Dan Pokorny

THE INFLUENCE OF PREMATURITY, MATERNAL ANXIETY, AND INFANTS' NEUROBIOLOGICAL RISK ON MOTHER-INFANT INTERACTIONS

In this study, we investigated how the birth of a very low birth weight preterm (VLBW) infant influences the mother-infant interaction at 3 months. We also focused on the impact of the infants neurobiological risk and maternal anxiety, and their interaction. The comparison of the VLBW preterm sample (n = 79) with an external full-term sample (n = 35) showed mother-infant interactions of the families with the preterm infant to be more vocally responsive during the interaction, but less facially responsive during the interaction. Additionally, higher levels of maternal anxiety were associated with preterm infants being less facially responsive in interaction with their mother. While neurobiological risk of the infant played a part in this association, with higher risk infants also being less facially responsive, the relationship with maternal anxiety and the mother-child interaction was stronger. How these findings may influence therapeutic interventions is discussed.

Stereotypical Relationship patterns and psychopathology

Background: We explored the relationship between the consistency of relationship patterns and the severity of psychopathology. Method: Relationship patterns were assessed by means of Relationship Anecdote Paradigm interviews rated according to the Core Conflictual Relationship Theme (CCRT) method. The repetition of the same type of CCRT components across relationship narratives indicated stereotypical patterns. Results: Subjects treated in an inpatient setting (n = 25) told narratives with more consistent patterns than subjects in an outpatient setting (n = 32). Relationship episodes of normal adults (n = 23) were more flexible compared with the two clinical groups. Especially repetitions of the wish component were closely associated with the severity of psychopathology assessed by SCL-90R. Conclusions: The consistency of relationship patterns seems to be connected with the severity of psychopathology.

The verbalization of emotions in the therapeutic dialogue: A correlate of therapeutic outcome?

An English version of the “Affective Dictionary Ulm” was constructed based on Dahls emotion theory for the computerized investigation of affective vocabularies of transcripts stemming from the Penn Psychotherapy Project. Therapist and patient vocabularies from “most successful” and “least successful” psychodynamic therapies were investigated at the beginning and at the end of treatment. Two hypotheses were partially confirmed: (1) therapists verbalize more emotions than their patients, and (2) “most successful” therapists will name more emotion words than their “least successful” colleagues. Furthermore, we found that–in comparison with their initial levels–at the end of treatment “most successful” therapists tended to verbalize emotions of the subcategory “anger.” These represent affective states where according to Dahls (1978) emotion theory a subject attributes the “focus of control” of a situation towards the self.Eine englische Fassung des „Affecktinan Diktionais” Ulm wurde auf der Basis von Dahls...

Reformulation of the Core Conflictual Relationship Theme (CCRT) categories: The CCRT-LU Category System.

The Core Conflictual Relationship Theme (CCRT) method, developed by Lester Luborsky, is regarded as an established technique for assessing central relationship patterns in psychotherapy research. Numerous studies have investigated associated research areas and clinical applications. Many of these studies have reported problems with the CCRT method attributable to the underlying construct of the CCRT categories. This study describes the development of alternative German CCRT categories, the CCRT-LU categories, in which LU stands for the place of development (Leipzig/Ulm) and for the ‘logically unified’ aspect of the system. For the 1st time, the CCRT-LU categories are assigned to a sample of clinical intake interviews with 32 female patients.

The German specimen case, amalia x: Empirical studies

The authors provide a perspective on how psychoanalytic process research can be implemented. This is based on a process research model described elsewhere and summarizes the kinds of studies that can be situated on the four levels of the model. The authors summarize multiple empirical studies that were performed in a completely tape-recorded psychoanalytic therapy and have been published. These studies demonstrate the many modalities empirical process research has available to objectively study psychoanalytic process phenomena and their implication for outcome.

