Treating personality disorder after dsm 5 era. hot topics and compairing models

Journal title PSICOBIETTIVO
Author/s Giuseppe Nicolò, Antonino Carcione
Publishing Year 2014 Issue 2014/2
Language Italian Pages 17 P. 29-45 File size 556 KB
DOI 10.3280/PSOB2014-002003
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Patients with Personality Disorders despite being one of the biggest challenges for mental health services (up about 15% of the clinical population) rarely receive a complete and integrated treatment as provided by the literature, they are usually treated with a pharmacological approach to reduce symptoms. This paper will discuss the publication of the DSM 5 and its implication in treatment, in particular the pattern of treatment of Terzocentro of Cognitive Psychotherapy in Rome that promoted the research on meta-cognition and on severe patients will be described and analyzed.

Keywords: Personality Disorders; DSM 5; Meta-cognition; Interpersonal Meta-cognitive Psychotherapy; Integrated Treatment.

  1. Akiskal H.S., Chen S.E., Davis G.C. et al. (1985) “Borderline: an adjective in search of a noun”, J. Clin. Psychiatry, 46: 41-48
  2. Akiskal H.S. (2007) “The emergence of the bipolar spectrum: validation along clinical-epidemiologic and familial-genetic lines”, Psychopharmacology Bullettin, 40(4): 99-115.
  3. American Psychiatric Association (1980) Diagnostic and Statistical Manual of Mental Disorder. Third Edition, American Psychiatric Association, Washington, DC
  4. American Psychiatric Association (2000) Diagnostic and Statistical Manual of Mental Disorder. Fourth Edition (4th reversion), American Psychiatric Association, Washington, DC
  5. American Psychiatric Association (2013) Diagnostic and Statistical Manual of Mental Disorder. Fifth Edition (DSM 5) (5th reversion), American Psychiatric Association, Washington, DC
  6. Angst J., Gamma A., Lewinsohn P. (2002) “The evolving epidemiology of bipolar disorder”, World Psychiatry, 1(3): 146-8
  7. Baron-Cohen S., Wheelwright S., Hill J., Raste Y., Plumb I. (2001) The “Reading the Mind in the Eyes”. Test revised version: a study with normal adults, and adults with Asperger syndrome or high-functioning autism
  8. Bateman A.W., Fonagy P. (2000) “Effectiveness of psychotherapeutic treatment of personality disorders”, British Journal of Psychiatry, 177: 138-143
  9. Bateman A.W., Fonagy P. (2004) “Mentalization-based treatment of BPD”, Journal Pers Disord., 18(1): 36-51
  10. Baron-Cohen S., Leslie A.M., Frith U. (1985) “Does the autistic child have a ‘theory of mind’?”, Cognition, 21: 37-46
  11. Baus N., Fischer-Kern M., Naderer A., Klein J., Doering S., Pastner B.,
  12. Leithner-Dziubas K., Plener P.L., Kapusta N.D. (2014) “Personality
  13. organization in borderline patients with a history of suicide attempts”, Psychiatry Res., 5
  14. Beck A.T., Freeman A. et al. (1990) Terapia cognitiva dei disturbi della personalità, Mediserve, Firenze, 1993 Blum N., St. John D., Pfohl B. et al. (2008) “Systems Training for Emotional Predictability and Problem Solving (STEPPS) for outpatients with borderline personality disorder: a randomized controlled trial and 1-year follow-up”, Am. J. Psychiatry, 165: 468-78
  15. Bowlby J. (1969) Attaccamento e perdita: l’attaccamento alla madre, Bollati Boringhieri, Torino, 1989
  16. Carcione A., Falcone M., Magnolfi G., Manaresi F. (1997) “La funzione metacognitiva in psicoterapia: Scala di Valutazione della Metacognizione (S.Va.M.)”, Psicoterapia, 9: 91-107
  17. Carcione A., Falcone M. (1999) “Il concetto di metacognizione come costrutto clinico fondamentale per la psicoterapia”, in Semerari A. (a cura di), Psicoterapia cognitiva del paziente grave, Raffaello Cortina, Milano
  18. Clark L.A. (2013) “A Critique of Gunderson’s Views of DSM 5: Commentary on ‘Seeking Clarity for Future Revisions of the Personality Disorders in DSM 5’”, Personality Disorders: Theory, Research, and Treatment, 4, 4, 379-380
  19. Clark L.A., Livesley W.J., Morey L. (1997) “Personality disorder assessment: The challenge of construct validity”, Journal of Personality Disorders, 11: 205-231
