • auditory processing problems

  • reading difficulties

  • emotional instability

Non-dominant Side (usually the right)

  • recognizing facial expression

  • decoding vocal intonation

  • rhythm

  • music

  • visual learning

  • difficulty recognizing facial expression

  • difficulty decoding vocal intonation

  • implicated in social skill struggles


Either/Both Temporal Lobe Problems

  • memory problems, amnesia

  • headaches or abdominal pain without a clear explanation

  • anxiety or fear for no particular reason

  • abnormal sensory perceptions, visual or auditory distortions

  • feelings of déjà vu or jamais vu

  • periods of spaciness or confusion

  • religious or moral preoccupation

  • hypergraphia, excessive writing

  • seizures

 

 

Secure Attachments as a Defense Against Trauma

 “All people mature and thrive in a social context that has profound effects on how they cope with life’s stresses.  Particularly early in life, the social context plays a critical role in fuffering an individual against stressful situations, and in building the psychological and biological capacities to deal with further stresses.  The primary function of parents can be thought of as helping children modulate their arousal by attuned and well-timed provision of playing, feeding, comforting, touching, looking, cleaning, and resting—in short, by teaching them skills that will gradually help them modulate their own arousal.  Secure attachment bonds serve as primary defenses against trauma-induced psychopathology in both children and adults (Finkelhor & Browne, 1984).  In children who have been exposed to severe stressors, the quality of the parental bond is probably the single most important determinant of long-term damage (McFarlane, 1988).”  van der Kolk, Bessel, Alexander C. McFarlane, and Lars Weisaeth, eds.  1996. Traumatic stress: The effects of overwhelming experience on mind, body, and society.  New York and London: Guilford Press. .p. 185

_______________________

 

 

Sleep Disorders

 

            “The sleep disorders are organized into four major sections according to presumed etiology.  Primary Sleep Disorders are those in which none of the etiologies listed below (i.e., another mental disorder, a general medical condition, or a substance) is responsible.  Primary Sleep Disorders are presumed to arise from endogenous abnormalities in sleep-wake generating or timing mechanisms, often complicated by conditioning factors.  Primary Sleep Disorders in turn are divided into Dyssomnias (characterized by abnormalities in the amount, quality, or timing of sleep) and Parasomnias (characterized by abnormal behavioral or physiological events occurring in association with sleep, specific sleep stages, or sleep-awake transitions).

            Sleep Disorder Related to Another Mental Disorder involves a prominent complaint of sleep disturbance that results from a diagnosable mental disorder (often a Mood Disorder or Anxiety Disorder) but that is sufficiently severe to warrant independent clinical attention.  Presumably, the pathophysiological mechanisms responsible for the mental disorder also affect sleep-awake regulation. 

            Sleep Disorder Due to a General Medical Condition involves a prominent complaint of sleep disturbance that results from the direct physiological effects of a general medical condition on the sleep-wake system.

            Substance-Induced Sleep Disorder involves prominent complaints of sleep disturbance that result from the concurrent use, or recent discontinuation of use, of a substance (including medications).

            That systematic assessment in individuals who present with prominent complaints of sleep disturbance includes an evaluation of the specific type of sleep complaint and a consideration of concurrent mental disorders, general medical conditions, and substance (including medication) use that may be responsible for the sleep disturbance.

            Five distinct sleep stages can be measured by polysomnography:  rapid eye movement (REM) sleep and four stages of non-rapid eye movement (NREM) sleep (stages 1, 2, 3, and 4).  Stage 1 NREM sleep is a transition from wakefulness to sleep and occupies about 5% of time spent asleep in healthy adults.  Stage 2 NREM sleep, which is characterized by specific EEG waveforms (sleep spindles and K complexes), occupies about 50% of time spent asleep.  Stages 3 and 4 NREM sleep (also known collectively as slow-wave sleep) are the deepest levels of sleep and occupy about 10%-20% of sleep time.  REM sleep, during which the majority of typical storylike dreams occur, occupies about 20%-25% of total sleep.

            These sleep stages have a characteristic temporal organization across the night.  NREM stages 3 and 4 tend to occur in the first one-third to one-half of the night and increase in duration in response to sleep deprivation.  REM sleep occurs cyclically throughout the night, alternating with NREM sleep about every 80-100 minutes.  REM sleep periods increase in duration toward the morning.  Human sleep also varies characteristically across the life span.  After relative stability with large amounts of slow-wave sleep in childhood and early adolescence, sleep continuity and depth deteriorate across the adult age range.  This deterioration is reflected by increased wakefulness and stage 1 sleep and decreased stages 3 and 4 sleep.  Because of this, age must be considered in the diagnosis of a Sleep Disorder in any individual.

            Polysomnography is the monitoring of multiple electrophysiological parameters during sleep and generally includes measurement of EEG activity, electroculographic activity, and electromyographic activity.  Additional polysomnographic measures may include oral or nasal airflow, respiratory effort, chest and abdominal wall movement, oxyhemoglobin saturation, or exhaled carbon dioxide concentration; these measures are used to monitor respiration during sleep and to detect the presence and severity of sleep apnea.  Measurement of peripheral electromyographic activity may be used to detect abnormal movements during sleep.  Most polysomnographic studies are conducted during the person’s usual sleeping hours—that is, at night.  However, daytime polysomnographic studies also are used to quantify daytime sleepiness.  The most common daytime procedure is the Multiple Sleep Latency Test (MSLT), in which the individual is instructed to lie down in a dark room and not resist falling asleep; this protocol is repeated fives times during the day.  Sleep latency (the amount of time required to fall asleep) is measured on each trial and is used as an index of physiological sleepiness.  The converse of the MSLT is also used:  In the Repeated Test of Sustained Wakefulness (RTSW), the individual is placed in a quiet, dimly lit room and instructed to remain awake; this protocol is repeated several times during the day.  Again, sleep latency is measured, but is it used here as an index of the individual’s ability to maintain wakefulness.

            Standard terminology for polysomnographic measures is used throughout the test in this section.  Sleep continuity refers to the overall balance of sleep and wakefulness during a night of sleep.  “Better” sleep continuity indicates consolidated sleep and wakefulness; “worse” sleep continuity indicates disrupted sleep with more wakefulness.  Specific sleep continuity measures include sleep latency—the amount of time required to fall asleep (expressed in minutes); intermittent wakefulness—the amount of awake time after initial sleep onset (expressed in minutes); and sleep efficiency—the ratio of actual time spent asleep to time spent in bed (expressed as a percentage, with higher numbers indicating better sleep continuity).  Sleep architecture refers to the amount and distribution of specific sleep stages.  Sleep architecture measures include absolute amount of REM sleep and each NREM sleep stage (in minutes), relative amount of REM seep and NREM sleep stages (expressed as a percentage of total sleep time), and latency between sleep onset and the first REM period (REM latency).

            The text for each of the Sleep Disorders contains a section describing its relationship to corresponding disorders in The International Classification of Sleep Disorders:  (ICSD) diagnostic and Coding Manual, published in 1990 by the American Sleep Disorders Association.

_________________

 

Substance Dependence

Features

The essential feature of Substance Dependence is a cluster of cognitive, behavioral, and physiological symptoms indicating that the individual continues use of the substance despite significant substance-related problems.  There is a pattern of repeated self-administration that can result in tolerance, withdrawal, and compulsive drug-taking behavior.  A diagnosis of Substance Dependence can be applied to every class of substances except caffeine.  The symptoms of Dependence are similar across the various categories of substances, but for certain classes some symptoms are less salient, and in a few instances not all symptoms apply (e.g., withdrawal symptoms are not specified for Hallucinogenic Dependence).  Although not specifically listed as a criterion item, “craving” (a strong subjective drive to use the substance) is likely to be experienced by most (if not all) individuals with Substance Dependence.  Dependence is defined as a cluster of three or more of the symptoms listed below occurring at any time in the same 12-month-period.

Tolerance (Criterion 1) is the need for greatly increased amounts of the substance to achieve intoxication (or the desired effect) or a markedly diminished effect with continued use of the same amount of the substance.  The degree to which tolerance develops varies greatly across substances.  Furthermore, for a specific drug, varied degrees of tolerance may develop for its different central nervous system effects.  For example, for opioids, tolerance to respiratory depression and tolerance to analgesia develop at different rates.  Individuals with heavy use of opioids and stimulants can develop substantial (e.g., 10-f0ld) levels of tolerance, often to a dosage that would be lethal to a nonuser.  Alcohol tolerance can also be pronounced, but is usually less extreme than for amphetamine.  Many individuals who smoke cigarettes consume more than 20 cigarettes a day, an amount that would have produced symptoms of toxicity when they first started smoking.  Individuals with heavy use of cannabis or phencyclidine (PCP) are generally not aware of having developed tolerance (although it has been demonstrated in animal studies and in some individuals).  Tolerance may be difficult to determine by history alone when the substance used is illegal and perhaps mixed with various diluents or with other substances.  In such situations, laboratory tests may be helpful (e.g., high blood levels of the substance coupled with little evidence of intoxication suggest that tolerance is likely).  Tolerance must also be distinguished from individual variability in the initial sensitivity to the effects of particular substances.  For example, some first-time drinkers show very little evidence of intoxication with three or four drink, whereas others of similar weight and drinking histories had slurred speech and incoordination.

Withdrawal (Criterion 2a) is a maladaptive behavioral change, with physiological and cognitive concomitants, that occurs when blood or tissue concentrations of a substance decline in an individual who had maintained prolonged heavy use of the substance.  After developing unpleasant withdrawal symptoms, the persons is likely to take the substance to relieve or to avoid those symptoms (Criterion 2b), typically using the substance throughout the day beginning soon after awakening.  Withdrawal symptoms, which are generally the opposite of the acute effects of the substance, vary greatly across the calluses of substances, and separate criteria sets for Withdrawal are provided for most of the classes.  Marked and generally easily measured physiological signs of withdrawal are common with alcohol, opioids, and sedatives, hypnotics, and anxiolytics.  Withdrawal signs and symptoms are often present, but may be less apparent, with stimulants such as amphetamines and cocaine, as well as with nicotine and cannabis.  No significant withdrawal is seen even after repeated use of hallucinogens.  Withdrawal from phencyclidine and related substances has not yet been described in humans (although it has been demonstrated in animals).  Neither tolerance nor withdrawal is necessary or sufficient for a diagnosis of Substance Dependence.  However, for most classes of substances, a past history of tolerance or withdrawals is associated with a more severe clinical course (i.e., an earlier onset of Dependence, higher levels of substance intake, and a greater number of substance-related problems).  Some individuals (e.g., those with Cannabis Dependence) show a pattern of compulsive use without obvious signs of tolerance or withdrawal.  Conversely, some general medical and postsurgical patients without Opioid Dependence may develop a tolerance to prescribed opioids and experience withdrawal symptoms without showing any signs of compulsive use.  The specifiers With Physiological Dependence and Without Physiological Dependence are provided to indicate the presence or absence of tolerance or withdrawal.

The following items describe the pattern of compulsive substance use that is characteristic of Dependence.  The individual may take the substance in larger amounts or over a longer period than was originally intended (e.g., continuing to drink until severely intoxicated despite having set a limit of only one drink) (Criterion 3).  The individual may express a persistent desire to cut down or regulate substance use.  Often, there have been many unsuccessful efforts to decrease or discontinue use (Criterion 4).  The individual may spend a great deal of time obtaining the substance, using the substance, or recovering from its effects (Criterion 5).  In some instances of Substance Dependence, virtually all of the person’s daily activities revolve around the substance.  Important social, occupational, ore recreational activities may be given up or reduced because of substance use (Criterion 6).  The individual may withdraw from family activities and hobbies in order to use the substance in private or to spend more time with substance-using friends.  Despite recognizing the contributing role of the substance to a psychological or physical problem (e.g., sever depressive symptoms or damage to organ systems), the person continues to use the substance (Criterion 7).  The key issue in evaluating this criterion is not eh existence of the problem, but rather the individual’s failure to abstain from using the substance despite having evidence of the difficulty it is causing.

 

Specifiers

            Tolerance and withdrawal may be associated with a higher risk for immediate general medical problems and a higher relapse rate.  Specifiers are provided to note their presence or absence:

With Physiological Dependence.  This specifier should be used when Substance Dependence is accompanied by evidence of tolerance (Criterion 1) or withdrawal (Criterion 2).

Without Physiological Dependence.  This specifier should be used when there is no evidence of tolerance (Criterion 1) or withdrawal (Criterion 2).  In these individuals, Substance Dependence is characterized by a pattern of compulsive use (at least three items from Criteria 3-7).”

 

Diagnostic and Statistical Manual of Mental Disorders. 2000. 4th ed. Washington, D.C.: American Psychiatric Association. P. 193-195.

 

 

 

_______________________

 

PTSD, DID, and EMDR

Posttraumatic Stress Disorder

"The essential feature of Posttraumatic Stress Disorder us the development of characteristic symptoms following exposure to an extreme traumatic stressor involving direct personal experience of an event that involves actual or threatened death or serious injury, or other threat to one's physical integrity; or witnessing an event that involves death, injury, or a threat to the physical integrity of another person; or learning about unexpected or violent death, serious harm, or threat of death or injury experienced by a family member or other close associate (Criteria A1).  The person's response to the event must involve intense fear, helplessness, or horror (or in children, the response must involve disorganized or agitated behavior) (Criterion A2).  The characteristic symptoms resulting from the exposure to the extreme trauma include persistent reexperiencing of the traumatic event (Criterion E), and the disturbance must cause clinically significant distress or impairment in social, occupational, or other important areas of functioning (Criterion F).

