Psychology Commons^™

The Clinical Significance Of Single Features Of Borderline Personality Disorder: Anger, Affective Instability, Impulsivity, And Chronic Emptiness In Psychiatric Outpatients, William Ellison, Lia Rosenstein, Iwona Chelminski, Kristy Dalrymple, Mark Zimmerman

William D Ellison

Although dimensional models of borderline personality disorder (BPD) are consistent with findings showing that minimal levels of pathology are associated with substantial increases in psychosocial impairment, it is still unclear whether different individual BPD criteria are each clinically significant on their own. The current study uses semistructured interview data from 1,870 adults presenting for outpatient psychiatric treatment to investigate whether the BPD criteria of impulsivity, affective instability, emptiness, and anger are each related to psychosocial morbidity when met in the absence of the other eight criteria. Analyses showed that each of these criteria was associated with dysfunction in comparison with …

Attachment And Social Cognition In Borderline Personality Disorder: Specificity In Relation To Antisocial And Avoidant Personality Disorders, Josesph Beeney, Stephanie Stepp, Michael Hallquist, Lori Scott, Aidan Wright, William Ellison, Kimberly Nolf, Paul Pilkonis

William D Ellison

Theory and research point to the role of attachment difficulties in borderline personality disorder (BPD). Attachment insecurity is believed to lead to chronic problems in social relationships, attributable, in part, to impairments in social cognition, which comprise maladaptive mental representations of self, others, and self in relation to others. However, few studies have attempted to identify social–cognitive mechanisms that link attachment insecurity to BPD and to assess whether such mechanisms are specific to the disorder. For the present study, empirically derived indices of mentalization, self–other boundaries, and identity diffusion were tested as mediators between attachment style and personality disorder symptoms. …

How Many Different Ways Do Patients Meet The Diagnostic Criteria For Major Depressive Disorder?, Mark Zimmerman, William Ellison, Diane Young, Iwona Chelminski, Kristy Dalrymple

William D Ellison

There are 227 possible ways to meet the symptom criteria for major depressive disorder (MDD). However, symptom occurrence is not random, and some symptoms co-occur significantly beyond chance. This raises the questions of whether all of the theoretically possible different ways of meeting the MDD criteria actually occur in patients, and whether some combinations of criteria are much more common than others. More than 1500 patients who met DSM-IV criteria for MDD at the time of the evaluation were interviewed with semi-structured interviews. The patients met the MDD symptom criteria in 170 different ways. Put another way, one-quarter (57/227) of …

Psychosocial Morbidity Associated With Bipolar Disorder And Borderline Personality Disorder In Psychiatric Out-Patients: Comparative Study, Mark Zimmerman, William Ellison, Theresa Morgan, Diane Young, Iwona Chelminski, Kristy Dalrymple

William D Ellison

Background The morbidity associated with bipolar disorder is, in part, responsible for repeated calls for improved detection and recognition. No such commentary exists for the improved detection of borderline personality disorder. Clinical experience suggests that it is as disabling as bipolar disorder, but no study has directly compared the two disorders. Aims To compare the levels of psychosocial morbidity in patients with bipolar disorder and borderline personality disorder. Method Patients were assessed with semi-structured interviews. We compared 307 patients with DSM-IV borderline personality disorder but without bipolar disorder and 236 patients with bipolar disorder but without borderline personality disorder. Results …

A Meta-Analysis Of The Relation Between Patient Adult Attachment Style And The Working Alliance, Kenneth N. Levy, Samantha L. Bernecker, William D. Ellison, Kenneth N Levy, Samantha L Bernecker, William D Ellison

William D Ellison

The Impact Of Pathological Narcissism On Psychotherapy Utilization, Initial Symptom Severity, And Early-Treatment Symptom Change: A Naturalistic Investigation, William Ellison, Kenneth Levy, Nicole Cain, Emily Ansell, Aaron Pincus

William D Ellison

The impact of pathological narcissism on psychotherapy has seldom been investigated empirically, despite extensive clinical theory proposing that highly narcissistic individuals should be reluctant to engage in treatment and derive smaller benefits from therapy. In this study, we investigate the relationship between scores on the Pathological Narcissism Inventory (PNI; Pincus et al., 2009), which assesses both narcissistic grandiosity and narcissistic vulnerability, and clinical variables in a sample of outpatients (N = 60) at a community mental health center. Results indicated that grandiosity, but not vulnerability, was negatively related to the use of adjunctive services and positively predicted client-initiated termination of …

Attachment Style, Kenneth Levy, William Ellison, Lori Scott, Samantha Bernecker

William D Ellison

Attachment theory, developed by Bowlby to explain human bonding, has profound implications for conducting and adapting psychotherapy. We summarize the prevailing definitions and measures of attachment style. We review the results of three meta-analyses examining the association between attachment anxiety, avoidance, and security and psychotherapy outcome. Fourteen studies were synthesized, which included 19 separate therapy cohorts with a combined sample size of 1,467. Attachment anxiety showed a d of −.46 with posttherapy outcome, while attachment security showed a d of.37 association with outcome. Attachment avoidance was uncorrelated with outcome. The age and gender composition of the samples moderated the relation …