Effects of Motive-Oriented Therapeutic Relationship in a Ten-Session General Psychiatric Treatment of Borderline Personality Disorder: A Randomized Controlled Trial

Background: Motive-oriented therapeutic relationship (MOTR) was postulated to be a particularly helpful therapeutic ingredient in the early treatment phase of patients with personality disorders, in particular with borderline personality disorder (BPD). The present randomized controlled study using an add-on design is the first study to test this assumption in a 10-session general psychiatric treatment with patients presenting with BPD on symptom reduction and therapeutic alliance. Methods: A total of 85 patients were randomized. They were either allocated to a manual-based short variant of the general psychiatric management (GPM) treatment (in 10 sessions) or to the same treatment where MOTR was deliberately added to the treatment. Treatment attrition and integrity analyses yielded satisfactory results. Results: The results of the intent-to-treat analyses suggested a global efficacy of MOTR, in the sense of an additional reduction of general problems, i.e. symptoms, interpersonal and social problems (F 1, 73 = 7.25, p < 0.05). However, they also showed that MOTR did not yield an additional reduction of specific borderline symptoms. It was also shown that a stronger therapeutic alliance, as assessed by the therapist, developed in MOTR treatments compared to GPM (Z 55 = 0.99, p < 0.04). Conclusions: These results suggest that adding MOTR to psychiatric and psychotherapeutic treatments of BPD is promising. Moreover, the findings shed additional light on the perspective of shortening treatments for patients presenting with BPD.

Cross-cultural analysis of type D (distressed) personality in 6222 patients with ischemic heart disease: a study from the International HeartQoL Project

BACKGROUND Type D (distressed) personality, the conjoint effect of negative affectivity (NA) and social inhibition (SI), predicts adverse cardiovascular outcomes, and is assessed with the 14-item Type D Scale (DS14). However, potential cross-cultural differences in Type D have not been examined yet in a direct comparison of countries. AIM To examine the cross-cultural validity of the Type D construct and its relation with cardiovascular risk factors, cardiac symptom severity, and depression/anxiety. METHODS In 22 countries, 6222 patients with ischemic heart disease (angina, 33%; myocardial infarction, 37%; or heart failure, 30%) completed the DS14 as part of the International HeartQoL Project. RESULTS Type D personality was assessed reliably across countries (αNA>.80; αSI>.74; except Russia, which was excluded from further analysis). Cross-cultural measurement equivalence was established for Type D personality at all measurement levels, as the factor-item configuration, factor loadings, and error structure were not different across countries (fit: CFI=.91; NFI=.88; RMSEA=.018), as well as across gender and diagnostic subgroups. Type D personality was more prevalent in Southern (37%) and Eastern (35%) European countries compared to Northern (24%) and Western European and English-speaking (both 27%) countries (p<.001). Type D was not confounded by cardiac symptom severity, but was associated with a higher prevalence of hypertension, smoking, sedentary lifestyle, and depression. CONCLUSION Cross-cultural measurement equivalence was demonstrated for the Type D scale in 21 countries. There is a pan-cultural relationship between Type D personality and some cardiovascular risk factors, supporting the role of Type D personality across countries and cardiac conditions.