Traumatic events that are experienced directly include, but are not limited to, military combat, violent personal assault (sexual assault, physical attack, robbery, mugging), being kidnapped, being taken hostage, terrorist attack, torture, incarceration as a prisoner of war or in a concentration camp, natural or manmade disasters, severe automobile accidents, or being diagnosed with a life-threatening illness.  For children, sexually traumatic events may include developmentally inappropriate sexual experiences without threatened or actual violence or injury.  Witnessed events include, but are not limited to, observing the serious injury or unnatural death of another person due to violent assault, accident, war, or disaster or unexpectedly witnessing a dead body or body parts.  Events experienced by others that are learned about include, but are not limited to, violent personal assault, serious accident, or serious injury experienced y a family member or a close friend; learning about the sudden, unexpected death of a family member or a close friend; or learning that one's child has a life threatening disease.  The disorder may be especially sever or long lasting when the stressor is of human design (e.g., torture, rape). the likelihood of developing this disorder may increase as the intensity of and physical proximity to the stressor increase.

The traumatic event can be reexperienced in various ways.  Commonly the person has recurrent and intrusive recollections of the event (Criterion B1) or recurrent distressing dreams during which the event can be replayed or otherwise represented (Criterion B2). In rare instances, the person experiences dissociative states that last from a few seconds to several hours, or even days, during which components of the event are relived and the person behaves as though experiencing the event at that moment (Criterion B3).  These episodes, often referred to as "flashbacks," are typically brief but can be associated with prolonged distress and heightened arousal.  Intense psychological distress (Criterion B4) or physiological reactivity (Criterion B5) often occurs when the person is exposed to triggering events that resemble or symbolize an aspect of the traumatic event (e.g., anniversaries of the traumatic event; cold, snowy weather or uniformed guards for survivors of death camps in cold climates; hot, humid weather for combat veterans of the South Pacific; entering any elevator for an woman who was reaped in an elevator).

Stimuli associated with the trauma are persistently avoided.  The person commonly makes deliberate efforts to avoid thoughts, feelings, or conversations about the traumatic event (Criterion C1) and to avoid activities, situations, or people who around recollections of it (Criterion C2).  This avoidance of reminders may include amnesia for an important aspect of the traumatic event (Criterion C3).  Diminished responsiveness to the external work, referred to as "psychic numbing" or "emotional anesthesia," usually begins soon after the traumatic event.  The individual may complain of having markedly diminished interest or participation in previously enjoyed activities (Criterion C4), of feeling detached or estranged from other people (Criterion C5), or of having markedly reduced ability to feel emotions (especially those associated with intimacy, tenderness and sexuality) (Criterion C6).  The individual may have a sense of a foreshortened future (e.g., not expecting to have a career, marriage, children, or a normal life span) (Criterion C7).

The individual has persistent symptoms of anxiety or increased arousal that were not present before the trauma.  these symptoms may include difficulty falling or staying asleep that may be to recurrent nightmares during which the traumatic event is relived (Criterion D1), hypervigilance (Criterion D4), and exaggerated startle response (Criterion D5).  Some individuals report irritability or outburst of anger (Criterion D2) or difficulty concentrating or completing tasks (Criterion D3)."

 

Dissociative Identity Disorder (DID)

"The essential feature of Dissociative identity Disorder is the presence of two or more distinct identities or personality states (Criterion A) that recurrently take control of behavior (Criterion B).  There is an inability to recall important personal information, the extent of which is too great to be explained by ordinary forgetfulness (Criterion C).  The disturbance is not due tot eh direct physiological effects of a substance or a general medical condition (Condition D.).  In children, the symptoms cannot be attributed to imaginary playmates or other fantasy play.

Dissociative Identity Disorder reflects a failure to integrate various aspects of identity, memory, and consciousness.  Each personality state may be experienced as if it has a distinct personal history, self-image, and identity, including a separate name.  Usually there is a primary identity that carries the individual's given name and is passive, dependent, guilty, and depressed.  The alternate identities frequently have different names and characteristics that contrast with the primary identity (e.g., are hostile, controlling, and self-destructive).  Particular identities may emerge in specific circumstances and may differ in reported age and gender, vocabulary, general knowledge, or predominant affect.  Alternate identities are experienced as taking control in sequence, ore at the expense of the other, and may deny knowledge of one another, be critical of one another, or appear to be in open conflict.  Occasionally, one or more powerful identities allocate time to the others.  Aggressive or hostile identities may at times interrupt activities or place the others in uncomfortable situations.

Individuals with this disorder experience frequent gaps in memory for personal history, both remote and recent.  The amnesia is frequently asymmetrical.  The more passive identities tend to have more constricted memories, whereas the more hostile, controlling, or "protector" identities have more complete memories.  An identity that is not in control may nonetheless gain access to consciousness by producing auditory or visual hallucinations (e.g., a voice giving instructions).  Evidence of amnesia may be uncovered by reports from others who have witnessed behavior that is disavowed by the individual or by the individual's own discoveries (e.g., finding items of clothing at home that the individual cannot remember having bought).  There may be loss of memory not only for recurrent periods of time, but also an overall loss of biographical memory for some extended period of childhood, adolescence, or even adulthood.  Transitions among identities are often triggered by psychosocial stress.  The time required to switch from one identity to another is usually a matter of seconds, but, less frequently, may b gradual.  Behavior that may be frequently associated with identity switches include rapid blinking, facial changes, changes in voice or demeanor, or disruption in the individual's train of thoughts.  The number of identities reported ranges from 2 to more than 100.  Half of reported cases include the individuals with 10 or fewer identities."

Diagnostic and Statistical Manual of Mental Disorders. 2000.  4th ed. Washington, D.C.: American Psychiatric Association.

EMDR

Eye Movement Desensitization and Reprocessing

"Eye Movement Desensitization and Reprocessing (EMDR)1 integrates elements of many effective psychotherapies in structured protocols that are designed to maximize treatment effects. These include psychodynamic, cognitive behavioral, interpersonal, experiential, and body-centered therapies2. EMDR is an information processing therapy and uses an eight phase approach.

During EMDR1 the client attends to past and present experiences in brief sequential doses while simultaneously focusing on an external stimulus. Then the client is instructed to let new material become the focus of the next set of dual attention. This sequence of dual attention and personal association is repeated many times in the session.

Eight Phases of Treatment

The first phase is a history taking session during which the therapist assesses the client's readiness for EMDR and develops a treatment plan. Client and therapist identify possible targets for EMDR processing. These include recent distressing events, current situations that elicit emotional disturbance, related historical incidents, and the development of specific skills and behaviors that will be needed by the client in future situations.

During the second phase of treatment, the therapist ensures that the client has adequate methods of handling emotional distress and good coping skills, and that the client is in a relatively stable state. If further stabilization is required, or if additional skills are needed, therapy focuses on providing these. The client is then able to use stress reducing techniques whenever necessary, during or between sessions. However, one goal is not to need these techniques once therapy is complete.

In phase three through six, a target is identified and processed using EMDR procedures. These involve the client identifying the most vivid visual image related to the memory (if available), a negative belief about self, related emotions and body sensations. The client also identifies a preferred positive belief. The validity of the positive belief is rated, as is the intensity of the negative emotions.

After this, the client is instructed to focus on the image, negative thought, and body sensations while simultaneously moving his/her eyes back and forth following the therapist's fingers as they move across his/her field of vision for 20-30 seconds or more, depending upon the need of the client. Athough eye movements are the most commonly used external stimulus, therapists often use auditory tones, tapping, or other types of tactile stimulation. The kind of dual attention and the length of each set is customized to the need of the client. The client is instructed to just notice whatever happens. After this, the clinician instructs the client to let his/her mind go blank and to notice whatever thought, feeling, image, memory, or sensation comes to mind. Depending upon the client's report the clinician will facilitate the next focus of attention. In most cases a client-directed association process is encouraged. This is repeated numerous times throughout the session. If the client becomes distressed or has difficulty with the process, the therapist follows established procedures to help the client resume processing. When the client reports no distress related to the targeted memory, the clinician asks him/her to think of the preferred positive belief that was identified at the beginning of the session, or a better one if it has emerged, and to focus on the incident, while simultaneously engaging in the eye movements. After several sets, clients generally report increased confidence in this positive belief. The therapist checks with the client regarding body sensations. If there are negative sensations, these are processed as above. If there are positive sensations, they are further enhanced.

In phase seven, closure, the therapist asks the client to keep a journal during the week to document any related material that may arise and reminds the client of the self-calming activities that were mastered in phase two.

The next session begins with phase eight, re-evaluation of the previous work, and of progress since the previous session. EMDR treatment ensures processing of all related historical events, current incidents that elicit distress, and future scenarios that will require different responses. The overall goal is produce the most comprehensive and profound treatment effects in the shortest period of time, while simultaneously maintaining a stable client within a balanced system.

After EMDR processing, clients generally report that the emotional distress related to the memory has been eliminated, or greatly decreased, and that they have gained important cognitive insights. Importantly, these emotional and cognitive changes usually result in spontaneous behavioral and personal change, which are further enhanced with standard EMDR procedures." www.emdr.com

__________________

Major Depressive Disorder

Diagnostic Features

The essential feature of Major Depressive Disorder is a clinical course that is characterized by one or more Major Depressive Episodes without a history of Manic, Mixed, or Hypomanic Episodes (Criteria A and C).  Episodes of Substance-Induced Mood Disorder (due to the direct physiological effects of a drug of abuse, a medication, or toxin exposure) or of Mood Disorder Due to a General Medical Condition do not count toward a diagnosis of Major Depressive Disorder.  In addition, the episodes must not be better accounted for by Schizoaffective Disorder and are not superimposed on Schizophrenia, Schizophreniform Disorder, Delusional Disorder, or Psychotic Disorder Not Otherwise Specified (Criterion B).

            The fourth digit in the diagnostic code for Major Depressive Disorder indicates whether it is a Single Episode (used only for first episodes) or Recurrent.  It is sometimes difficult to distinguish between a single episode with waxing and waning symptoms and two separate episodes.  For purposes of this manual, an episode is considered to have ended when the full criteria for eh Major Depressive Episode have not been met for at least 2 consecutive months.  During this 2-month period, there is either complete resolution of symptoms or the presence of depressive symptoms that no longer meet the full criteria for a Major Depressive Episode (In Partial Remission).

            The fifth digit in the diagnostic code for Major Depressive Disorder indicates the current state of the disturbance.  If the criteria for a Major Depressive Disorder are met, the severity of the episode is notes as Mild, Moderate, Severe Without Psychotic Features, or Severe With Psychotic Features.  If the criteria for a Major Depressive Episode are not currently met, the fifth digit is used to indicate whether the disorder is In Partial Remission or In Full Remission.

            If Manic, Mixed, or Hypomanic Episodes develop in the course of Major Depressive Disorder, the diagnosis is changed to a Bipolar Disorder.  However, if manic or hypomanic symptoms occur as a direct effect of antidepressant treatment, use of other medications, substance use, or toxin exposure, the diagnosis of Major Depressive Disorder remains appropriate and an addition diagnosis of Substance-induced Mood Disorder, With Manic features (or With Mixed Features), should be noted.  Similarly, if manic or hypomanic symptoms occur as a direct effect of a general medical condition, the diagnosis of Major Depressive Disorder remains appropriate and an additional diagnosis of Mood Disorder Due to a General Medical Condition, With Manic Features (or With Mixed Features), should be noted.” p. 369

Course

Major Depressive Disorder may begin at any age, with an average age at onset in the mid-20s.  Epidemiological data suggest that the age at onset is decreasing for those born more recently.  The course of Major Depressive Disorder, Recurrent, is variable.  Some people have isolated episodes that are separated by many years without any depressive symptoms, whereas others have clusters of episodes, and still others have increasingly frequent episodes as they grow older.  Some evidence suggests that the periods of remission generally last longer early in the course of the disorder.  The number of prior episodes predicts the likelihood of developing a subsequent Major Depressive Episode.  At least 60% of individuals with Major Depresssive Disorder, Single Episode, can be expected to have a second episode.  Individuals who have had tow episodes have a 70% chance of having a third, and individuals who have had three episodes have a 90% chance  of having a fourth.  About 5%-10% of individuals with Major Depressive Disorder, single Episode, subsequently develop a Manic Episode (i.e., develop Bipolar I Disorder).

            Major Depressive Episodes may end completely (in about two-thirds of cases), or only partially or not at all (in about one-third of cases).  For individuals who have only partial remission, there is a greater likelihood of developing additional episodes and of continuing the pattern of partial interepisode recovery.  The longitudinal course specifiers With Full Interepisode Recovery and Without Full Interepisode Recovery may therefore have prognostic value.  A number of individuals have pre-existing Dysthymic Disorder prior to the onset of Major Depressive Disorder, single Episode.  Some evidence suggests that these individuals are more likely to have additional Major Depressive Episodes, have poorer interepisode recovery, and may require additional acute-phase treatment and a longer period of continuing treatment to attain and maintain a more thorough and longer-lasting euthymic state.

            Follow-up naturalistic studies suggested that 1 year after the diagnosis of a major Depressive Episode, 40% of individuals still have symptoms that are sufficiently severe to meet criteria for a full Major Depressive Episode, roughly 20% continue to have some symptoms that no longer meet full criteria for a Major Depressive Episode (i.e., major Depressive Disorder, In Partial Remission), and 40% have no Mood Disorder.  The severity of the initial Major Depressive Episode appears to predict persistence.  Chronic general medical conditions are also a risk factor for more persistent episodes.

