Hans Vertommen

Coping strategies in relation to personality disorders

Abstract Dysfunctional coping strategies can be expected to be among the criteria distinguishing personality disorders from normal personality functioning. In the present study the relationship between the basic coping modes problem-solving, social support seeking and avoidance was investigated in a sample of 137 psychiatric in-patients, using both a dimensional and a categorical approach. The general pattern of association found was that of a lack of social support seeking, together with an excess of avoidant coping.

Process and outcome in psychodynamic hospitalization-based treatment for patients with a personality disorder.

This study examined the relationship between the psychotherapeutic process and outcome in 44 patients who completed hospitalization-based psychodynamic treatment for personality disorders. Using self-report and interview ratings, outcome was assessed in terms of symptoms and personality functioning, and the psychotherapeutic process in terms of self and object relations, felt safety, and reflective functioning. Symptom and process measures were administered at intake, every 3 months during treatment, and at 3 and 12 months follow-up. Personality measures were collected at intake, the end of treatment, and at 3 and 12 months follow-up. Using Piecewise Linear Growth Curve Analysis results showed improvement in symptoms, personality functioning, self and object relations and felt safety, but not in reflective functioning. Linear changes in self and object representation and felt safety, but not in reflective functioning, predicted improvement in outcome.

The Impact of Previous Experience on Children's Reactions to Venepunctures

The relationship between childrens previous experience with venepunctures and their responses to a subsequent blood test was studied in 47 children hospitalized for a surgical intervention. We replicated the results of earlier studies, revealing no effect of the amount of experience but a significant effect of the quality of previous experience. Children with a history of negative medical experiences were found to show higher levels of state anxiety prior to the procedure and to be more distressed and less cooperative during the procedure than children with previous positive or neutral experiences. A comparison of both groups of experienced children with inexperienced children revealed that negative past experiences are likely to sensitize the child, whereas positive or neutral past experiences do not have a significant impact on subsequent reactions. This effect occurs independently of the coping style of the child (sensitizing versus repression).

Outcome and Outcome Trajectories of Personality Disordered Patients During and After a Psychoanalytic Hospitalization-Based Treatment

This study aims to identify different outcome trajectories in a psychoanalytic hospitalization-based treatment in a sample of 70 patients with personality disorders using a naturalistic 12 month follow-up design. Trajectory analysis identified four groups of patients, i.e., patients showing (a) high initial symptom levels and considerable and consistent improvement late in treatment (High-Low group; HL), (b) medium initial symptom levels and a quick and sustained response (Medium-Low group; ML), (c) medium initial symptom levels but without substantial improvement (Medium-Medium group; MM), and (d) low initial symptom levels without substantial further improvement during and after treatment (Low-Low group; LL). Further, data suggested that these four trajectories were related in theoretically meaningful ways to pre-treatment variables, such as anaclitic and introjective personality styles and trauma. Results are discussed in the context of other studies showing the need for differential treatment approaches based on pretreatment characteristics.

Validation of the Psychopathic Personality Inventory among psychiatric inpatients: sociodemographic, cognitive and personality correlates.

This study examined the internal structure and validity of the Psychopathic Personality Inventory (PPI) in a sample of 399 psychiatric inpatients. The construct validity of the PPI was examined by means of Confirmatory Factor Analysis (CFA). The divergent and convergent validity of the PPI were examined by correlating the PPI with demographic variables, intelligence, DSM-IV Axis I and Axis II disorders, and measures of impulsiveness, aggression, narcissism, and psychopathy. CFA supports the presumed 8-factor structure of the PPI and shows that the first-order PPI scales can be represented by two higher-order factors, that is, PPI-I (fearless dominance) and PPI-II (impulsive-aggressiveness). Males scored significantly higher on all PPI scales than females. PPI-I correlated positively with functional impulsiveness, amorality, social imperturbability, and self-centered narcissism. PPI-II was negatively related to age and educational level, and positively to physical and verbal aggression, dysfunctional impulsivity, and other-centered narcissism. Implications for clinical practice are outlined.

Psychometric properties of the Coping Strategy Indicator in a Flemish sample

Abstract The Coping Strategy Indicator (CSI) is a self-report measure of the degree to which the coping strategies of problem-solving, seeking social support and avoidance have been used in response to a specific stressor. The current study presents a factor analysis of the Dutch CSI and describes the psychometric properties of the instrument. As expected, the analysis reveals a clear three-factor solution with the same factor pattern as found in the original study. We also provide data concerning the relationship with demographics.