The therapist's attachment representation and the patient's attachment to the therapist

Abstract This study examines the relationship between the therapists own attachment representation (Adult Attachment Interview, AAI) and the patients attachment relationship to the therapist (clients attachment to the therapist, CATS). The attachment representations of n=22 psychotherapists who treated n=429 patients were assessed. A general effect of the secure/insecure therapist attachment status on the attachment of the patient to the therapist was not found whereas the more specific effects expected could be confirmed: The more preoccupied the therapists attachment status was, the more the patient experienced a preoccupied-merger attachment to the therapist. The more dismissing the therapists attachment status was, the more the patient experienced an avoidant-fearful attachment to the therapist. In summary, not the general security/insecurity of the therapists attachment representation but rather the type of the insecurity is associated with the subjective patients attachment-related experience of the therapeutic dyad.

On the Connection Between Affective Evaluation of Recollected Relationship Experiences and the Severity of the Psychic Impairment

This study, carried out at three different university centers contributes to validating the valence dimension of the CCRT-method. Working on the state of the CCRT-research on affective evaluation of relationship narratives, the connection between the valence dimension of the responses from others (RO), responses of the self (RS) and the severity of the psychic disorder has been analysed with the help of two different samples (n = 266 resp. n = 32) taken from female patients. Both, therapists as well as patients themselves, evaluated the severity of the impairment similarly. The more the patients were impaired, the more negatively they describes both their own reactions and those of their interaction partners as shown in the relationship episodes.

Self-assessment of interpersonal schemas using the relationship patterns questionnaire: A quantitative approach

This article reviews measures used to assess relationship patterns, 1 of which is the Relationship Patterns Questionnaire (RPQ) developed by Kurth and Pokorny (1999). The RPQ is based on the Structural Analysis of Social Behavior (Benjamin, 1974) and the core conflictual relationship theme (Luborsky, 1977). Using data from a representative German population survey (N=2,007), the authors introduced empirical RPQ scales for the reaction of the object, reaction of the subject, and introject items to complement the theoretical scales of the questionnaire. Means and standard deviations according to age, gender, and place of residence are reported as well as correlations between the scales and their dependency on sociodemographic parameters. The empirical scales show good internal consistency and clinical relevance. Thus, the RPQ is suitable to identify a patients relationship patterns quickly and economically both in practice and in research.

Emotions and Primary Process in Guided Imagery Psychotherapy: Computerized Text-Analytic Measures

This single-case study explored the therapeutic ingredients of a psychotherapy method using an imagery technique. From a 19-session psychodynamic psychotherapy, 6 sessions containing guided affective imagery were compared with the remaining 13 sessions, which did not contain imagery. The completely transcribed sessions were screened by 3 computerized text-analytic instruments: the Regressive Imagery Dictionary (RID), the Affective Dictionary Ulm (ADU), and computerized Referential Activity (cRA). We hypothesized that imagery will elicit more primary process (as indicated by RID), more (and in particular more positive) affects (as indicated by ADU), and more Referential Activity (as indicated by cRA). Results from all 3 vocabulary measures confirm these hypotheses. These results are of interest regarding how to access the domain of implicit (procedural) knowledge in psychotherapy and may contribute to the domain of dream research.

Tumor patients in psychodynamic psychotherapy including daydreaming: can imagery enhance primary process and positive emotions?

Abstract This therapy process study investigates the use of guided affective imagery for tumor patients. The therapeutic access to tumor patients is generally described as complex and challenging because of a disturbed emotion regulation and a defensive focus on reality. After autologous blood stem cell transplantation, 29 patients were treated with psychotherapy, including two daydreaming imagery sessions. Three text-analytical measures—Affective Dictionary Ulm, Regressive Imagery Dictionary, and Computerized Referential Activity for verbatim session transcripts—as well as the Quality of Life Questionnaire and the Karnofsky Performance Status were administered. Results show that guided affective imagery was able to enhance the psychotherapeutic process in tumor patients by activating the primary process, decreasing anxiety, and increasing referential activity. The positive emotional shift during imagery was achieved by the patients irrespective of their oncological severity status. Study limitations and future directions for research are discussed.