            Episodes of Major Depressive Disorder often follow a severe psychosocial stressor, such as the death of a loved one or divorce.  Studies suggest that psychosocial events 9stressors) may play a more significant role in the precipitation of the first or second episodes of Major Depressive Disorder and may play less of a role in the onset of subsequent episodes.  Chronic general medical conditions and Substance Dependence (particularly Alcohol or Cocaine Dependence) may contribute to the onset or exacerbation of Major Depressive Disorder.

            It is difficult to predict whether the first episode of a Major Depressive Disorder in a young person will ultimately evolve into a Bipolar Disorder.  Some data suggest that the acute onset of severe depression, especially with psychotic features and psychomotor retardation, in a young person without prepubertal psychopathology is more likely to predict a bipolar disorder.  A family history of Bipolar Disorder may also be suggestive of subsequent development of Bipolar Disorder.” p. 372-373

 

Diagnostic and statistical manual of mental disorders. 2000. 4th ed.  Washington, D.C.: American Psychiatric Association.

 

________________

Major Depressive Disorder

 “Diagnostic Features

The essential feature of Major Depressive Disorder is a clinical course that is characterized by one or more Major Depressive Episodes without a history of Manic, Mixed, or Hypomanic Episodes (Criteria A and C).  Episodes of Substance-Induced Mood Disorder (due to the direct physiological effects of a drug of abuse, a medication, or toxin exposure) or of Mood Disorder Due to a General Medical Condition do not count toward a diagnosis of Major Depressive Disorder.  In addition, the episodes must not be better accounted for by Schizoaffective Disorder and are not superimposed on Schizophrenia, Schizophreniform Disorder, Delusional Disorder, or Psychotic Disorder Not Otherwise Specified (Criterion B).

            The fourth digit in the diagnostic code for Major Depressive Disorder indicates whether it is a Single Episode (used only for first episodes) or Recurrent.  It is sometimes difficult to distinguish between a single episode with waxing and waning symptoms and two separate episodes.  For purposes of this manual, an episode is considered to have ended when the full criteria for eh Major Depressive Episode have not been met for at least 2 consecutive months.  During this 2-month period, there is either complete resolution of symptoms or the presence of depressive symptoms that no longer meet the full criteria for a Major Depressive Episode (In Partial Remission).

            The fifth digit in the diagnostic code for Major Depressive Disorder indicates the current state of the disturbance.  If the criteria for a Major Depressive Disorder are met, the severity of the episode is notes as Mild, Moderate, Severe Without Psychotic Features, or Severe With Psychotic Features.  If the criteria for a Major Depressive Episode are not currently met, the fifth digit is used to indicate whether the disorder is In Partial Remission or In Full Remission.

            If Manic, Mixed, or Hypomanic Episodes develop in the course of Major Depressive Disorder, the diagnosis is changed to a Bipolar Disorder.  However, if manic or hypomanic symptoms occur as a direct effect of antidepressant treatment, use of other medications, substance use, or toxin exposure, the diagnosis of Major Depressive Disorder remains appropriate and an addition diagnosis of Substance-induced Mood Disorder, With Manic features (or With Mixed Features), should be noted.  Similarly, if manic or hypomanic symptoms occur as a direct effect of a general medical condition, the diagnosis of Major Depressive Disorder remains appropriate and an additional diagnosis of Mood Disorder Due to a General Medical Condition, With Manic Features (or With Mixed Features), should be noted.” p. 369

 “Course

Major Depressive Disorder may begin at any age, with an average age at onset in the mid-20s.  Epidemiological data suggest that the age at onset is decreasing for those born more recently.  The course of Major Depressive Disorder, Recurrent, is variable.  Some people have isolated episodes that are separated by many years without any depressive symptoms, whereas others have clusters of episodes, and still others have increasingly frequent episodes as they grow older.  Some evidence suggests that the periods of remission generally last longer early in the course of the disorder.  The number of prior episodes predicts the likelihood of developing a subsequent Major Depressive Episode.  At least 60% of individuals with Major Depresssive Disorder, Single Episode, can be expected to have a second episode.  Individuals who have had tow episodes have a 70% chance of having a third, and individuals who have had three episodes have a 90% chance  of having a fourth.  About 5%-10% of individuals with Major Depressive Disorder, single Episode, subsequently develop a Manic Episode (i.e., develop Bipolar I Disorder).

            Major Depressive Episodes may end completely (in about two-thirds of cases), or only partially or not at all (in about one-third of cases).  For individuals who have only partial remission, there is a greater likelihood of developing additional episodes and of continuing the pattern of partial interepisode recovery.  The longitudinal course specifiers With Full Interepisode Recovery and Without Full Interepisode Recovery may therefore have prognostic value.  A number of individuals have pre-existing Dysthymic Disorder prior to the onset of Major Depressive Disorder, single Episode.  Some evidence suggests that these individuals are more likely to have additional Major Depressive Episodes, have poorer interepisode recovery, and may require additional acute-phase treatment and a longer period of continuing treatment to attain and maintain a more thorough and longer-lasting euthymic state.

            Follow-up naturalistic studies suggested that 1 year after the diagnosis of a major Depressive Episode, 40% of individuals still have symptoms that are sufficiently severe to meet criteria for a full Major Depressive Episode, roughly 20% continue to have some symptoms that no longer meet full criteria for a Major Depressive Episode (i.e., major Depressive Disorder, In Partial Remission), and 40% have no Mood Disorder.  The severity of the initial Major Depressive Episode appears to predict persistence.  Chronic general medical conditions are also a risk factor for more persistent episodes.

            Episodes of Major Depressive Disorder often follow a severe psychosocial stressor, such as the death of a loved one or divorce.  Studies suggest that psychosocial events 9stressors) may play a more significant role in the precipitation of the first or second episodes of Major Depressive Disorder and may play less of a role in the onset of subsequent episodes.  Chronic general medical conditions and Substance Dependence (particularly Alcohol or Cocaine Dependence) may contribute to the onset or exacerbation of Major Depressive Disorder.

            It is difficult to predict whether the first episode of a Major Depressive Disorder in a young person will ultimately evolve into a Bipolar Disorder.  Some data suggest that the acute onset of severe depression, especially with psychotic features and psychomotor retardation, in a young person without prepubertal psychopathology is more likely to predict a bipolar disorder.  A family history of Bipolar Disorder may also be suggestive of subsequent development of Bipolar Disorder.” p. 372-373

 Diagnostic and statistical manual of mental disorders. 2000. 4th ed.  Washington, D.C.: American Psychiatric Association.

________________

DID-PTSD-EMDR

Dissociative Identity Disorder (DID)

"The essential feature of Dissociative identity Disorder is the presence of two or more distinct identities or personality states (Criterion A) that recurrently take control of behavior (Criterion B).  There is an inability to recall important personal information, the extent of which is too great to be explained by ordinary forgetfulness (Criterion C).  The disturbance is not due tot eh direct physiological effects of a substance or a general medical condition (Condition D.).  In children, the symptoms cannot be attributed to imaginary playmates or other fantasy play.

Dissociative Identity Disorder reflects a failure to integrate various aspects of identity, memory, and consciousness.  Each personality state may be experienced as if it has a distinct personal history, self-image, and identity, including a separate name.  Usually there is a primary identity that carries the individual's given name and is passive, dependent, guilty, and depressed.  The alternate identities frequently have different names and characteristics that contrast with the primary identity (e.g., are hostile, controlling, and self-destructive).  Particular identities may emerge in specific circumstances and may differ in reported age and gender, vocabulary, general knowledge, or predominant affect.  Alternate identities are experienced as taking control in sequence, ore at the expense of the other, and may deny knowledge of one another, be critical of one another, or appear to be in open conflict.  Occasionally, one or more powerful identities allocate time to the others.  Aggressive or hostile identities may at times interrupt activities or place the others in uncomfortable situations.

Individuals with this disorder experience frequent gaps in memory for personal history, both remote and recent.  The amnesia is frequently asymmetrical.  The more passive identities tend to have more constricted memories, whereas the more hostile, controlling, or "protector" identities have more complete memories.  An identity that is not in control may nonetheless gain access to consciousness by producing auditory or visual hallucinations (e.g., a voice giving instructions).  Evidence of amnesia may be uncovered by reports from others who have witnessed behavior that is disavowed by the individual or by the individual's own discoveries (e.g., finding items of clothing at home that the individual cannot remember having bought).  There may be loss of memory not only for recurrent periods of time, but also an overall loss of biographical memory for some extended period of childhood, adolescence, or even adulthood.  Transitions among identities are often triggered by psychosocial stress.  The time required to switch from one identity to another is usually a matter of seconds, but, less frequently, may b gradual.  Behavior that may be frequently associated with identity switches include rapid blinking, facial changes, changes in voice or demeanor, or disruption in the individual's train of thoughts.  The number of identities reported ranges from 2 to more than 100.  Half of reported cases include the individuals with 10 or fewer identities."

Diagnostic and Statistical Manual of Mental Disorders. 2000.  4th ed. Washington, D.C.: American Psychiatric Association.

PTSD, DID, and EMDR

Posttraumatic Stress Disorder

"The essential feature of Posttraumatic Stress Disorder us the development of characteristic symptoms following exposure to an extreme traumatic stressor involving direct personal experience of an event that involves actual or threatened death or serious injury, or other threat to one's physical integrity; or witnessing an event that involves death, injury, or a threat to the physical integrity of another person; or learning about unexpected or violent death, serious harm, or threat of death or injury experienced by a family member or other close associate (Criteria A1).  The person's response to the event must involve intense fear, helplessness, or horror (or in children, the response must involve disorganized or agitated behavior) (Criterion A2).  The characteristic symptoms resulting from the exposure to the extreme trauma include persistent reexperiencing of the traumatic event (Criterion E), and the disturbance must cause clinically significant distress or impairment in social, occupational, or other important areas of functioning (Criterion F).

Traumatic events that are experienced directly include, but are not limited to, military combat, violent personal assault (sexual assault, physical attack, robbery, mugging), being kidnapped, being taken hostage, terrorist attack, torture, incarceration as a prisoner of war or in a concentration camp, natural or manmade disasters, severe automobile accidents, or being diagnosed with a life-threatening illness.  For children, sexually traumatic events may include developmentally inappropriate sexual experiences without threatened or actual violence or injury.  Witnessed events include, but are not limited to, observing the serious injury or unnatural death of another person due to violent assault, accident, war, or disaster or unexpectedly witnessing a dead body or body parts.  Events experienced by others that are learned about include, but are not limited to, violent personal assault, serious accident, or serious injury experienced y a family member or a close friend; learning about the sudden, unexpected death of a family member or a close friend; or learning that one's child has a life threatening disease.  The disorder may be especially sever or long lasting when the stressor is of human design (e.g., torture, rape). the likelihood of developing this disorder may increase as the intensity of and physical proximity to the stressor increase.

The traumatic event can be reexperienced in various ways.  Commonly the person has recurrent and intrusive recollections of the event (Criterion B1) or recurrent distressing dreams during which the event can be replayed or otherwise represented (Criterion B2). In rare instances, the person experiences dissociative states that last from a few seconds to several hours, or even days, during which components of the event are relived and the person behaves as though experiencing the event at that moment (Criterion B3).  These episodes, often referred to as "flashbacks," are typically brief but can be associated with prolonged distress and heightened arousal.  Intense psychological distress (Criterion B4) or physiological reactivity (Criterion B5) often occurs when the person is exposed to triggering events that resemble or symbolize an aspect of the traumatic event (e.g., anniversaries of the traumatic event; cold, snowy weather or uniformed guards for survivors of death camps in cold climates; hot, humid weather for combat veterans of the South Pacific; entering any elevator for an woman who was reaped in an elevator).

Stimuli associated with the trauma are persistently avoided.  The person commonly makes deliberate efforts to avoid thoughts, feelings, or conversations about the traumatic event (Criterion C1) and to avoid activities, situations, or people who around recollections of it (Criterion C2).  This avoidance of reminders may include amnesia for an important aspect of the traumatic event (Criterion C3).  Diminished responsiveness to the external work, referred to as "psychic numbing" or "emotional anesthesia," usually begins soon after the traumatic event.  The individual may complain of having markedly diminished interest or participation in previously enjoyed activities (Criterion C4), of feeling detached or estranged from other people (Criterion C5), or of having markedly reduced ability to feel emotions (especially those associated with intimacy, tenderness and sexuality) (Criterion C6).  The individual may have a sense of a foreshortened future (e.g., not expecting to have a career, marriage, children, or a normal life span) (Criterion C7).

The individual has persistent symptoms of anxiety or increased arousal that were not present before the trauma.  these symptoms may include difficulty falling or staying asleep that may be to recurrent nightmares during which the traumatic event is relived (Criterion D1), hypervigilance (Criterion D4), and exaggerated startle response (Criterion D5).  Some individuals report irritability or outburst of anger (Criterion D2) or difficulty concentrating or completing tasks (Criterion D3)."

 

EMDR

Eye Movement Desensitization and Reprocessing

"Eye Movement Desensitization and Reprocessing (EMDR)1 integrates elements of many effective psychotherapies in structured protocols that are designed to maximize treatment effects. These include psychodynamic, cognitive behavioral, interpersonal, experiential, and body-centered therapies2. EMDR is an information processing therapy and uses an eight phase approach.