Construction and validation of a marital intimacy questionnaire

The degree of intimacy experienced in ones marital relationship significantly contributes to a persons physical, emotional, and psychological well-being. This contribution is attested by the growing number of research findings linking the failure to develop an intimate relationship with a partner to a variety of problems, including loneliness (Derlega & Margulis, 1982), marital dissatisfaction (Schaefer & Olson, 1981; Waring, McElrath, Mitchell, & Derry, 1981), physical illness (Reis, Wheeler, Kernis, Spiegel, & Nezlek, 1985), depression (Hickie et al., 1990; Waring & Patton, 1984), psychosomatic illness (Waring, 1983), and sexual abuse (Marshall, 1989). In view of these findings, it is not surprising to see that intimacy is increasingly recognized as a key characteristic of marital relationships, of which the importance is reflected in a large body of literature (for a review, see Van den Broucke, Vandereycken, & Veommen, in press). According to recent conceptualizations, marital intimacy may be regarded either as a process (i.e., a characteristic way of relating of two partners that develops over time), or as a state (i.e., a relatively stable structural quality of a relationship that emerges from this process; Acitelli & Duck, 1987). In the latter sense, it refers to a multidimensional construct, which may include such diverse aspects as reciprocal understanding, affection, self-validation, support, and commitment (Chelune, Robison, & Kommor, 1984; Reis & Shaver, 1988; Sternberg, 1988). Several of these aspects are contained in existing measures of marital intimacy. Examples of such instruments are the Personal Assessment of Intimacy in Relationships (PAIR; Schaefer & Olson, 1981), which provides information about the expected and perceived degree of marital intimacy in five areas (emotional, social, sexual, intellectual, and recreational); the Waring Intimacy Questionnaire (WIQ; Waring & Reddon, 1983), which measures eight components of intimacy (affection, expressiveness, compatibility, cohesion, sexuality, conflict resolution, autonomy, and identity); and the Intimate Bond Measure (IBM; Wilhelm & Parker, 1988), which assesses two dimensions of intimacy (care and control). All of these instruments have been empirically validated and their psychometric properties are well established. An important disadvantage, however, is that they are not based on a theoretical model of marital intimacy. As a result, it is not clear exactly what they measure. Although they all claim to assess marital intimacy, it is obvious that they are not tapping into the same dimensions, which raises concerns about their construct validity. Moreover, in want of a sound theoretical basis, the term intimacy is used in these questionnaires to indicate a heterogeneous mixture of variables, referring to both experiential aspects (e.g., cohesion or sexual fulfillment) and behavioral ones (e.g., expressing thoughts or resolving conflicts), and making no distinction between relational characteristics (e.g., compatibility), individual capabilities (e.g., expressing feelings), or qualities of the relationship between a couple and its social environment (e.g., autonomy towards ones parents). Thirdly, and perhaps most importantly, some of the dimensions assessed by the above instruments could be viewed as possible manifestations or outcomes of marital intimacy rather than as actual subdimensions of the construct. Sexuality, for example, has been found to correlate only moderately with marital intimacy (Patton & Waring, 1985). By including this aspect in an operational definition of intimacy, the latter, in fact, becomes a synonym for marital quality in general and does not add any new meaning to it. A THEORETICAL MODEL OF MARITAL INTIMACY A possible way to address the above shortcomings is to integrate theory formulation and test construction into a construct validation approach (Wiggins, 1973). …

Dissociatieve ervaringen bij Vlamingen en Nederlanders; een studie met de Dissociation Questionnaire (DIS–Q)

SamenvattingDit is de eerste studie naar het voorkomen van dissociatieve ervaringen bij Vlamingen en Nederlanders (n = 374) aan de hand van een nieuw ontwikkelde vragenlijst, de Dissociation Questionnaire (DIS–Q). De resultaten illustreren dat dissociatieve ervaringen relatief frequent voorkomen in de bevolking en significant verminderen met het ouder worden. Ongeveer 3% van de bevolking vermeldt ernstige dissociatieve ervaringen en 1% behaalt een score vergelijkbaar met de partiënten met meervoudige persoonlijkheidsstoornis. Opvallend was het feit dat de meerderheid in deze groep mannen waren. Deze bevindingen suggereren dat het voorkomen van dissociatieve symptomen onderschat wordt door hulpverleners.

Therapy-Related Assessment of Self-Harming Behaviors in Eating Disordered Patients: A Case Illustration

Understanding an individuals self-harming behaviors should be the basis for selecting person-specific therapeutic interventions. For that purpose, the assessment is aimed at identifying the self-harming behaviors and related symptoms as well as analyzing the external (situational) and internal (cognitive and emotional) conditions that contribute directly to the instigation of the self-harming behaviors. In this article, we demonstrate the use of a new assessment procedure that may guide the selection of therapeutic interventions. Data collection and processing are illustrated by an individual case study of an eating-disordered patient showing different types of self-harming behavior such as vomiting, alcohol abuse, cutting, and suicide attempts.

Psychometric characteristics of the Psychopathic personality inventory in a Dutch-speaking population

The Psychopathic Personality Inventory (PPI) is a self-report measure developed by Lilienfeld and Andrews (1996). The PPI is based on the personality-based approach of psychopathy and it aims to measure the core personality traits of psychopathy in criminal, clinical, noncriminal, and nonclinical populations. In this study, the Dutch adaptation of the PPI was administered to a nonclinical sample of 314 participants representative of the Flemish general population in Belgium. The factorial structure of the Dutch adaptation of the PPI and its scale characteristics were investigated. Its convergent and divergent validity were examined by exploring correlations both at the total score level and at the subscale score level, with self-report questionnaires measuring aggressiveness, impulsiveness, and the Diagnostic and Statistical Manual of Mental Disorders (4th ed. [DSM-IV]; American Psychiatric Association, 1994) personality disorders. Associations with 3 demographic variables were inspected as well. Most of the PPI subscales were found to have fairly high internal consistency coefficients. They were also found to refer to different but interrelated aspects of psychopathy. The PPI subscales were found to reflect not just personality traits, but also aspects of behavior. Most PPI subscale scores seemed to be affected by gender and age, but not by educational level.