Does the severity of psychopathological symptoms mediate the relationship between patient personality and therapist response?

Psychotherapy

Volumn 52, Issue 2, 2015, Pages 228-237

  Lingiardi, Vittorio ^a   Tanzilli, Annalisa ^a   Colli, Antonello ^b  

^a SAPIENZA UNIVERSITY OF ROME   (Italy)

^b UNIVERSITY OF URBINO   (Italy)

Author keywords

Personality disorders; SWAP 200; Symptom severity; Therapist emotional response; TRQ

Indexed keywords

ADULT; ARTICLE; AVOIDANT PERSONALITY DISORDER; BORDERLINE STATE; CLINICAL PSYCHOLOGY; COUNTER TRANSFERENCE; DISEASE SEVERITY; DISORIENTATION; FEMALE; HELPLESSNESS; HISTRIONIC PERSONALITY DISORDER; HUMAN; MAJOR CLINICAL STUDY; MALE; MENTAL DISEASE; PERSONALITY; PERSONALITY DISORDER; PSYCHIATRIST; PSYCHOTHERAPY; QUESTIONNAIRE; SCHIZOTYPAL PERSONALITY DISORDER; SYMPTOM CHECKLIST 90; SYMPTOMATOLOGY; EMOTION; HEALTH PERSONNEL ATTITUDE; HUMAN RELATION; MIDDLE AGED; PSYCHOLOGY; SEVERITY OF ILLNESS INDEX;

ADULT; ATTITUDE OF HEALTH PERSONNEL; COUNTERTRANSFERENCE (PSYCHOLOGY); EMOTIONS; FEMALE; HUMANS; MALE; MIDDLE AGED; PERSONALITY; PERSONALITY DISORDERS; PROFESSIONAL-PATIENT RELATIONS; SEVERITY OF ILLNESS INDEX; SURVEYS AND QUESTIONNAIRES;

EID: 84929517176     PISSN: 00333204     EISSN: 19391536     Source Type: Journal    
DOI: 10.1037/a0037919     Document Type: Article

References (55)