During EMDR1 the client attends to past and present experiences in brief sequential doses while simultaneously focusing on an external stimulus. Then the client is instructed to let new material become the focus of the next set of dual attention. This sequence of dual attention and personal association is repeated many times in the session.

Eight Phases of Treatment

The first phase is a history taking session during which the therapist assesses the client's readiness for EMDR and develops a treatment plan. Client and therapist identify possible targets for EMDR processing. These include recent distressing events, current situations that elicit emotional disturbance, related historical incidents, and the development of specific skills and behaviors that will be needed by the client in future situations.

During the second phase of treatment, the therapist ensures that the client has adequate methods of handling emotional distress and good coping skills, and that the client is in a relatively stable state. If further stabilization is required, or if additional skills are needed, therapy focuses on providing these. The client is then able to use stress reducing techniques whenever necessary, during or between sessions. However, one goal is not to need these techniques once therapy is complete.

In phase three through six, a target is identified and processed using EMDR procedures. These involve the client identifying the most vivid visual image related to the memory (if available), a negative belief about self, related emotions and body sensations. The client also identifies a preferred positive belief. The validity of the positive belief is rated, as is the intensity of the negative emotions.

After this, the client is instructed to focus on the image, negative thought, and body sensations while simultaneously moving his/her eyes back and forth following the therapist's fingers as they move across his/her field of vision for 20-30 seconds or more, depending upon the need of the client. Athough eye movements are the most commonly used external stimulus, therapists often use auditory tones, tapping, or other types of tactile stimulation. The kind of dual attention and the length of each set is customized to the need of the client. The client is instructed to just notice whatever happens. After this, the clinician instructs the client to let his/her mind go blank and to notice whatever thought, feeling, image, memory, or sensation comes to mind. Depending upon the client's report the clinician will facilitate the next focus of attention. In most cases a client-directed association process is encouraged. This is repeated numerous times throughout the session. If the client becomes distressed or has difficulty with the process, the therapist follows established procedures to help the client resume processing. When the client reports no distress related to the targeted memory, the clinician asks him/her to think of the preferred positive belief that was identified at the beginning of the session, or a better one if it has emerged, and to focus on the incident, while simultaneously engaging in the eye movements. After several sets, clients generally report increased confidence in this positive belief. The therapist checks with the client regarding body sensations. If there are negative sensations, these are processed as above. If there are positive sensations, they are further enhanced.

In phase seven, closure, the therapist asks the client to keep a journal during the week to document any related material that may arise and reminds the client of the self-calming activities that were mastered in phase two.

The next session begins with phase eight, re-evaluation of the previous work, and of progress since the previous session. EMDR treatment ensures processing of all related historical events, current incidents that elicit distress, and future scenarios that will require different responses. The overall goal is produce the most comprehensive and profound treatment effects in the shortest period of time, while simultaneously maintaining a stable client within a balanced system.

After EMDR processing, clients generally report that the emotional distress related to the memory has been eliminated, or greatly decreased, and that they have gained important cognitive insights. Importantly, these emotional and cognitive changes usually result in spontaneous behavioral and personal change, which are further enhanced with standard EMDR procedures." www.emdr.com

 1Shapiro, F. (2001). Eye Movement Desensitization and Reprocessing: Basic Principles, Protocols and Procedures (2nd ed.). New York: Guilford Press.

2Shapiro, F. (2002). EMDR as an Integrative Psychotherapy Approach: Experts of Diverse Orientations Explore the Paradigm Prism. Washington, DC: American Psychological Association Books.

 

 

 

 

NeuroBiology of Trauma

 

Affect Regulation II: Affect dysregulation and disorders of the self.

Record: 1

 

Title:   Affect dysregulation and disorders of the self.     

Author(s):     Schore, Allan N. , U California at Los Angeles, David

Geffen School of Medicine, Los Angeles, CA, US

Source:         2003. New York, NY, US: W. W. Norton & Co, Inc. xvii,

403 pp.        

ISBN: 0-393-70407-8 (hardcover, 0-393-704008-4 (set))

Language:     English

Key Concepts:         right brain; affective development; attachment;

neuroscience; developmental neuropsychiatry; relational trauma;

psychopathologies; biopsychosocial model; infant mental health 

Abstract:       This is the first volume in Schore's comprehensive

treatment of affect, regulation, and human development. In Part I,

Schore updates attachment theory by defining it as a regulation theory.

He details the positive impact of early affective communications on the

organization of a control system in the infant's development right

brain. Because the right hemisphere is dominant for the processing of

social, emotional, and bodily information, the relationally-influenced

development and organization of this hemisphere has profound effects on

a person's capacity for empathy, attention, and coping with stress.

Schore presents a compelling biopsychosocial model of the relations

between dynamic organizations of the right brain and essential adaptive

human functions. The second part of this volume focuses on abnormal

development and describes the negative impact of relational trauma on

right brain development. Schore models both the origins of affect

dysregulation that characterize various psychopathologies and the

intergenerational transmission of a predisposition to personality

disorders. Schore suggests that the nonverbal right hemisphere is

dominant in basic human adaptive functions, and that impaired right

brain functions lie at the core of all psychopathologies. (PsycINFO

Database Record (c) 2003 APA, all rights reserved)

Subjects:      *Attachment Behavior; *Emotional Development; *Human

Development; *Psychopathology; *Right Brain; Biopsychosocial Approach;

Infant Development; Neurosciences

Classification:          Psychological & Physical Disorders (3200)

Population:    Human (10)

Special Feature:       Index (100)

 

References (300)

Intended Audience:   Psychology: Professional & Research (PS)

Table of Contents:    Acknowledgments

 

Preface

 

Part I: Developmental affective neuroscience

 

..The experience-dependent maturation of a regulatory system in the

orbital-prefrontal cortex and the origin of developmental

psychopathology

 

..The experience-dependent maturation of an evaluative system in the

cortex

 

..Attachment and the regulation of the right brain

 

..Parent-infant communication and the neurobiology of emotional

development

 

Part II: Developmental neuropsychiatry

 

..Early organization of the nonlinear right brain and the development of

a predisposition to psychiatric disorders

 

..The effects of a secure attachment relationship on right-brain

development, affect regulation, and infant mental health

 

..The effects of relational trauma on right-brain development, affect

regulation, and infant mental health

 

..Dysregulation of the right brain: A fundamental mechanism of traumatic

attachment and the psychopathogenesis of posttraumatic stress disorders

 

..Effect of early relational trauma on affect regulation: The

development of borderline and antisocial personality disorders and a

predisposition to violence

 

Permissions

 

References

 

Index

Publication Type:      Authored Book (120); Print(Paper)  

Release Date:          20030505     

Accession Number:    2003-00021-000      

         

Persistent link to this record:

http://search.epnet.com/direct.asp?an=2003-00021-000&db=psyh      

         

Cut and Paste: <A

href="http://search.epnet.com/direct.asp?an=2003-00021-000&db=psyh">Affe

ct dysregulation and disorders of the self.</A>    

         

Database:      PsycINFO      

  _____

 

Record: 2

 

Title:   Affect regulation and the repair of the self.         

Author(s):     Schore, Allan N. , U California, David Geffen School of

Medicine, Los Angeles, CA, US

Source:         2003. New York, NY, US: W. W. Norton & Co, Inc. 363 pp.        

ISBN: 0-393-70407-6 (hardcover, 0-393-704008-4 (set))

Language:     English

Key Concepts:         affect; regulation; human development; early emotional

development; psychoneurobiological models; psychotherapeutic change;

biological substrate organization; unconscious mind; biopsychosocial

model 

Abstract:       The 2nd volume of A. Schore's comprehensive treatment of

affect, regulation, and human development, this book applies his

developmental theory to critical areas of early emotional development,

psychoanalysis, and psychotherapy. Part 1 of the book offers

psychoneurobiological models for describing the mechanisms basic to

psychotherapeutic change. These chapters show how current

neuroscientific findings confirm Schore's own hypothesis regarding the

fundamental mechanisms of human communication. Part 2 explores the early

organization of the biological substrate of the human unconscious mind.

The description of the critical impact of early object relations on the

development of internal psychic structures is elaborated. /// Schore's

findings address numerous disciplines, from neuroscience to psychology,

psychiatry, psychoanalysis, pediatrics, psychosomatic medicine,

education, and social work. The biopsychosocial model that emerges from

Schore's research highlights the integrative character of the biological

and the psychological realms in early development and over the course of

the human lifespan. (PsycINFO Database Record (c) 2003 APA, all rights

reserved)

Subjects:      *Biopsychosocial Approach; *Emotional Control;

*Emotional Development; *Human Development; Behavior Change; Models;

Neurobiology; Psychotherapy; Unconscious (Personality Factor) 

Classification:          Developmental Psychology (2800)

Population:    Human (10)

Special Feature:       Index (100)

 

References (300)

Intended Audience:   Psychology: Professional & Research (PS)

Table of Contents:    Part I: Developmentally oriented psychotherapy

 

..Interdisciplinary research as a source of clinical models

 

..Minds in the making: Attachment, the self-organizing brain, and the

developmentally-oriented psychoanalytic psychotherapy

 

..Clinical implications of a psychoneurobiological model of projective

identification

 

..Advances in neuropsychoanalysis, attachment theory, and trauma

research: Implications for self psychology

 

Part II: Developmental Neuropsychoanalysis

 

..Early superego development: The emergence of shame and narcissistic

affect regulation in the practicing period

 

..A century after Freud's project: Is a rapprochement between

psychoanalysis and neurobiology at hand?

 

..The right brain, the right mind, and psychoanalysis

 

..The right brain as the neurobiological substratum of Freud's dynamic

unconscious

 

Appendix: Principles of psychotherapeutic treatment

 

Permissions

 

References

 

Index

Publication Type:      Authored Book (120); Print(Paper)  

Release Date:          20030505     

Accession Number:    2003-02881-000      

         

Persistent link to this record:

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href="http://search.epnet.com/direct.asp?an=2003-02881-000&db=psyh">Affe

ct regulation and the repair of the self.</A>        

         

Database:      PsycINFO      

  _____

 

Record: 3

 

Title:   Mental disorder and violence: Personality dimensions and

clinical features.      

Author(s):     Nestor, Paul G. , U Massachusetts, Dept of Psychology,

Boston, MA, US

Address:        Nestor, Paul G., Brockton VAMC, Psychiatry 116A, 940

Belmont St, Brockton, MA, US, 02301, paul.nestor@umb.edu     

Source:         American Journal of Psychiatry , Vol 159(12), Dec 2002.

pp. 1973-1978. Journal URL: http://ajp.psychiatryonline.org/     

Publisher:      US: American Psychiatric Assn.      

ISSN: 0002-953X (Print)

Digital Object Identifier:

http://dx.doi.org/10.1176/appi.ajp.159.12.1973   

Language:     English

Key Concepts:         personality dimensions; violence; mental disorders;

impulse control; affect regulation; narcissism; paranoid cognitive

personality style      

Abstract:       Examines the role of personality dimensions in the

greater rates of violence that have now been established to accompany

certain classes of mental disorders. Empirical studies are reviewed that

have often used objective measures of personality and epidemiological

samples with low levels of subject selection biases. The risk of

violence may be understood in terms of four fundamental personality

dimensions: 1) impulse control, 2) affect regulation, 3) narcissism, and

4) paranoid cognitive personality style. Low impulse control and affect

regulation increase the risk for violence across disorders, especially

for primary and comorbid substance abuse disorders. By contrast,

paranoid cognitive personality style and narcissistic injury increase

the risk for violence, respectively, in persons with schizophrenia

spectrum disorders and in samples of both college students and

individuals with personality disorders. This review supports the

hypothesis that these four fundamental personality dimensions operate

jointly, and in varying degrees, as clinical risk factors for violence

among groups with these classes of mental disorders. (PsycINFO Database

Record (c) 2003 APA, all rights reserved)

Subjects:      *Impulsiveness; *Mental Disorders; *Personality Traits;

*Violence; Cognitive Style; Emotional Control; Narcissism; Paranoia      

Classification:          Psychological Disorders (3210)

Population:    Human (10)

Form/Content Type: Literature Review/Research Review (1300)

Special Feature:       References (300)

 

Peer Reviewed (600)

Publication Type:      Journal Article (250); Print(Paper)  

Release Date:          20030115     

Accession Number:    2002-11257-003      

         

Persistent link to this record:

http://search.epnet.com/direct.asp?an=2002-11257-003&db=psyh      

         

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href="http://search.epnet.com/direct.asp?an=2002-11257-003&db=psyh">Ment

al disorder and violence: Personality dimensions and clinical

features.</A>

         

Database:      PsycINFO      

  _____

 

Record: 4

 

Title:   Spatial but not verbal cognitive deficits at age 3 years in

persistently antisocial individuals.   

Author(s):     Raine, Adrian , U Southern California, Los Angeles, CA,

US

 

Yaralian, Pauline S. , U Southern California, Los Angeles, CA, US

 

Reynolds, Chandra , U Southern California, Los Angeles, CA, US

 

Venables, Peter H. , U Southern California, Los Angeles, CA, US

 

Mednick, Sarnoff A. , U Southern California, Los Angeles, CA, US

Address:        Raine, Adrian, U Southern California, Dept of

Psychology, Los Angeles, CA, US, 90089-1061, raine@usc.edu   

Source:         Development & Psychopathology , Vol 14(1), Win 2002. pp.

