Metacognitive Interpersonal Therapy for reducing emotional dysregulation, improving metacognition and promoting change in maladptive schemas in complex histrionic personality disorder

Journal title QUADERNI DI PSICOTERAPIA COGNITIVA
Author/s Giancarlo Dimaggio, Marcella Toma, Giampaolo Salvatore, Donatella Fiore, Luisa Buonocuore
Publishing Year 2013 Issue 2013/33
Language Italian Pages 23 P. 91-113 File size 166 KB
DOI 10.3280/QPC2013-033007
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Compromised capacities to make sense of both one’s own and the others’ mental states and to integrate different states in a coherent self-representation, that is metacognition, are key features of Histrionic Personality Disorder. Other problems are emotional dysregulation and maladaptive interpersonal schemas. These problems are even more severe when other traits such as Borderline or Narcissistic ones co-occurr. In order to be effective psychotherapy must deal with all these problems. In this work we describe the steps of individual psychotherapy during hospitalizations of a young woman suffering from both Histrionic and Borderline personality disorders with narcissistic traits. Patient has been treated with Metacognitive Interpersonal Therapy. Therapy goals were: decreasing emotional dysregulation; b) improving metacognition in order to foster a better quality of interpersonal relationships. Outcome was good. We discuss implications for applying Metacognitive Interpersonal Therapy to personality disorders of the dramatic cluster.

Keywords: Histrionic personality disorder, therapy relationship, metacognition, interpersonal schemas.