1. Alwin, D. F., & Hauser, R. M. (1975). The decomposition of effects in path analysis. American Sociological Review, 40, 37-47. doi:10.2307/ 2094445
2. Baron, R. M., & Kenny, D. A. (1986). The moderator-mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations. Journal of Personality and Social Psychology, 51, 1173-1182. doi:10.1037/0022-3514.51.6.1173
3. Bateman, A. W., & Fonagy, P. (2006). Mentalization based treatment for borderline personality disorder: A practical guide. Oxford, UK; New York, NY: Oxford University Press. doi:10.1093/med/9780198570905.001.0001
4. Betan, E., Heim, A. K., Zittel Conklin, C., & Westen, D. (2005). Countertransference phenomena and personality pathology in clinical practice:An empirical investigation. The American Journal of Psychiatry, 162, 890-898. doi:10.1176/appi.ajp.162.5.890
5. Blagov, P. S., Bi, W., Shedler, J., & Westen, D. (2012). The Shedler-Westen Assessment Procedure (SWAP): Evaluating psychometric questions about its reliability, validity, and fixed score distribution. Assessment, 19, 370-382. doi:10.1177/1073191112436667
6. Bradley, R., Hilsenroth, M., Guarnaccia, C., & Westen, D. (2007). Relationship between clinician assessment and self-assessment of personality disorders using the SWAP-200 and PAI. Psychological Assessment, 19, 225-229. doi:10.1037/1040-3590.19.2.225
7. Brody, F., & Farber, B. (1996). The effects of therapist experience and patient diagnosis on countertransference. Psychotherapy: Theory, Research, Practice, Training, 33, 372-380. doi:10.1037/0033-3204.33.3.372
8. Burgoon, J. K., Stern, L. A., & Dillman, L. (1995). Interpersonal adaptation:Dyadic interaction patterns. New York, NY: Cambridge University Press. doi:10.1017/CBO9780511720314
9. Clarkin, J. F., Yeomans, F. E., & Kernberg, O. F. (2006). Psychotherapy for borderline personality: Focusing on object relations. Washington, DC: American Psychiatric Publishing.
10. Cogan, R., & Porcerelli, J. (2004). Personality Pathology, Adaptive Functioning, and Strengths at The Beginning and end of Psychoanalysis. Journal of the American Psychoanalytic Association, 52, 1230-1231.
11. Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). Hillsdale, MI: Erlbaum.
12. Colli, A., Tanzilli, A., Dimaggio, G., & Lingiardi, V. (2014). Patient personality and therapist response: An empirical investigation. The American Journal of Psychiatry, 171, 102-108. doi:10.1176/appi.ajp .2013.13020224
13. Dahl, H. S. J., Røssberg, J. I., Bøgwald, K. P., Gabbard, G. O., & Høglend, P. A. (2012). Countertransference feelings in one year of individual therapy: An evaluation of the factor structure in the Feeling Word Checklist-58. Psychotherapy Research, 22, 12-25. doi:10.1080/ 10503307.2011.622312
14. Derogatis, L. R. (1994). Symptom checklist-90-R: Administration, scoring, and procedures manual (3rd ed.). Minneapolis, MN: National Computer Systems.
15. Fauth, J. (2006). Toward more (and better) countertransference research. Psychotherapy, 43, 16-31. doi:10.1037/0033-3204.43.1.16
16. First, M. B., Gibbon, M., Spitzer, R. L., Williams, J. B. W., & Benjamin, L. S. (1997). Structured clinical interview for DSM-IV Axis II personality disorders (SCID-II). Washington, DC: American Psychiatric Press, 1997.
17. Freud, S. (1910). The future prospects of psychoanalytic therapy (Standard Edition, 11, pp. 139-151). London: Hogarth Press.
18. Freud, S. (1912). Recommendations to physicians practicing psychoanalysis (Standard Edition, 12, pp. 111-120). London: Hogarth Press.
19. Gabbard, G. O. (1993). An overview of countertransference with borderline patients. Journal of Psychotherapy Practice and Research, 2, 7-18.
20. Gabbard, G. O. (1995). Countertransference: The emerging common ground. The International Journal of Psychoanalysis, 76, 475-485.
21. Gabbard, G. O. (2001). A contemporary psychoanalytic model of countertransference. Journal of Clinical Psychology, 57, 983-991. doi:10.1002/ jclp.1065
22. Gabbard, G. O. (Eds.). (2009). Textbook of psychotherapeutic treatments. Washington, DC: American Psychiatric Publishing. doi:10.1176/appi .books.9781585623648
23. Gazzillo, F., Lingiardi, V., & Del Corno, F. (2011). Toward the validation of three assessment instruments derived from the PDM P Axis: The Psychodynamic Diagnostic Prototypes, the Core Preoccupations Questionnaire and the Pathogenic Beliefs Questionnaire. Bollettino di Psicologia Applicata, 265, 31-45.
24. Gelso, C. J., & Hayes, J. A. (2007). Countertransference and the therapist's inner experience: Perils and Possibilities. New Jersey, NJ: Erlbaum.
25. Hayes, J. A., Gelso, C. J., & Hummel, A. M. (2011). Managing countertransference. Psychotherapy, 48, 88-97. doi:10.1037/a0022182
26. Heimann, P. (1950). On counter-transference. The International Journal of Psychoanalysis, 31, 81-84.
27. Kernberg, O. F. (1965). Notes on countertransference. Journal of the American Psychoanalytic Association, 13, 38-56. doi:10.1177/ 000306516501300102
28. Kernberg, O. F. (1984). Severe personality disorders: Psychotherapeutic strategies. New Haven, CT: Yale University Press.