25-44. Journal URL: http://uk.cambridge.org/journals/dpp/        

Publisher:      US: Cambridge Univ Press. Publisher URL:

http://www.journals.cup.org

ISSN: 0954-5794 (Print)

Language:     English

Key Concepts:         verbal intelligence; antisocial; childhood development;

spatial deficits         

Abstract:       Previous studies have repeatedly shown verbal

intelligence deficits in adolescent antisocial individuals, but it is

not known whether these deficits are in place prior to kindergarten or

whether they are acquired throughout childhood. This study assesses

whether cognitive deficits occur as early as age 3 yrs and whether they

are specific to persistently antisocial individuals. Verbal and spatial

abilities were assessed at ages 3 and 11 yrs, while antisocial behavior

was assessed at ages 9 and 17 yrs. Persistently antisocial individuals

had spatial deficits in the absence of verbal deficits at age 3 yrs

compared to comparisons, and also spatial and verbal deficits at age 11

yrs. Age 3 spatial deficits were independent of social adversity, early

hyperactivity, poor test motivation, poor test comprehension, and social

discomfort during testing, and they were found in females as well as

males. Findings suggest that early spatial deficits contribute to

persistent antisocial behavior whereas verbal deficits are

developmentally acquired. An early-starter model is proposed whereby

early spatial impairments interfere with early bonding and attachment,

reflect disrupted right hemisphere affect regulation and expression, and

predispose to later persistent antisocial behavior. (PsycINFO Database

Record (c) 2002 APA, all rights reserved)

Subjects:      *Antisocial Personality; *Cognitive Ability; *Spatial

Ability; *Verbal Ability        

Classification:          Behavior Disorders & Antisocial Behavior (3230)

Population:    Human (10)

 

Male (30)

 

Female (40)

Location:       Africa; India  

Age Group:    Childhood (birth-12 yrs) (100)

 

School Age (6-12 yrs) (180)

 

Adolescence (13-17 yrs) (200)

Form/Content Type: Empirical Study (0800)

Special Feature:       References (300)

 

Peer Reviewed (600)

Publication Type:      Journal Article (250); Print (Paper) 

Release Date:          20020424     

Correction Date:       20020522     

Accession Number:    2002-02602-002      

         

Persistent link to this record:

http://search.epnet.com/direct.asp?an=2002-02602-002&db=psyh      

         

Cut and Paste: <A

href="http://search.epnet.com/direct.asp?an=2002-02602-002&db=psyh">Spat

ial but not verbal cognitive deficits at age 3 years in persistently

antisocial individuals.</A>   

         

Database:      PsycINFO      

  _____

 

Record: 5

 

Title:   Trauma recovery in female survivors: Age, affect regulation and

safe attachment.     

Author(s):     Bolduc-Hicks, Lynda Lee , Massachusetts School Of

Professional Psychology, US

Source:         Dissertation Abstracts International: Section B: The

Sciences & Engineering , Vol 63(5-B), Dec 2002. pp. 2573.        

Publisher:      US: Univ Microfilms International.   

ISSN: 0419-4217 (Print)

Order Number:          AAI3052711  

Language:     English

Key Concepts:         trauma recovery; interpersonal violence; age

differences; affect regulation; safe attachmemt; women 

Abstract:       The purpose of this retrospective study was to examine

the relationship between age, Affect Regulation and Safe Attachment in

adult female survivors of interpersonal trauma and identify differences

between survivor groups differing in onset of trauma and recovery

status. Clinicians working with trauma survivors in outpatient mental

health settings completed assessments of resilience and recovery using

the Multidimensional Trauma Recovery and Resiliency Scale (MTRR)

designed to assess the ways in which survivors of trauma respond to

their experiences. Pearson correlations were conducted using MTRR data

for 125 female survivors of trauma to identify the relationship between

age, Affect Regulation, and Safe Attachment with all survivors and the

differences between survivors based on these areas of psychological

functioning. Several hypotheses were explored in this study. First, it

was hypothesized that there would be a positive relationship between

age, Affect Regulation, and Safe Attachment within each of these three

groups as a result of the interrelationship between affect and

interpersonal relationships. Findings demonstrated that both domain

scores for each group of survivors showed clear trends suggesting that

Safe Attachment and Affect Regulation were positively related.

Differences were postulated between the three groups of survivors on

onset of trauma, recovery status and by the MTRR domains of Safe

Attachment and Affect Regulation according to mean MTRR domain scores. A

MANOVA was conducted to identify differences in variation in MTRR scores

across recovery status and for onset of trauma. No distinctions between

groups were found as a result of onset of trauma however a significant

main effect was found for recovery status as it demonstrated the ability

to distinguish stages of recovery based on mean scores. Significant

interaction effects were revealed from mean scores on Safe Attachment

concerning an expected trajectory of recovery for all survivors. Lastly,

it was also hypothesized that mean scores would increase as a result of

adult development or chronological age where older survivors of

interpersonal violence would obtain higher MTRR mean scores independent

of onset of exposure to interpersonal violence. Various findings for the

Pearson Correlations and multivariate analysis of variance are discussed

following clinical implications of the results. (PsycINFO Database

Record (c) 2003 APA, all rights reserved)

Subjects:      *Age Differences; *Attachment Behavior; *Emotional

Control; *Emotional Trauma; *Recovery (Disorders); Human Females;

Violence       

Classification:          Health & Mental Health Treatment & Prevention

(3300)

Population:    Human (10)

 

Female (40)

Age Group:    Adulthood (18 yrs & older) (300)

Form/Content Type: Empirical Study (0800)

Special Feature:       Peer Reviewed (600)

Publication Type:      Dissertation Abstract (350); Print(Paper)  

Release Date:          20030324     

Accession Number:    2002-95022-128      

         

Persistent link to this record:

http://search.epnet.com/direct.asp?an=2002-95022-128&db=psyh      

         

Cut and Paste: <A

href="http://search.epnet.com/direct.asp?an=2002-95022-128&db=psyh">Trau

ma recovery in female survivors: Age, affect regulation and safe

attachment.</A>     

         

Database:      PsycINFO      

  _____

 

Record: 6

 

Title:   An investigation of relationships between affective experience,

affect regulation, coping, and chronic pain.         

Author(s):     Jones, David Alexander , U Western Ontario, Canada

Source:         Dissertation Abstracts International: Section B: The

Sciences & Engineering , Vol 63(5-B), Dec 2002. pp. 2587.        

Publisher:      US: Univ Microfilms International.   

ISSN: 0419-4217 (Print)

Order Number:          AAINQ68048  

Language:     English

Key Concepts:         affective experience; affect regulation; coping; chronic

pain   

Abstract:       Method. Information regarding three affective experience

(AE) and three affect regulation (AR) dimensions was gathered from a

heterogeneous sample of 104 chronic pain patients using the Affect

Regulation and Experience Q-Sort (AREQ). Self-report questionnaires

included visual analog pain scales, the Coping Strategies Questionnaire,

Multidimensional Pain Inventory, McGill Pain Questionnaire, Profile of

Mood States (Bipolar), and Center for Epidemiological Studies Depression

scale. Four hypotheses regarding the roles of AE and AR were tested in

separate studies. Study 1. The first study hypothesized that AR and AE

dimensions in pain patients would be similar to, but show important

differences from those demonstrated in psychiatric patients.

Confirmatory factor analysis failed to show goodness of fit for the six

AREQ scales, despite their demonstrating excellent internal consistency

and strong factor loadings for five of the six scales. Exploratory

analysis yielded five AE factors and six AR factors for pain patients.

Study 2. Multiple regression was used to demonstrate that

Catastrophizing is a complex construct characterized by both secondary

cognitive appraisal and affective components. Thirty-one percent of the

variance in Catastrophizing scores was explained by a combination of

cognitive appraisal variables and six AREQ scales, even after pain

severity and chronicity, age, and sex of participants were considered.

Study 3. Hierarchical cluster analysis was used to show that subgroups

of pain patients could be identified on the basis of their AR scores and

the amount of intense negative affect they experienced. The cluster

analysis identified four patient subgroups: Adaptive Copers, Emotionally

Distressed, Avoidant Copers, and Externalizers. Cluster stability was

confirmed by replicating cluster assignment using Modal Profile

Analysis. Study 4. Canonical correlation was performed to identify

relationships between the six AREQ variables, pain reports, and MPI pain

outcome scores. One significant canonical correlate was identified, and

hypotheses regarding specific relationships were generated for the four

pain subgroups identified in Study 3. Conclusions. A clinical interview

and the AREQ were useful tools for describing the important affective

dimensions in pain patients, for developing affective profiles for

chronic pain patients, clarifying the nature of Catastrophizing, and for

characterizing subgroups of patients with different affective profiles.

(PsycINFO Database Record (c) 2003 APA, all rights reserved)

Subjects:      *Chronic Pain; *Coping Behavior; *Emotional Control;

*Emotional States    

Classification:          Health & Mental Health Treatment & Prevention

(3300)

Population:    Human (10)

Age Group:    Adulthood (18 yrs & older) (300)

Form/Content Type: Empirical Study (0800)

Special Feature:       Peer Reviewed (600)

Publication Type:      Dissertation Abstract (350); Print(Paper)  

Release Date:          20030324     

Accession Number:    2002-95022-064      

         

Persistent link to this record:

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Cut and Paste: <A

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investigation of relationships between affective experience, affect

regulation, coping, and chronic pain.</A>  

         

Database:      PsycINFO      

  _____

 

Record: 7

 

Title:   Adult attachment, developmental personality styles and

interpersonal affect regulation.      

Author(s):     Sherry, Alissa Rene' , U Southern Mississippi, US

Source:         Dissertation Abstracts International: Section B: The

Sciences & Engineering , Vol 63(5-B), Dec 2002. pp. 2625.        

Publisher:      US: Univ Microfilms International.   

ISSN: 0419-4217 (Print)

Order Number:          AAI3054072  

Language:     English

Key Concepts:         attachment; developmental personality styles;

interpersonal affect regulation; adults      

Abstract:       This study explores the relationships between

developmental personality styles and (a) adult attachment and (b) affect

regulation. These variables were examined among a sample of participants

(N = 273) using Bartholomew's (Griffin & Bartholomew, 1994) Relationship

Scales Questionnaire (RSQ), the Millon Clinical Multiaxial Inventory-III

(MCMI-III), and an Interpersonal Affect Regulation Scale based on a

method developed by Mikulincer, Orbach and Iavnieli (1998). In the first

part of the study, adult attachment dimensions (secure, dismissing,

preoccupied and fearful) were correlated using canonical correlation

analysis (CCA) with the ten personality disorder scales on the MCMI-III

(Avoidant, Paranoid, Schizotypal, Schizoid, Compulsive, Borderline,

Antisocial, Narcissistic, Histrionic and Dependent). Findings indicated

that the adult attachment dimensions were able to predict seven of the

ten personality styles. These were Avoidant, Paranoid, Schizoid,

Schizotypal, Histrionic, Dependent, and Borderline. In addition, secure

attachment was negatively correlated with all of these personality

styles except for Histrionic. In the second part of the study, a second

CCA was conducted between the MCMI-III personality disorder scales and

the interpersonal affect regulation scores. Interpersonal affect

regulation was assessed by first having participants generate 10 traits

that describe themselves and freely recall four scenarios of previous

relationships. These scenarios varied in terms of whether the

relationship had a positive or negative impact on the participant and

whether a positive or negative event occurred during the relationship.

The participants were then instructed to generate 10 traits that

described each of the people in each of these scenarios. Finally, the

participants rated the extent to which they possessed each of the

generated traits on a scale ranging from 1 (a little) to 4 (extremely).

Results indicated that positive relationship, regardless of the valence

of the event, were able to predict five of the personality styles:

Avoidant, Dependent, Histrionic, Narcissitic and Obsessive Compulsive.

Results suggested that adult attachment theory may be a viable model in

which to conceptualize developmental personality styles, with only

moderate support for the concept of interpersonal affect regulation and

its relation to personality styles. The specific relationships between

the attachment dimensions and the personality styles are discussed.

(PsycINFO Database Record (c) 2003 APA, all rights reserved)

Subjects:      *Attachment Behavior; *Emotional Control; *Interpersonal

Interaction; *Personality Traits     

Classification:          Developmental Psychology (2800)

Population:    Human (10)

Age Group:    Adulthood (18 yrs & older) (300)

Form/Content Type: Empirical Study (0800)

Special Feature:       Peer Reviewed (600)

Publication Type:      Dissertation Abstract (350); Print(Paper)  

Release Date:          20030324     

Accession Number:    2002-95022-293      

         

Persistent link to this record:

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Cut and Paste: <A

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t attachment, developmental personality styles and interpersonal affect

regulation.</A>       

         

Database:      PsycINFO      

  _____

 

Record: 8

 

Title:   Initial validation of the Emotion Expression Scale for Children

(EESC).        