  1. American Psychiatric Association (2012). DSM-V development. http://www.dsm5.org/ProposedRevisions/Pages/DSM-5TypeandTraitCross-Walk.aspx
  2. American Psychiatric Association (2000). Diagnostic and Statistical Manual of Mental Disorders, 4th edition. DSM-IV TR. Washington, DC: American Psychiatric Association.
  3. Bateman A.W., Fonagy P. (2004). Il trattamento basato sulla mentalizzazione. Psicoterapia con il paziente borderline (trad. it. Milano: Raffaello Cortina, 2006).
  4. Blashfield R.K., Davis R.T. (1993). Dependent and histrionic personality disorders. In: Sutker P.B., Adams H.E., editors, Comprehensive handbook of psychopathology. New York: Plenum Press, pp. 395-409.
  5. Boon S. Draijer N. (1993). The differentiation of patients with MPD or DD NOS from patients with cluster B personality disorder. Dissociation, 6: 126-135.
  6. Carcione A., Semerari A., Nicolò G., Pedone R., Popolo R., Conti L., Fiore D., Procacci M.,
  7. Dimaggio G. (2010). Le disfunzioni meta cognitive nei disturbi di personalità. Research in Psychotherapy, 2 (13): 217-240. DOI: 10.1016/j.psychres.2010.12.03
  8. Clarkin J.F., Yeomans F.E., Kernberg O.F. (1999). Psychoterapy for Borderline Personality. New York: Wiley.
  9. Dimaggio G., Semerari A. (2003). I disturbi di personalità, Modelli e trattamento, stati mentali, metarappresentazione, cicli interpersonali. Roma-Bari: Laterza. Dimaggio G., Semerari A., Carcione A. Nicolò G., Procacci M. (2007). Psychoterapy of Personality Disorders: Metacognition, States of Mind and Interpersonal Cycles. London: Routledge.
  10. Dimaggio G., Norcross J. (2008). Treating patients with two or more personalità disorders: An introduction. Journal of Clinical Psychology, 64: 127-138. DOI: 10.1002/jclp.2044
  11. Dimaggio G., Lysaker P.H. (2011). Metacognizione e psicopatologia. Valutazione e trattamento. Milano: Raffaello Cortina.
  12. Fiore D., Semerari A. (2003), Il disturbo borderline di personalità. In: Dimaggio G., Semerari A., a cura di, Disturbi di personalità:modelli e trattamento. Roma-Bari: Laterza.
  13. Gabbard G.O. (2002), Psichiatria psicodinamica. Terza edizione. Washington, DC: APA Press.
  14. Hamburger M.E., Lilienfeld S.O., Hogben M. (1996). Psychopathy, gender and gender roles: Implications for antisocial and histrionic personality disorders. Journal of Personality Disorders, 10: 41-55. DOI: 10.1521/pedi.1996.10.1.4
  15. Hartung C.M., Widiger T.A. (1999), Gender differences in the diagnosis of mental disorders: conclusion and controversies of the DSM-IV. Psychological Bulletin, 123: 260-278.
  16. Hoglend P. (1996). Analysis of transference in patients with personality disorders. Journal of Personality Disorders, 10: 122-131. DOI: 10.1521/pedi.1996.10.2.12
  17. Horowitz M.J. (1991). Hysterical personality style and the histrionic personality disorder. Northvale, NJ: Jason Aronson.
  18. Horowitz M.J., editor (1991). Person schema in Person Schemas and Maladaptive Interpersonal Patterns. Chicago: Horowitz University of Chicago Press.
  19. Horowitz M.J. (1997). Psychoterapy for histrionic personality disorder. Journal of Psychoterapy Practice and Research, 6: 93-107.
  20. Kellett S. (2007), A time series evaluation of the treatment of histrionic personality disorder with cognitive analytic therapy. Psychology and Psychoterapy: Theory, Research and Practice, 80: 389-405. DOI: 10.1348/147608306X16142
  21. Liotti G. (1995). La dimensione interpersonale della coscienza. Roma: Carocci.
  22. Linehan M.M. (1993), Trattamento cognitivo-comportamentale del disturbo borderline (trad. it. Milano: Raffaello Cortina, 2001, nuova ed. ampliata 2011).
  23. Luborsky L., Crits-Christoph P. (1998), Understanding Transference. Washington DC: American Psychological Association.
  24. Millon T., Everly (1985). Personality and its disorders. New York: Wiley.
  25. Millon T. (1994). Personality disorders: Conceptual distinctions and classification issues. In: Costa P.T., Widiger T.A., editors, Personality disorders and the five factor, model of personality. Washington DC: American Psychological Association.
  26. Pepper C.M., Klein D.N., Anderson R.L., Riso L.P., Ovimette P.C., Lizardi H. (1995). DSMIII-R Axis II comorbidity in distymia and major depression. American Journal of Psychiatry, 152: 239-247.
  27. Reich J. (1987). Sex distribution of DSM-III personality disorders in psychiatric out patients. American Journal of Psychiatry, 144: 181-187.
  28. Safran J.D., Muran J.C. (2000). Negotiating the therapeutic alliance. A relational treatment guide. New York: Guilford Press.
  29. Safran J.D., Muran J.C. (2003). Teoria e pratica dell’alleanza terapeutica (trad. it.: Roma-Bari: Laterza, 2000).
  30. Semerari A., Carcione A., Dimaggio G., Nicolò G., Pedone R., Procacci M. (2005), Metarepresentive functions in Borderline Personality Disorder. Journal of Personality Disorders, 19: 690-710. DOI: 10.1521/pedi.2005.19.6.690SemerariA,DimaggioG.,NicolòG.,ProcacciM.,CarcioneA.(2007).Understandingminds:differentfunctionsanddifferentdisorders?Thecontributionofpsychotherapeuticresearch.PsychotherapyResearch,17:106-119.doi:10.1080/1050330050053695
  31. Shapiro D. (1965), Neurotic Styles. New York: Basic Books.
  32. Van Valkenberg, C., Lilienfeld S.O., Larntz K., Akiskal H.S. (1986). The relationship of histrionic personality disorder to antisocial personality disorder and somatization disorders. American Journal of Psychiatry, 143: 718-722.
  33. Young J.E., Klosko I.S., Weishoar M.E. (2003). Schema therapy: A pratictioner’s guide. New York: Guilford Press.

Giancarlo Dimaggio, Marcella Toma, Giampaolo Salvatore, Donatella Fiore, Luisa Buonocuore, La terapia metacognitivo-interpersonale per ridurre la disregolazione emotiva, migliorare le funzioni metacognitive, e favorire la modificazione degli schemi sé-altro nel disturbo istrionico di personalità complicato in "QUADERNI DI PSICOTERAPIA COGNITIVA" 33/2013, pp 91-113, DOI: 10.3280/QPC2013-033007