29. Lingiardi, V., Shedler, J., & Gazzillo, F. (2006). Assessing personality change in psychotherapy with the SWAP-200: A case study. Journal of Personality Assessment, 86, 23-32. doi:10.1207/s15327752jpa8601_04
30. MacKinnon, D. P., Fairchild, A. J., & Fritz, M. S. (2007). Mediation analysis. Annual Review of Psychology, 58, 593-614. doi:10.1146/ annurev.psych.58.110405.085542
31. McIntyre, S. M., & Schwartz, R. C. (1998). Therapists' differential countertransference reactions toward clients with major depression or borderline personality disorder. Journal of Clinical Psychology, 54, 923-931. doi:10.1002/(SICI)1097-4679(199811)54:7_923::AID-JCLP6_3.0.CO;2-F
32. McWilliams, N. (2011). Psychoanalytic diagnosis: Understanding personality structure in the clinical process (2nd ed.). New York, NY: Guilford Press.
33. Muran, J. C., & Barber, J. P. (2010). The therapeutic alliance: An evidence-based guide to practice. New York, NY: Guilford Press.
34. Norcross, J. C. (2011). Psychotherapy relationships that work (2nd ed.). New York, NY: Oxford University Press. doi:10.1093/acprof:oso/ 9780199737208.001.0001
35. Ogden, T. (1982). Projective identification and psychotherapeutic technique. New York, NY: Jason Aronson.
36. OPD Task Force. (Ed.) (2008). Operationalized Psychodynamic Diagnosis OPD-2: Manual of diagnosis and treatment planning. Ashland, OH:Hogrefe & Huber Publishers.
37. PDM Task Force. (Ed.) (2006). Psychodynamic diagnostic manual. Silver Spring, MD: Alliance of Psychoanalytic Organizations.
38. Powers, A., & Westen, D. (2009). Personality subtypes in patients with panic disorder. Comprehensive Psychiatry, 50, 164-172. doi:10.1016/j .comppsych.2008.07.006
39. Preacher, K. J., & Kelley, K. (2011). Effect sizes measures for mediation models: Quantitative strategies for communicating indirect effects. Psychological Methods, 16, 93-115. doi:10.1037/a0022658
40. Racker, H. (1957). The meanings and uses of countertransference. The Psychoanalytic Quarterly, 26, 303-357.
41. Røssberg, J. I., Hoffart, A., & Friis, S. (2003). Psychiatric staff members' emotional reactions toward patients. A psychometric evaluation of an extended version of the Feeling Word Checklist (FWC-58). Nordic Journal of Psychiatry, 57, 45-53. doi:10.1080/08039480310000257
42. Røssberg, J. I., Karterud, S., Pedersen, G., & Friis, S. (2007). An empirical study of countertransference reactions toward patients with personality disorders. Comprehensive Psychiatry, 48, 225-230. doi:10.1016/j .comppsych.2007.02.002
43. Røssberg, J. I., Karterud, S., Pedersen, G., & Friis, S. (2010). Psychiatric symptoms and countertransference feelings: An empirical investigation. Psychiatry Research, 178, 191-195. doi:10.1016/j.psychres.2009.09.019
44. Safran, J. D. (1984). Assessing the cognitive-interpersonal cycle. Cognitive Therapy and Research, 8, 333-347. doi:10.1007/BF01173309
45. Sandler, J. (1976). Countertransference and role-responsiveness. International Review of Psycho-Analysis, 3, 43-47.
46. Schwartz, R. C., Smith, S. D., & Chopko, B. (2007). Psychotherapists' countertransference reactions toward clients with antisocial personality disorder and schizophrenia: An empirical test of theory. American Journal of Psychotherapy, 61, 375-393.
47. Shedler, J., & Westen, D. (2004). Refining personality disorder diagnosis:Integrating science and practice. The American Journal of Psychiatry, 161, 1350-1365. doi:10.1176/appi.ajp.161.8.1350
48. Shedler, J., & Westen, D. (2007). The Shedler-Westen Assessment Procedure (SWAP): Making personality diagnosis clinically meaningful. Journal of Personality Assessment, 89, 41-55. doi:10.1080/ 00223890701357092
49. Sobel, M. E. (1982). Asymptotic confidence intervals for indirect effects in structural equation models. Sociological Methodology, 13, 290-312. doi:10.2307/270723
50. Streiner, D. L. (2003). Being inconsistent about consistency: When coefficient alpha does and doesn't matter. Journal of Personality Assessment, 80, 217-222. doi:10.1207/S15327752JPA8003_01
51. Thompson-Brenner, H., & Westen, D. (2005). Personality subtypes in eating disorders: Validation of a classification in a naturalistic sample. The British Journal of Psychiatry, 186, 516-524. doi:10.1192/bjp.186.6.516
52. Westen, D., Gabbard, G. O., & Blagov, P. (2006). Back to the future:Personality structure as a context for psychopathology. In R. F. Krueger & J. L. Tackett (Eds.), Personality and psychopathology: Building bridges (pp. 335-384). New York, NY: Guilford Press.
53. Westen, D., & Shedler, J. (1999a). Revising and assessing axis II, part I:Developing a clinically and empirically valid assessment method. The American Journal of Psychiatry, 156, 258-272.
54. Westen, D., & Shedler, J. (1999b). Revising and assessing axis II, part II:Toward an empirically based and clinically useful classification of personality disorders. The American Journal of Psychiatry, 156, 273-285.
55. Zittel Conklin, C., & Westen, D. (2003). The therapist response questionnaire. Atlanta, Emory University, Departments of Psychology and Psychiatry and Behavioral Sciences. Retrieved from http://www.psychsystems.net/Manuals/Countertransference/Westen%20countertransference%20questionnaire.pdf