Consistent with principles of developmental psychopathology, this paper presents a broad psychodynamic structural developmental perspective that establishes conceptual continuities between processes of normal personality development, personality organization, concepts of psychopathology, and processes of therapeutic change. The major assumption of this approach is that personality development proceeds in a dialectic synergistic interaction between the development of capacities for interpersonal relatedness and the development of self-definition or identity. Extensive research demonstrates that these two dimensions define two broad types of personality organization, each with a particular experiential mode; preferred forms of cognition, defense, and adaptation; unique qualities of interpersonal relatedness and specific types of object and self-representation. Severe disruptions of this normal dialectic developmental process result in various forms of psychopathology organized in two basic configurations in which there is distorted defensive preoccupation, at different developmental levels, with one of these polarities (relatedness or self-definition) at the expense of the development of the other dimension. This paper reviews empirical findings supporting this approach to normal and disrupted personality development throughout the life cycle and considers its relationship to the internalizing-externalizing distinction in childhood and adolescence, attachment theory, and research on the interaction between biological and psychosocial factors in development across the life span. Finally, we discuss the implications of this approach for intervention and prevention.
Ego Psychology And Mental Disorder Developmental Approach To Psychopathology [UPDATED]
Fonagy et al. have suggested that ET is not only influenced by the immediate context (for example, if a speaker actually seems reliable), but it can also reflect a trait-like tendency to trust others, which underpins resilience to psychopathology. Critically, it is argued that the stance to trust socially transmitted information is rooted in developmental experiences such as attachment security, childhood adversity and the associated capacity to reflect on mental states (i.e., mentalizing). It could be one of the mechanisms mediating individual differences in social learning linked to histories of trauma and deprivation [e.g. 19, 20] and may explain some developmental vulnerabilities for psychopathology, in particular more severe forms of mental disorder [8, 9].
ET, that is, trust in communication or communicated knowledge, has traditionally been a largely theoretical concept and has only recently been applied to developmental psychopathology with direct clinical implications. Hitherto there has been little evidence that we are aware of on the relationship between ET, developmental experiences and psychopathology: the purpose of the present study was to identify initial empirical data in this domain and to create an opportunity for the further exploration of the role of this dispositional attribute in developmental psychopathology [8, 9].
As predicted, we found that Mistrust and Credulity scores were associated with higher scores on the global psychopathology severity index and that both factors partially mediated the link between early adversity and psychopathology. These results are consistent with our assumption that both Mistrust and Credulity may be expected to undermine adaptation and increase the developmental risk of mental health problems [50, 51]. Congruent with the finding that secure childhood attachment turns out not to be a protective factor for mental disorder [52], the Trust factor was not associated with reduced levels of mental health symptoms, nor was it a moderator in buffering against childhood adversity, so could not be regarded as a resilience factor. We may speculate that the presence of Trust may be a default mode of social functioning and in that sense a somewhat neutral value. Trusting over and above the average brings no additional benefit from a clinical standpoint. We presume that Trust may bring with it other benefits for social functioning, arising out of an enhanced capacity for acquiring new information from social communication [53], but this remains to be explored in future studies, and in clinical samples in particular. These findings on psychopathology are in line with the idea, which we have previously discussed [24], that working to reduce epistemic mistrust and credulity may be a crucial common factor in the effectiveness of psychotherapeutic interventions enabling improved adaptation to interpersonal environments. Future research might explore these issues in clinical populations and in relation to psychotherapy outcomes.
There are also limitations to the present studies that need to be considered. The samples were community-based rather than clinical but many of the conclusions here have reached into the clinical domain. This is based on the continuum based equifinality notion within developmental psychopathology [64], but clearly further research on the relationship between the three factors in relation to explicit mental disorder diagnoses would be necessary to substantiate the suggestions in this paper. In particular, as much of the clinical inspiration for the measure and the interpretation of its association with self-rating scales in attachment and general psychopathology comes from the study of borderline personality disorder, the relationship between the ETMCQ scales and borderline personality disorder would be desirable. Second, as this study used a cross-sectional design, and although the direction of effect is based on the assumption that childhood experience refers to the past, while psychopathology and epistemic stance are current experiences, we cannot rule out alternative explanations such as selective recall of adverse events in individuals with current difficulties. Future longitudinal studies should test these directions and investigate the long-term effects of the epistemic stance on mental health symptoms and psychological constructs. Third, we did not assess general interpersonal trust [65], which would generate discriminant validity of the epistemic trust factor. The prediction from the model would suggest additional specific variance accounted for by ETMCQ when general trust was controlled for. Fourth, although we undertook a limited replication of Study 1 in Study 2, we are acutely aware of the problems of replication within psychology and the unproductive lines of inquiry isolated findings can create in the field [66]. Further studies would therefore beneficially seek to replicate ours. Finally, our findings focused only on self-report measures: future studies assessing the association between the ETMCQ and experimental designs which test laboratory social learning. We assume that the real time learning and memory performance of those scoring high on the ETMCQ would be impaired in tasks where learning involved detection of personal relevance and the need to reflect a mental state of the sender.
This paper reviews maladaptive trait development (DSM-5 Section III Criterion B), the development of DSM-5 Section II borderline personality disorder, and research on the development of identity, self-direction, empathy/mentalizing, and intimacy (DSM-5 Section III Criterion A). Combined, these previously disparate literatures begin to point to an integrated developmental theory of personality pathology, which suggests that Criterion A concepts (identity, self-direction, empathy, and intimacy) coalesce around the development of self, marking a discontinuous (qualitative) developmental shift. This developmental shift is a function of the demands placed on individuals to take on independent adult role function, combined with biologically-based maturational cognitive and emotional advances during adolescence. Section II personality disorder ensues when an integrated and coherent sense of self fails to develop, resulting in nonfulfilment of adult role function. In this sense, Criterion A self function can account for the onset of Section II personality disorder in adolescence, while Criterion B provides a useful descriptive account of continuous aspects of personality function over time.
The debate concerning the pathogenesis and the maintaining factors of eating disorders, anorexia nervosa in particular, is ongoing especially since therapeutic interventions do not result in satisfactory and enduring rates of remission. This paper presents a model for the pathogenesis of eating disorders, based on the hypothesis of a deficiency in the development of the self. We present the theory in light of new evidence concerning the role of attachment insecurity in the development and maintenance of eating disorders. In particular, we define the self in eating disorders in a comprehensive way by taking into account recent evidence from experimental psychology and neurobiology. The paper considers the development of the self in terms of its synchronic (i.e., experienced in the moment) and diachronic (i.e., experienced as continuous over time) aspects. Both synchronic and diachronic aspects of the self are relevant to the expression of eating disorder symptoms. Further, the maturation of the self is interwoven with the development of attachment functioning from infancy to adolescence. This interplay between these developmental processes of the self and of attachment could be crucial in understanding the pathogenesis of eating disorders. The final part of the paper suggests a neurobiological link between the theory of the self in the eating disorders and the spatiotemporal functioning of the brain. Disturbances in spatiotemporal functioning may represent the neurobiological pathway by which deficiencies in the self is related to attachment functions in individuals with eating disorders.
Introduces students to the manifestation, etiology, assessment, and treatment of mental disorders. Special attention is paid to how racial, cultural, gender and other socio-cultural variables influence the manifestation of psychopathology. Discussion of the uses of DSM in the assessment and diagnosis of mental disorders will be emphasized. This course is reserved for COUD, COUM, COUMBLT, COUN, COUP, and COUS students only. 2ff7e9595c
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