Author(s):     Penza-Clyve, Susan , U Maine, Dept of Psychology, ME, US

 

Zeman, Janice , U Maine, Dept of Psychology, ME, US

Address:        Penza-Clyve, Susan, Rhode Island Hosp, Div of Child &

Family Psychiatry, 593 Eddy Street, Providence, RI, US, 02903,

spenza@lifespan.org

Source:         Journal of Clinical Child & Adolescent Psychology , Vol

31(4), Dec 2002. pp. 540-547. Journal URL:

http://www.erlbaum.com/Journals/journals/JCCP/jccp.htm        

Publisher:      US: Lawrence Erlbaum. Publisher URL:

http://www.erlbaum.com    

ISSN: 1537-4416 (Print)

 

1532-7639 (Electronic)

Language:     English

Key Concepts:         validity; Emotion Expression Scale for Children;

deficient emotion expression

Abstract:       The Emotion Expression Scale for Children (EESC) is a

new self-report, scale designed to examine 2 aspects of deficient

emotion expression: lack of emotion awareness and lack of motivation to

express negative emotion. Validity was assessed using self-report

measures of emotion regulation and self- and peer-report of

internalizing and externalizing symptoms. Using a community sample of

208 4th- and 5th-grade children (aged 9-12 yrs), reliability analyses

revealed high internal consistency and moderate test-retest reliability

of the EESC. The results provide initial support for concurrent validity

for the EESC factors evidenced by relations with measures of emotion

management. Associations were found between the EESC and measures of

internalizing symptoms. Sample vignettes from the Affect Regulation

Interview are appended. (PsycINFO Database Record (c) 2002 APA, all

rights reserved)

Subjects:      *Emotional Responses; *Expressed Emotion; *Self Report;

*Test Validity; Emotionality (Personality); Test Reliability

Classification:          Clinical Psychological Testing (2224)

 

Psychosocial & Personality Development (2840)

Population:    Human (10)

 

Male (30)

 

Female (40)

Age Group:    Childhood (birth-12 yrs) (100)

 

School Age (6-12 yrs) (180)

Form/Content Type: Empirical Study (0800)

Special Feature:       References (300)

 

Peer Reviewed (600)

Publication Type:      Journal Article (250); Print(Paper)  

Release Date:          20021113     

Accession Number:    2002-06079-011      

         

Persistent link to this record:

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Cut and Paste: <A

href="http://search.epnet.com/direct.asp?an=2002-06079-011&db=psyh">Init

ial validation of the Emotion Expression Scale for Children (EESC).</A> 

         

Database:      PsycINFO      

  _____

 

Record: 9

 

Title:   The challenges of psychoanalytic developmental theory. 

Author(s):     Tyson, Phyllis

Address:        Tyson, Phyllis, 677 Turquoise St, La Jolla, CA, US,

92037-1807, Phyllis@tysonz.com   

Source:         Journal of the American Psychoanalytic Association , Vol

50(1), Win 2002. pp. 19-52.

Publisher:      US: AnaIytic Press. Publisher URL:

http://www.psychoanalysis.net/iPPsa       

ISSN: 0003-0651 (Print)

Language:     English

Key Concepts:         psychoanalytic developmental theory; affect; mental

development; self-regulation; behavioral sciences; nonlinear dynamic

systems; systems theory; structural theory        

Abstract:       Comments on the evolution of psychoanalytic

developmental theory and on the challenges it currently faces--and

poses. The author attempts to paint a broad picture of past and current

psychoanalytic views of affect and then briefly surveys research from

related fields that challenges analysts to reconsider not only their own

notions about affect but also the models they use to understand mental

development and function. The author examines the validity of a

psychoanalytic developmental point of view, then examines affect and

self-regulation in Freud's models of the mind. Affect and the behavioral

sciences are discussed, as are affects and neurobiology. The author

addresses the idea of nonlinear dynamic systems as a framework for

understanding human behavior, as well as examining systems theory and

structural theory. The author then describes the importance of

self-as-agent in affect regulation. (PsycINFO Database Record (c) 2002

APA, all rights reserved)

Subjects:      *Emotional Control; *Emotional Development; *History;

*Human Development; *Psychoanalytic Theory; Behavioral Sciences; Chaos

Theory; Structuralism; Systems Theory    

Classification:          Psychoanalytic Theory (3143)

 

Psychosocial & Personality Development (2840)

Population:    Human (10)

Age Group:    Childhood (birth-12 yrs) (100)

 

Adolescence (13-17 yrs) (200)

 

Adulthood (18 yrs & older) (300)

Special Feature:       References (300)

 

Peer Reviewed (600)

Publication Type:      Journal Article (250); Print (Paper) 

Release Date:          20020522     

Accession Number:    2002-01033-002      

         

Persistent link to this record:

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Cut and Paste: <A

href="http://search.epnet.com/direct.asp?an=2002-01033-002&db=psyh">The

challenges of psychoanalytic developmental theory.</A>

         

Database:      PsycINFO      

  _____

 

Record: 10

 

Title:   Affect optimization and affect complexity: Modes and styles of

regulation in adulthood.      

Author(s):     Labouvie-Vief, Gisela , Wayne State U, Dept of

Psychology, Detroit, MI, US

 

Medler, Marshall , Wayne State U, Dept of Psychology, Detroit, MI, US

Address:        Labouvie-Vief, Gisela, Wayne State U, Dept of

Psychology, 71 West Warren Avenue, Detroit, MI, US, 48202,

gvief@sun.science.wayne.edu       

Source:         Psychology & Aging , Vol 17(4), Dec 2002. pp. 571-587.

Journal URL: http://www.apa.org/journals/pag.html        

Publisher:      US: American Psychological Assn. Publisher URL:

http://www.apa.org 

ISSN: 0882-7974 (Print)

Digital Object Identifier:

http://dx.doi.org/10.1037//0882-7974.17.4.571   

Language:     English

Key Concepts:         affect optimization; affect complexity; self-regulation;

emotion regulation; coping; defensive processes; 15-86 yr olds 

Abstract:       In this research, the authors hypothesize that affect

regulation involves 2 independent strategies: affect optimization, the

tendency to constrain affect to positive values, and affect complexity,

the amplification of affect in the search for differentiation and

objectivity. Community residents age 15 to 86 were assessed by using 2

convergent measurement domains: 1 based on measures of positive-negative

affect and cognitive-affective complexity and 1 based on measures of

coping and defense. Both domains yielded the hypothesized affect

optimization and affect complexity dimensions. As predicted, the affect

optimization dimensions are primarily related to relationship quality

variables, and the affect complexity dimensions to socioeconomic status

and education. Hence, positive affect and its maximization have

different significance in the context of high- or low-affect complexity.

(PsycINFO Database Record (c) 2002 APA, all rights reserved)

Subjects:      *Coping Behavior; *Defense Mechanisms; *Emotional

Control; *Self Control         

Classification:          Psychosocial & Personality Development (2840)

Population:    Human (10)

 

Male (30)

 

Female (40)

Location:       US     

Age Group:    Adolescence (13-17 yrs) (200)

 

Adulthood (18 yrs & older) (300)

 

Young Adulthood (18-29 yrs) (320)

 

Thirties (30-39 yrs) (340)

 

Middle Age (40-64 yrs) (360)

 

Aged (65 yrs & older) (380)

 

Very Old (85 yrs & older) (390)

Form/Content Type: Conference Proceedings/Symposia (0600)

 

Empirical Study (0800)

Special Feature:       References (300)

 

Peer Reviewed (600)

Conference:   Annual scientific meetings of the Gerontological Society

of America., Nov, 1998, Philadelphia, PA, US        

Conference Note:     A previous version of this article was presented

at the aforementioned meeting.     

Publication Type:      Journal Article (250); Print(Paper)  

Release Date:          20021204     

Correction Date:       20021226     

Accession Number:    2002-06812-005      

         

Persistent link to this record:

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ct optimization and affect complexity: Modes and styles of regulation in

adulthood.</A>       

         

Database:      PsycINFO      

  _____

 

Record: 11

 

Title:   Towards a psychodynamic understanding of binge drinking behavior

in first-semester college freshmen. 

Author(s):     Blandt, Catherine W.

Address:        Blandt, Catherine W., 990 Spring Run Lane, Martinsville,

NJ, US, 08836, c_wildrick@yahoo.com      

Source:         Journal of College Student Development , Vol 43(6),

Nov-Dec 2002. pp. 775-791.

Publisher:      US: ACPA Executive Office. 

ISSN: 0897-5264 (Print)

Language:     English

Key Concepts:         drinking behavior; psychodynamics; affect regulation;

self-esteem; object relations; college freshmen   

Abstract:       Investigated the relationship between student

characteristics and drinking behavior from a psychodynamic perspective.

Respondents were 181 male and 196 female traditional-age (aged 18-19

yrs) college freshman attending a small, private university. Affect

regulation, self-esteem, and object relations were measured with

following instruments: the Toronto Alexithymia Scale, the Rosenberg

Self-Esteem Scale, the Bell Object Relations and Reality Testing

Inventory, and the College Alcohol Survey. Results reveal clear

differences in the relationship between ego functioning and drinking

behavior for men compared to women. Findings indicate that the meaning

of alcohol use may differ for male and female students. Implications for

methodology, theory, and practice are discussed. (PsycINFO Database

Record (c) 2002 APA, all rights reserved)

Subjects:      *College Students; *Drinking Behavior; *Psychodynamics;

*Student Characteristics; Emotional Stability; Human Sex Differences;

Object Relations; Self Esteem        

Classification:          Classroom Dynamics & Student Adjustment &

Attitudes (3560)

Population:    Human (10)

 

Male (30)

 

Female (40)

Location:       US     

Age Group:    Adulthood (18 yrs & older) (300)

 

Young Adulthood (18-29 yrs) (320)

Form/Content Type: Empirical Study (0800)

Special Feature:       References (300)

 

Peer Reviewed (600)

Publication Type:      Journal Article (250); Print(Paper)  

Release Date:          20021226     

Accession Number:    2002-08349-001      

         

Persistent link to this record:

http://search.epnet.com/direct.asp?an=2002-08349-001&db=psyh      

         

Cut and Paste: <A

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rds a psychodynamic understanding of binge drinking behavior in

first-semester college freshmen.</A>       

         

Database:      PsycINFO      

  _____

 

Record: 12

 

Title:   Affect regulation and addictive aspects of repetitive

self-injury in hospitalized adolescents.      

Author(s):     Nixon, Mary K. , Children's Hosp of Eastern Ontario,

Mental Health Patient Service Unit, Ottawa, ON, Canada

 

Cloutier, Paula F. , Children's Hosp of Eastern Ontario, Mental Health

Patient Service Unit, Ottawa, ON, Canada

 

Aggarwal, Sanjay , Queen's U, School of Medicine, Kingston, ON, Canada

Address:        Nixon, Mary K., Children's Hosp of Eastern Ontario,

Mental Health Patient Service Unit, 401 Smyth Road, Ottawa, ON, Canada,

K1H 8L1, nixon@cheo.on.ca

Source:         Journal of the American Academy of Child & Adolescent

Psychiatry , Vol 41(11), Nov 2002. pp. 1333-1341. Journal URL:

http://www.jaacap.com/    

Publisher:      US: Lippincott Williams & Wilkins. Publisher URL:

http://www.lww.com

ISSN: 0890-8567 (Print)

Language:     English

Key Concepts:         self-injurious behavior; addiction; adolescent

psychiatric inpatients; affect regulation    

Abstract:       The incidence of self-injurious behavior (SIB) in

adolescent psychiatric inpatients has been reported to be as high as

61%, yet few data exist on the characteristics and functional role of

SIB in this population. Because of the repetitive nature of SIB and its

potential to increase in severity features of SIB and its specific

reinforcing effects were examined. Participants were 42 self-injuring

adolescents (aged 12-18 yrs) admitted to a hospital over a 4 mo period.

Data sources consisted of self-report questionnaires and medical chart

review. Reported urges to self-injure were almost daily in 78.6% of the

adolescents, with acts occurring more than once a week in 83.3%. The two

primary reasons endorsed for engaging in self-injury were "to cope with

feelings of depression" and "to release unbearable tension." Of the

sample, 97.6% endorsed three or more addictive symptoms. SIB in

hospitalized adolescents serves primarily to regulate dysphoric affect

and displays many addictive features. Those with clinically elevated

levels of internalized anger appear at risk for more addictive features

of this behavior. (PsycINFO Database Record (c) 2003 APA, all rights

reserved)

Subjects:      *Addiction; *Adolescent Psychiatry; *Affective

Disorders; *Psychiatric Patients; *Self Inflicted Wounds; Emotional

States

Classification:          Behavior Disorders & Antisocial Behavior (3230)

Population:    Human (10)

 

Male (30)

 

Female (40)

 

Inpatient (50)

Location:       Canada        

Age Group:    Childhood (birth-12 yrs) (100)

 

School Age (6-12 yrs) (180)

 

Adolescence (13-17 yrs) (200)

 

Adulthood (18 yrs & older) (300)

Form/Content Type: Empirical Study (0800)

Special Feature:       References (300)

 

Peer Reviewed (600)

Publication Type:      Journal Article (250); Print(Paper)  

Release Date:          20030115     

Accession Number:    2002-06766-023      

         

Persistent link to this record:

http://search.epnet.com/direct.asp?an=2002-06766-023&db=psyh      

         

Cut and Paste: <A

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ct regulation and addictive aspects of repetitive self-injury in

hospitalized adolescents.</A>       

         

Database:      PsycINFO      

  _____

 

Record: 13

 

Title:   Introducing genetic psychophysiology.      

Author(s):     de Geus, Eco J. C. , Vrije U, Dept of Biological

Psychology, Amsterdam, Netherlands

Source:         Biological Psychology , Vol 61(1-2), Oct 2002. pp. 1-10.