  20. Conte H.R., Plutchik R., Jung B.B., Picard S., Karasu T.B., Lotterman A.
  21. (1990) “Psychological mindedness as a predictor of psychotherapy outcome: a preliminary report”, Compr. Psychiatry, 31(5): 426-431
  22. Dimaggio G., Nicolò G., Semerari A., Carcione A. (2013) “Investigating the personality disorder psychotherapy process: The roles of symptoms, quality of affects, emotional dysregulation, interpersonal processes, and mentalizing”, Psychother Res., 23(6): 624-32
  23. Fairbairn W.R.D. (1952) Studi Psicoanalitici Sulla Personalità, Bollati Boringhieri, Torino, 1970
  24. Glenn C.R., Klonsky E.D. (2013) “Nonsuicidal self-injury disorder: an empirical investigation in adolescent psychiatric patients”, J. Clin. Child Adolesc. Psychol., 42(4): 496-507
  25. Fonagy P. (1991) “Thinking about thinking: some clinical and theoretical considerations in the treatment of a borderline patient”, International Journal of PsychoAnalysis, 72: 639-656
  26. Fonagy P., Target M., Steele H., Steel M. (1998) Reflective-Functioning Manual version 5 for application to Adult Attachment Interviews, on line manual
  27. Fonagy P., Gergely G., Elliot L. Jurist, Target M. (2002) Affect Regulation, Mentalization, and the Development of the Self, Other Press, New York
  28. Gumley A. (2011) “Metacognition, affect regulation and symptom expression: a transdiagnostic perspective”, Psychiatry Res., 30, 190(1): 72-78
  29. Gunderson J.G. (2013) “Seeking Clarity for Future Revisions of the Personality Disorders in DSM 5”, Personality Disorders: Theory, Research, and Treatment, 4, 4: 368-37
  30. Gunderson J.G., Daversa M.T., Grilo C.M. et al. (2006) “Predictors of 2-year outcome for patients with borderline personality disorder”, Am. J. Psychiatry, 163: 822-26 Jellema A. (2000) “Insicure Attachment States: Their relationship to Borderline and Narcissistic Personality Disorders and treatment process in Cognitive
  31. Analytic Therapy”, Clinical Psychology and Psychotherapy, 7: 138-154
  32. Pellecchia G., Moroni F., Carcione A., Colle L., Dimaggio G., Nicolò G., Semerari A. (2013) “Metacognition Assessment Interview: Instrument
  33. description and factor structure”, articolo proposto per la pubblicazione
  34. Haslam N. (2011) “The latent structure of personality and psychopathology: A review of trends in taxometric research”, The Scientific Review of Mental Health Practice: Objective Investigations of Controversial and Unorthodox Claims in Clinical Psychology, Psychiatry, and Social Work, 8: 17-29
  35. Hemphälä M., Hodgins S. (2014) “Do psychopathic traits assessed in mid-adolescence predict mental health, psychosocial, and antisocial, including criminal outcomes, over the subsequent 5 years?”, Can. J. Psychiatry, 59(1): 40-9
  36. Hopwood C.J., Wright A.G., Donnellan M.B. (2011) “Evaluating the Evidence for the General Factor of Personality across Multiple Inventories”, J. Res Pers., 45(5): 468-478
  37. Horowitz M.J. (1987) States of mind. Configurational analysis of individual psychology 2nd edition, Plenum Press, New York.