Psychological adaptation to spousal loss in old age: The role of personality

Spousal loss is an inevitable critical life event for most individuals in old age, mostly associated with a negative impact on various well-being measures, ie. lower life satisfaction, higher rates of loneliness and depressive symptoms compared to married peers. While the negative effects on well-being are well documented in literature, the modifying factors accounting for the large variability in adaptation to loss are discussed controversially. The potential relevance of personality in the adaptation process has rarely been examined and findings regarding the role of time since loss are contradictory. Based on a vulnerability-stress-model this contribution aims a) to compare psychological well-being of bereaved individuals with married counterparts and b) to investigate the protective effects of different personality traits (Big Five, resilience), and the role of time since loss for adaptation in terms of life satisfaction, loneliness and depression. Data from a questionnaire study about the loss of a spouse in middle and old age in the German- and French-speaking parts of Switzerland are reported. The study is part of the Swiss National Centre of Competence in Research LIVES (Swiss National Science Foundation). The sample consists of 351 widowed persons (39% men, widowed since 0 - 5 years), and 605 married controls (50% men), aged 60 - 89 years. Group comparisons reveal the detrimental effect of spousal bereavement on all indicators of psychological adaptation. Results from hierarchical regression analyses show furthermore, that the effect of spousal loss on all psychological outcomes is moderated by personality traits. Separate analyses with the group of bereaved individuals suggest, that the protective effect of personality varies by the time passed since loss. Our results contribute to a better understanding of the variability in psychological adaptation to spousal loss in old age and give hints for counselling practice.

The Social Life of Anti-Terrorism Laws. The War on Terror and the Classifications of the "Dangerous Other"

This book addresses two developments in the conceptualisation of citizenship that arise from the 'war on terror', namely the re-culturalisation of membership in a polity and the re-moralisationof access to rights. Taking an anthropological perspective, it traces the ways in which the trans-nationalisation of the 'war on terror' has affected notions of 'the dangerous other' in different political and social contexts, asking what changes in the ideas of the state and of the nation have been promoted by the emerging culture of security, and how these changes affect practices of citizenship and societal group relations.

What drives adult personality development? A comparison of theoretical perspectives and empirical evidence

Increasing numbers of empirical studies provide compelling evidence that personality traits change across the entire lifespan. What initiates this continuing personality development and how does this development proceed? In this paper, we compare six theoretical perspectives that offer testable predictions about why personality develops the way it does and identify limitations and potentials of these perspectives by reviewing how they hold up against the empirical evidence. While all of these perspectives have received some empirical support, there is only little direct evidence for propositions put forward by the five-factor theory of personality and the theory of genotype→environment effects. In contrast, the neo-socioanalytic theory appears to offer a comprehensive framework that fits the empirical findings and allows the integration of other, more specialized, perspectives that focus on specific aspects of personality development like the role of time, systematic differences between categories of social roles or the active partake of the person himself or herself. We draw conclusions on the likely driving factors for adult personality development and identify avenues for future research.

Vocational identity trajectories: Differences in personality and development of well-being

This person-centred study investigated the longitudinal patterns of vocational identity development in relation to personality, the development of well-being, gender, nationality and the attended school track among two cohorts of Swiss adolescents in 8th or 9th grade (N = 269) and in 11th or 12th grade (N = 230). The results confirmed the existence of four identity statuses, namely, achievement, foreclosure, moratorium and diffusion. Forty-two per cent of students showed progressive patterns of identity development, while 37% remained in their identity status over time. Students with different statuses and status change patterns differed significantly in their personality traits. Higher neuroticism related to the emergence of identity exploration over time, while conscientiousness related to maintaining or achieving a sense of identity commitment in terms of achievement or foreclosure. Controlling for the effects of socio-demographics and personality traits, students who reached or maintained a state characterized by identity clarity and commitment showed a relative increase in life satisfaction, while those entering a state of identity crisis or exploration showed a decrease in life satisfaction. Copyright © 2011 John Wiley & Sons, Ltd.

Engagement in adolescent career preparation: Social support, personality, and the development of choice decidedness and congruence

This longitudinal panel study investigated predictors and outcomes of active engagement in career preparation among 349 Swiss adolescents from the beginning to the end of eighth grade. Latent variable structural equation modeling was applied. The results showed that engagement in terms of self- and environmental-exploration and active career planning related positively to interindividual increases in career decidedness and choice congruence. More perceived social support, early goal decidedness, and particular personality traits predicted more engagement. Support and personality impacted outcomes only mediated through engagement. Early decidedness and congruence were significant predictors of their respective later levels. Implications for practice are presented.