Journal URL:

http://www.elsevier.com/inca/publications/store/5/0/5/5/8/0/   

Publisher:      Netherlands: Elsevier Science. Publisher URL:

http://www.elsevier.com    

ISSN: 0301-0511 (Print)

Digital Object Identifier:

http://dx.doi.org/10.1016/S0301-0511(02)00049-2        

Language:     English

Key Concepts:         molecular genetic techniques; behavioral geneticists;

individual differences; cognitive abilities; physical health;

psychophysiology     

Abstract:       Genetic psychophysiology examines interindividual

variation in psychophysiological traits using behavioral genetic and

molecular genetic techniques. It aims to delineate the pathways that

lead from genomic variation to individual differences in cognitive

abilities, affect regulation, and mental and physical health. This

editorial provides an introduction to the twin design and gene finding

strategies using psychophysiological endophenotypes. It also gives a

brief outline of the papers presented in this special issue on genetic

psychophysiology. Its main objective, and the objective of the entire

special issue, is to interest psychophysiologists in the enormous

potential of research in this area and to foster the development of

collaborative relationships between psychophysiologists and molecular

and behavioral geneticists that are necessary to move research in this

area forward. (PsycINFO Database Record (c) 2002 APA, all rights

reserved)

Subjects:      *Cognitive Ability; *Health; *Individual Differences;

*Psychophysiology; *Behavioral Genetics  

Classification:          Psychophysiology (2560)

Form/Content Type: Editorial (0700)

Special Feature:       References (300)

 

Peer Reviewed (600)

Publication Type:      Journal Article (250); Print(Paper)  

Release Date:          20021204     

Correction Date:       20021226     

Accession Number:    2002-06555-004      

         

Persistent link to this record:

http://search.epnet.com/direct.asp?an=2002-06555-004&db=psyh      

         

Cut and Paste: <A

href="http://search.epnet.com/direct.asp?an=2002-06555-004&db=psyh">Intr

oducing genetic psychophysiology.</A>    

         

Database:      PsycINFO      

  _____

 

Record: 14

 

Title:   Skills training in affective and interpersonal regulation

followed by exposure: A phase-based treatment for PTSD related to

childhood abuse.      

Author(s):     Cloitre, Marylene , New York Presbyterian Hosp, Anxiety

& Traumatic Stress Program, New York, NY, US

 

Koenen, Karestan C. , Columbia U, Dept of Public Health, New York, NY,

US

 

Cohen, Lisa R. , St. Luke's-Roosevelt Hosp, Dept of Psychiatry, New

York, NY, US

 

Han, Hyemee , Weill Medical Coll of Cornell U, Dept of Psychiatry, New

York, NY, US

Address:        Cloitre, Marylene, 418 East 59th Street, Apartment 25B,

New York, NY, US, 10022, mcloitre@med.cornell.edu      

Source:         Journal of Consulting & Clinical Psychology , Vol 70(5),

Oct 2002. pp. 1067-1074. Journal URL:

http://www.apa.org/journals/ccp.html      

Publisher:      US: American Psychological Assn. Publisher URL:

http://www.apa.org 

ISSN: 0022-006X (Print)

Digital Object Identifier:

http://dx.doi.org/10.1037//0022-006X.70.5.1067

Language:     English

Key Concepts:         posttraumatic stress disorder; child sexual abuse

survivors; cognitive behavior therapy; exposure therapy; social skills

training; emotional control; treatment outcome; therapeutic alliance;

women

Abstract:       Fifty-eight women with posttraumatic stress disorder

(PTSD) related to childhood abuse were randomly assigned to a 2-phase

cognitive-behavioral treatment or a minimal attention wait list. Phase 1

of treatment included 8 weekly sessions of skills training in affect and

interpersonal regulation; Phase 2 included 8 sessions of modified

prolonged exposure. Compared with those on wait list, participants in

active treatment showed significant improvement in affect regulation

problems, interpersonal skills deficits, and PTSD symptoms. Gains were

maintained at 3- and 9-month follow-up. Phase 1 therapeutic alliance and

negative mood regulation skills predicted Phase 2 exposure success in

reducing PTSD, suggesting the value of establishing a strong therapeutic

relationship and emotion regulation skills before exposure work among

chronic PTSD populations. (PsycINFO Database Record (c) 2002 APA, all

rights reserved)

Subjects:      *Cognitive Therapy; *Posttraumatic Stress Disorder;

*Sexual Abuse; *Treatment Outcomes; *Victimization; Child Abuse;

Comorbidity; Emotional Control; Human Females; Social Skills Training;

Therapeutic Alliance 

Classification:          Psychotherapy & Psychotherapeutic Counseling

(3310)

Population:    Human (10)

 

Female (40)

Location:       US     

Form/Content Type: Empirical Study (0800)

 

Treatment Outcome Study (0860)

Special Feature:       References (300)

 

Peer Reviewed (600)

Publication Type:      Journal Article (250); Print(Paper)  

Release Date:          20020911     

Accession Number:    2002-18226-001      

         

Persistent link to this record:

http://search.epnet.com/direct.asp?an=2002-18226-001&db=psyh      

         

Cut and Paste: <A

href="http://search.epnet.com/direct.asp?an=2002-18226-001&db=psyh">Skil

ls training in affective and interpersonal regulation followed by

exposure: A phase-based treatment for PTSD related to childhood

abuse.</A>   

         

Database:      PsycINFO      

  _____

 

Record: 15

 

Title:   Affect regulation in women with borderline personality disorder

traits. 

Author(s):     Yen, Shirley , Brown U Medical School, Dept of

Psychiatry & Human Behavior, Providence, RI, US

 

Zlotnick, Caron , Brown U Medical School, Dept of Psychiatry & Human

Behavior, Providence, RI, US

 

Costello, Ellen , Brown U Medical School, Dept of Psychiatry & Human

Behavior, Providence, RI, US

Address:        Yen, Shirley, Brown U Medical School, Dept of Psychiatry

& Human Behavior, 700 Butler Drive, Providence, RI, US, 02906  

Source:         Journal of Nervous & Mental Disease , Vol 190(10), Oct

2002. pp. 693-696. Journal URL: http://www.jonmd.com/

Publisher:      US: Lippincott Williams & Wilkins. Publisher URL:

http://www.lww.com

ISSN: 0022-3018 (Print)

Digital Object Identifier:

http://dx.doi.org/10.1097/00005053-200210000-00006   

Language:     English

Key Concepts:         affect regulation; borderline personality disorder

traits  

Abstract:       Examined the relationship between specific dimensions of

affect regulation and borderline traits in a sample of 39 female

patients (mean age 35.5 yrs). Participants were administered the

Personality Diagnostic Questionnaire-Revised to assess the degree of

borderline traits and the Affect Intensity Measure and Affect Control

Scale to assess dimensions of affect regulation, selected based on the

biosocial theory of borderline personality disorder (BPD). Results from

hierarchical regression analyses indicate that level of affect intensity

and affect control were significantly associated with number of BPD

traits, even after controlling for level of depression. Findings for

affect control remained significant even after controlling for affect

intensity. These results, consistent with biosocial theory of BPD,

suggest that persons with BPD experience emotions more intensely and

have greater difficulty in controlling their affective responses.

(PsycINFO Database Record (c) 2002 APA, all rights reserved)

Subjects:      *Borderline Personality; *Emotional Control

Classification:          Personality Disorders (3217)

Population:    Human (10)

 

Male (30)

 

Female (40)

Age Group:    Adulthood (18 yrs & older) (300)

Form/Content Type: Empirical Study (0800)

Special Feature:       References (300)

 

Peer Reviewed (600)

Publication Type:      Journal Article (250); Print(Paper)  

Release Date:          20021113     

Accession Number:    2002-06229-006      

         

Persistent link to this record:

http://search.epnet.com/direct.asp?an=2002-06229-006&db=psyh      

         

Cut and Paste: <A

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ct regulation in women with borderline personality disorder traits.</A>  

         

Database:      PsycINFO      

  _____

 

Record: 16

 

Title:   The Inventory of Altered Self-Capacities (IASC): A standardized

measure of identity, affect regulation, and relationship disturbance.     

Author(s):     Briere, John , U Southern California, Los Angeles, CA,

US

 

Runtz, Marsha , U Victoria, Victoria, BC, Canada

Source:         Assessment , Vol 9(3), Sep 2002. pp. 230-239.   

Publisher:      US: Sage Publications. Publisher URL:

http://www.sagepub.com   

ISSN: 1073-1911 (Print)

Language:     English

Key Concepts:         Inventory of Altered Self-Capacities; disturbed

functioning in relation to self & others; psychometric properties;

general population; clients; college students       

Abstract:       Describes the Inventory of Altered Self-Capacities

(IASC), a 63-item standardized measure of disturbed functioning in

relation to self and others. The 7 scales of the IASC are Interpersonal

Conflicts, Idealization-Disillusionment, Abandonment Concerns, Identity

Impairment, Susceptibility to Influence, Affect Dysregulation, and

Tension Reduction Activities. The psychometric properties of the IASC

were examined in general population (n=620, aged 18-91 yrs), clinical

(n=116; mean age 31 yrs), and university samples (n=290; mean age 20

yrs). The IASC was found to have internal consistency/reliability and

validity in all 3 samples. Generally as predicted, IASC scales were

associated with existing measures tapping borderline and antisocial

personality features, depression, suicidality, substance abuse,

somatization, and dysfunctional sexual behavior. (PsycINFO Database

Record (c) 2002 APA, all rights reserved)

Subjects:      *Interpersonal Interaction; *Inventories;

*Psychometrics; *Social Adjustment        

Classification:          Clinical Psychological Testing (2224)

 

Psychological Disorders (3210)

Population:    Human (10)

 

Male (30)

 

Female (40)

 

Outpatient (60)

Location:       US     

Age Group:    Adulthood (18 yrs & older) (300)

 

Young Adulthood (18-29 yrs) (320)

 

Thirties (30-39 yrs) (340)

 

Middle Age (40-64 yrs) (360)

 

Aged (65 yrs & older) (380)

 

Very Old (85 yrs & older) (390)

Form/Content Type: Empirical Study (0800)

Special Feature:       References (300)

 

Peer Reviewed (600)

Publication Type:      Journal Article (250); Print(Paper)  

Release Date:          20020918     

Accession Number:    2002-04137-002      

         

Persistent link to this record:

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Cut and Paste: <A

href="http://search.epnet.com/direct.asp?an=2002-04137-002&db=psyh">The

Inventory of Altered Self-Capacities (IASC): A standardized measure of

identity, affect regulation, and relationship disturbance.</A>     

         

Database:      PsycINFO      

  _____

 

Record: 17

 

Title:   Attachment-related psychodynamics.       

Author(s):     Shaver, Phillip R.

 

Mikulincer, Mario

Address:        Shaver, Phillip R., U Calfornia, Davis, Dept of

Psychology, One Shields Ave, Davis, CA, US, 95616-8686,

prshaver@ucdavis.edu        

Source:         Attachment & Human Development , Vol 4(2), Sep 2002.

Special Issue: The psychodynamics of adult attachments--Bridging the gap

between disparate research traditions. pp. 133-161. Journal URL:

http://www.tandf.co.uk/journals/routledge/14616734.html        

Publisher:      United Kingdom: Taylor & Francis/Routledge. Publisher

URL: http://www.tandf.co.uk        

ISSN: 1461-6734 (Print)

 

1469-2988 (Electronic)

Language:     English

Key Concepts:         attachment theory; adult attachment; affect regulation;

defensive processes; psychodynamics; personality theory; individual

difference processes; assessment; self-report     

Abstract:       Because there has been relatively little communication

and cross-fertilization between the two major lines of research on adult

attachment, one based on coded narrative assessments of defensive

processes, the other on simple self-reports of "attachment style' in

close relationships, we here explain and review recent work based on a

combination of self-report and other kinds of method, including

behavioral observations and unconscious priming techniques. The review

indicates that considerable progress has been made in testing central

hypotheses derived from attachment theory and in exploring unconscious,

psychodynamic processes related to affect-regulation and

attachment-system activation. The combination of self-report assessment

of attachment style and experimental manipulation of other theoretically

pertinent variables allows researchers to test causal hypotheses. We

present a model of normative and individual-difference processes related

to attachment and identify areas in which further research is needed and

likely to be successful. One long-range goal is to create a more

complete theory of personality built on attachment theory and other

object relations theories. (PsycINFO Database Record (c) 2002 APA, all

rights reserved)

Subjects:      *Attachment Behavior; *Individual Differences;

*Personality Theory; *Psychodynamics; *Psychological Assessment; Defense

Mechanisms; Interpersonal Interaction; Object Relations; Self Report   

Classification:          Psychosocial & Personality Development (2840)

Form/Content Type: Literature Review/Research Review (1300)

Special Feature:       References (300)

 

Peer Reviewed (600)

Publication Type:      Journal Article (250); Print(Paper)  

Release Date:          20021120     

Accession Number:    2002-08087-002      

         

Persistent link to this record:

http://search.epnet.com/direct.asp?an=2002-08087-002&db=psyh      

         

Cut and Paste: <A

href="http://search.epnet.com/direct.asp?an=2002-08087-002&db=psyh">Atta

chment-related psychodynamics.</A>      

         

Database:      PsycINFO      

  _____

 

Record: 18

 

Title:   The dynamics of measuring attachment.   

Author(s):     Bartholomew, Kim

 

Moretti, Marlene

Address:        Bartholomew, Kim, Simon Fraser U, Dept of Psychology,

8888 University Dr, Burnaby, BC, Canada, V5A 1S6, bartholo@sfu.ca    

Source:         Attachment & Human Development , Vol 4(2), Sep 2002.

Special Issue: The psychodynamics of adult attachments--Bridging the gap

between disparate research traditions. pp. 162-165. Journal URL:

http://www.tandf.co.uk/journals/routledge/14616734.html        

Publisher:      United Kingdom: Taylor & Francis/Routledge. Publisher

URL: http://www.tandf.co.uk        

ISSN: 1461-6734 (Print)

 

1469-2988 (Electronic)

Language:     English

Key Concepts:         attachment theory; adult attachment; affect regulation;

defensive processes; psychodynamics; personality theory; individual

difference processes; assessment; interviews vs self-reports    

Abstract:       Comments on the paper by P. R. Shaver and M. Mikulciner

(see record 2002-08087-002) about research and assessment related to the

psychodynamics of adult attachment. The current authors specifically

address the adult attachment interview (AAI) compared with self-report

methods in measuring the dynamics of attachment. They noted the benefits

of the AAI, but are also persuaded by Shaver and Mikulciner's article

that self-reports of adult attachment are predictive of

attachment-related dynamic processes. It is suggested that the joint use

of self-reports and interviews would provide a useful way to further the

study of attachment dynamics. (PsycINFO Database Record (c) 2002 APA,

all rights reserved)

Subjects:      *Attachment Behavior; *Individual Differences;

*Personality Theory; *Psychodynamics; *Psychological Assessment; Defense

Mechanisms; Interpersonal Interaction; Interviews; Object Relations;

Self Report    

Classification:          Psychosocial & Personality Development (2840)

Form/Content Type: Comment (0500)

Special Feature:       References (300)

 

Peer Reviewed (600)

Publication Type:      Journal Article (250); Print(Paper)  

Release Date:          20021120     

Accession Number:    2002-08087-003      

         

Persistent link to this record:

http://search.epnet.com/direct.asp?an=2002-08087-003&db=psyh      

         

Cut and Paste: <A

href="http://search.epnet.com/direct.asp?an=2002-08087-003&db=psyh">The

dynamics of measuring attachment.</A>   

         

Database:      PsycINFO      

  _____

 

Record: 19

 

Title:   Developmental origins of attachment styles.        

Author(s):     Belsky, Jay

Address:        Belsky, Jay, Birkbeck Coll, Inst for the Study of

Children, Families & Social Issues, 7 Bedford Square, London, United

Kingdom, WC1E 7HX, j.belsky@bbk.ac.uk   

Source:         Attachment & Human Development , Vol 4(2), Sep 2002.

Special Issue: The psychodynamics of adult attachments--Bridging the gap

between disparate research traditions. pp. 166-170. Journal URL:

http://www.tandf.co.uk/journals/routledge/14616734.html        

Publisher:      United Kingdom: Taylor & Francis/Routledge. Publisher

URL: http://www.tandf.co.uk        

ISSN: 1461-6734 (Print)

 

1469-2988 (Electronic)

Language:     English

Key Concepts:         attachment theory; adult attachment; affect regulation;

defensive processes; psychodynamics; personality theory; individual

difference processes; assessment; self-report     

Abstract:       Comments on the paper by P. R. Shaver and M. Mikulciner

(see record 2002-08087-002) about research and assessment related to the

psychodynamics of adult attachment. Shaver and Mikulciner make a strong

case for their claim that social psychological, in contrast to the

developmental psychological, approach to the study of attachment in

adulthood is a valid way of tapping into the internal working model of

the individual. However, the author notes that until Shaver and

Mikulciner link their methods and measurements with indicators of

antecedent developmental experience, developmenalists will have reason

to question whether social psychologists are testing the same attachment

theory that developmentalists believe themselves to be measuring.

Attachment theory is not just a theory of the nature and functioning of

the internal working model of self, other and of the self in close

relationships, but a theory of the developmental origins of these very

individual differences. (PsycINFO Database Record (c) 2002 APA, all

rights reserved)

Subjects:      *Attachment Behavior; *Individual Differences;

*Personality Theory; *Psychodynamics; *Psychological Assessment; Defense

Mechanisms; Developmental Psychology; Interpersonal Interaction;

Intimacy; Object Relations; Self Report; Social Psychology        

Classification:          Psychosocial & Personality Development (2840)

Form/Content Type: Comment (0500)

Special Feature:       References (300)

 

Peer Reviewed (600)

Publication Type:      Journal Article (250); Print(Paper)  

Release Date:          20021120     

Accession Number:    2002-08087-004      

         

Persistent link to this record:

http://search.epnet.com/direct.asp?an=2002-08087-004&db=psyh      

         

Cut and Paste: <A

href="http://search.epnet.com/direct.asp?an=2002-08087-004&db=psyh">Deve

lopmental origins of attachment styles.</A>        

         

Database:      PsycINFO      

  _____

 

Record: 20

 

Title:   Assessing adult attachment: Empirical sophistication and

conceptual bases.    

Author(s):     Bernier, Annie

 

Dozier, Mary

Address:        Bernier, Annie, U Montreal, Dept of Psychology, CP 6128

Succ. Centre-Ville, Montreal, PQ, Canada, H3C 3J7,

annie.bernier@montreal.ca  

Source:         Attachment & Human Development , Vol 4(2), Sep 2002.

Special Issue: The psychodynamics of adult attachments--Bridging the gap

between disparate research traditions. pp. 171-179. Journal URL:

http://www.tandf.co.uk/journals/routledge/14616734.html        

Publisher:      United Kingdom: Taylor & Francis/Routledge. Publisher

URL: http://www.tandf.co.uk        

ISSN: 1461-6734 (Print)

 

1469-2988 (Electronic)

Language:     English

Key Concepts:         attachment theory; adult attachment; affect regulation;

defensive processes; psychodynamics; personality theory; individual

difference processes; assessment; self-report     

Abstract:       Comments on the paper by P. R. Shaver and M. Mikulciner

(see record 2002-08087-002) about research and assessment related to the

psychodynamics of adult attachment. The authors further discuss such

issues as the distinction between experimental sophistication and

conceptual meaning, the experimental demonstration of causality, and the

related yet clearly distinct concepts tapped by self-reports and

interview methodologies. (PsycINFO Database Record (c) 2002 APA, all

rights reserved)

Subjects:      *Attachment Behavior; *Individual Differences;

*Personality Theory; *Psychodynamics; *Psychological Assessment; Defense

Mechanisms; Interpersonal Interaction; Intimacy; Object Relations; Self

Report

Classification:          Psychosocial & Personality Development (2840)

Form/Content Type: Comment (0500)

Special Feature:       References (300)

 

Peer Reviewed (600)

Publication Type:      Journal Article (250); Print(Paper)  

Release Date:          20021120     

Accession Number:    2002-08087-005      

         

Persistent link to this record:

http://search.epnet.com/direct.asp?an=2002-08087-005&db=psyh      

         

Cut and Paste: <A

href="http://search.epnet.com/direct.asp?an=2002-08087-005&db=psyh">Asse

ssing adult attachment: Empirical sophistication and conceptual

bases.</A>   

         

Database:      PsycINFO      

  _____

 

Record: 21

 

Title:   Attachment style measurement: A clinical and epidemiological

perspective.  

Author(s):     Bifulco, Antonia

Address:        Bifulco, Antonia, U London, Lifespan Research Group,

Royal Holloway, 11, Bedford Square, London, United Kingdom, WC1B 3RA        

Source:         Attachment & Human Development , Vol 4(2), Sep 2002.

Special Issue: The psychodynamics of adult attachments--Bridging the gap

between disparate research traditions. pp. 180-188. Journal URL:

http://www.tandf.co.uk/journals/routledge/14616734.html        

Publisher:      United Kingdom: Taylor & Francis/Routledge. Publisher

URL: http://www.tandf.co.uk        

ISSN: 1461-6734 (Print)

 

1469-2988 (Electronic)

Language:     English

Key Concepts:         attachment theory; adult attachment; affect regulation;

defensive processes; psychodynamics; personality theory; individual

difference processes; assessment; self-report; narrative interview       

Abstract:       Comments on the paper by P. R. Shaver and M. Mikulciner

(see record 2002-08087-002) about research and assessment related to the

psychodynamics of adult attachment. This comment highlights a position,

somewhat overlooked in Shaver and Mikulciner's review, which sits

between the developmental and personality approaches and their

respective measurements of defensive processes and coding of brief

self-report questionnaires. A case is made for using a narrative style

of interview of attachment style, and four benefits of the narrative

interview are discussed--its utility for assessing social context, its

relevance for specific types of study, its relevance for models of

attachment style and depression, and the advantage of objective

assessment. (PsycINFO Database Record (c) 2002 APA, all rights reserved)

Subjects:      *Attachment Behavior; *Individual Differences;

*Personality Theory; *Psychodynamics; *Psychological Assessment; Defense

Mechanisms; Interpersonal Interaction; Interviews; Object Relations;

Self Report    

Classification:          Psychosocial & Personality Development (2840)

Form/Content Type: Comment (0500)

Special Feature:       References (300)

 

Peer Reviewed (600)

Publication Type:      Journal Article (250); Print(Paper)  

Release Date:          20021120     

Accession Number:    2002-08087-006      

         

Persistent link to this record:

http://search.epnet.com/direct.asp?an=2002-08087-006&db=psyh      

         

Cut and Paste: <A

href="http://search.epnet.com/direct.asp?an=2002-08087-006&db=psyh">Atta

chment style measurement: A clinical and epidemiological

perspective.</A>     

         

Database:      PsycINFO      

  _____

 

Record: 22

 

Title:   Building bridges.       

Author(s):     Carnelly, Katherine B.

 

Brennan, Kelly A.

Address:        Carnelly, Katherine B., U Southampton, Dept of

Psychology, Highfield, Southampton, United Kingdom, SO17 1BJ

Source:         Attachment & Human Development , Vol 4(2), Sep 2002.

Special Issue: The psychodynamics of adult attachments--Bridging the gap

between disparate research traditions. pp. 189-192. Journal URL:

http://www.tandf.co.uk/journals/routledge/14616734.html        

Publisher:      United Kingdom: Taylor & Francis/Routledge. Publisher

URL: http://www.tandf.co.uk        

ISSN: 1461-6734 (Print)

 

1469-2988 (Electronic)

Language:     English

Key Concepts:         attachment theory; adult attachment; affect regulation;

defensive processes; psychodynamics; personality theory; individual

difference processes; assessment; self-report     

Abstract:       Comments on the paper by P. R. Shaver and M. Mikulciner

(see record 2002-08087-002) about social psychological and developmental

approaches to research and assessment related to the psychodynamics of

adult attachment. The current authors discuss the use of self-report

measures of attachment style, address the uses of the Adult Attachment

Interview, and comment on the model presented by Shaver and Mikulciner.

(PsycINFO Database Record (c) 2002 APA, all rights reserved)

Subjects:      *Attachment Behavior; *Individual Differences;

*Personality Theory; *Psychodynamics; *Psychological Assessment; Defense

Mechanisms; Interpersonal Interaction; Object Relations; Self Report   

Classification:          Psychosocial & Personality Development (2840)

Form/Content Type: Comment (0500)

Special Feature:       References (300)

 

Peer Reviewed (600)

Publication Type:      Journal Article (250); Print(Paper)  

Release Date:          20021120     

Accession Number:    2002-08087-007      

         

Persistent link to this record:

http://search.epnet.com/direct.asp?an=2002-08087-007&db=psyh      

         

Cut and Paste: <A

href="http://search.epnet.com/direct.asp?an=2002-08087-007&db=psyh">Buil

ding bridges.</A>    

         

Database:      PsycINFO      

  _____

 

Record: 23

 

Title:   Attachment-related dynamics: What can we learn from self-reports

of avoidance and anxiety?   

Author(s):     Feeney, Judith A.

Address:        Feeney, Judith A., U Queensland, School of Psychology,

Brisbane, Australia, 4072, j.feeney@psy.uq.edu.au         

Source:         Attachment & Human Development , Vol 4(2), Sep 2002.

Special Issue: The psychodynamics of adult attachments--Bridging the gap

between disparate research traditions. pp. 193-200. Journal URL:

http://www.tandf.co.uk/journals/routledge/14616734.html        

Publisher:      United Kingdom: Taylor & Francis/Routledge. Publisher

URL: http://www.tandf.co.uk        

ISSN: 1461-6734 (Print)

 

1469-2988 (Electronic)

Language:     English

Key Concepts:         attachment theory; adult attachment; affect regulation;

defensive processes; psychodynamics; personality theory; individual

difference processes; assessment; self-report     

Abstract:       Comments on the paper by P. R. Shaver and M. Mikulciner

(see record 2002-08087-002) about research and assessment related to the

psychodynamics of adult attachment. Shaver and Mikulciner argue that

self-report measures of adult attachment provide a useful tool for

studying attachment-related dynamics, particularly when combined with

experimental research techniques. Because the current author's response

is generally favorable, the goals of this comment are to present

additional data supporting Shaver and Mikulciner's position, draw

attention to some aspects of empirical research not addressed by Shaver

and Mikulciner, and comment briefly on a possible limitation of reliance

on two-dimensional measures of adult attachment. (PsycINFO Database

Record (c) 2002 APA, all rights reserved)

Subjects:      *Attachment Behavior; *Individual Differences;

*Personality Theory; *Psychodynamics; *Psychological Assessment; Defense

Mechanisms; Interpersonal Interaction; Object Relations; Self Report   

Classification:          Psychosocial & Personality Development (2840)

Form/Content Type: Comment (0500)

Special Feature:       References (300)

 

Peer Reviewed (600)

Publication Type:      Journal Article (250); Print(Paper)  

Release Date:          20021120     

Accession Number:    2002-08087-008      

         

Persistent lin