  38. Horowitz M.J. (1991) “Hysterical personality style and the histrionic personality disorder”, in Sperber D. (2000). Metarepresentations, Oxford Univeristy Press, Oxford
  39. Jeremy D. (1984) “Assessing the cognitive-interpersonal cycle”, Cognitive Therapy and Research, 8, 4: 333-347
  40. Krueger R.F., Derringer J., Markon K.E., Watson D., Skodol A.E. (2012) “Initial construction of a maladaptive personality trait model and inventory for DSM 5” Psychological Medicine, 42: 1879-1890
  41. Lenzenweger M.F. (2012) “Facts, artifacts, mythofacts, invisible colleges, illusory colleges: the perils of publication segmentation, citation preference, and megamultiple authorship: a commentary on Blashfield and Reynolds”, J. Pers. Disord., 26(6): 841-847
  42. Leslie A.M. (1987) “Pretense and representation: the origin of ‘theory of mind’”, Psychological Review, 94: 412-426
  43. Linehan M.M. (1993a) Cognitive Behavioral Treatment of Borderline Personality Disorder, Guilford Press, New York
  44. Linehan M.M. (1993b) Skills training manual for treating borderline personality disorder, Guilford Press, New York
  45. Livesley J. (2012) “Integrated treatment: a conceptual framework for evidencebased approach to the treatment of personality disorders”, Journal of Personality disorders, 26: 17-42
  46. Luborsky L., Crits-Cristoph P. (1990) Capire il transfert, Raffaello Cortina, Milano, 1992
  47. Markus H., Nurius P. (1986) “Possible selves”, American Psychologist, 41: 954-959
  48. Main M. (1991) “Metacognitive knowledge, metacognitive monitoring and singular (coherent) vs multiple (incoherent) models of attachment. Findings and directions for future research”, in Harris P.J., Stevenson-Hinde J., Parkes C. (eds.), Routledge, New York
  49. McMain S.F., Guimond T., Streiner D.L., Cardish R.J., Links P.S. (2012) “Dialectical behavior therapy compared with general psychiatric management for borderline personality disorder: clinical outcomes and functioning over a 2-year follow-up”, Am. J. Psychiatry, 169(6): 650-61
  50. Mullins-Sweatt S.N., Bernstein D.P., Widiger T.A. (2012) “Retention or deletion of personality disorder diagnoses for DSM 5: An expert consensus approach”, Journal of Personality Disorders, 26: 689-703
  51. Nicolò G., Procacci M., Fiore D. (2012) “Il trattamento territoriale dei disturbi di personalità”, in Nicolò G., Pompili E., Manuale di Psichiatria Territoriale, Pacini Editore, Pisa
  52. Pedone R., Semerari A, Riccardi R., Nicolò G., Procacci M., Carcione A. (2013) “Measuring metacognition. Construct validation of the Metacognition Self-Assessment Scale (MSAS): a preliminary investigation in a non clinical sample”, articolo proposto per la pubblicazione
  53. Perris C., Skagerlind L. (1998) “An integrated, multilevels, metacognitive approach to the treatment of patients with schizophrenic disorder or a severe personality disorder”, in Perris C., McGorry P.D. (eds.), Cognitive psychotherapy of psychotic and personality disorders, John Wiley e Sons, Chichester
  54. Ramos V., Canta G., De Castro F., Leal I. (2013) “Discrete Subgroups of Adolescents Diagnosed With Borderline Personality Disorder: A Latent Class Analysis of Personality Features”, J. Pers. Disord., 17
  55. Ryle A. (1997) Cognitive analytic therapy and borderline personality disorder: the model and the method, John Wiley e Sons, Chichester Safran J.D., Muran J.C. (2000) Negotiating the therapeutic alliance: a relational treatment guide, Guilford Book Review, New York
  56. Seganti A. (1995) La memoria sensoriale delle relazioni. Ipotesi verificabili di psicoterapia psicoanalitica, Bollati Boringhieri, Torino
  57. Semerari A. (1999) Psicoterapia cognitiva del paziente grave, Raffaello Cortina, Milano
  58. Semerari A., Carcione A., Dimaggio G., Falcone M., Nicolò G., Procacci M. (2003) “Assessing Problematic States in patients’ narratives: the grid of problematic states”, Psychotherapy Research, 13: 337-353
  59. Semerari A., Carcione A., Dimaggio G., Falcone M., Nicolò G., Procacci M., Alleva G. (2003) “How to evaluate Metacognitive Functioning in Psychotherapy? The Metacognition Assessment Scale and its Applications”, Clinical Psychology and Psychotherapy, 10: 238-2616
  60. Semerari A., Carcione A., Dimaggio G., Nicoló G., Pedone R., Procacci M. (2005) “Metarepresentative functions in borderline personality disorder”, J. Pers. Disord., 19(6): 690-710
  61. Semerari A., Dimaggio G., Nicolò G., Procacci M., Carcione A. (2007) “Understanding minds, different functions and different disorders? The contribution of psychotherapeutic research”, Psychotherapy Research, 17: 106-119
  62. Semerari A., Dimaggio G., Nicolò G., Procacci M., Carcione A. (2007) “Understanding minds, different functions and different disorders? The contribution of psychotherapeutic research”, Psychotherapy Research, 17: 106-119
  63. Semerari A., Colle L., Pellecchia G., Buccione I., Carcione A., Dimaggio G., Nicolò G., Procacci M., Pedone R. (2014) “Metacognitive Dysfunctions in Personality Disorders: Correlations With Disorder Severity and Personality Styles”, J. Pers. Disord., Stoffers J.M., Völlm B.A., Rücker G., Timmer A., Huband N., Lieb K.
  64. (2012) “Psychological therapies for people with borderline personality disorder”, Cochrane Database Syst. Rev., 15
  65. Vinet E.V., Faúndez X., Larraguibel M. (2009) “Application of the Millon Adolescent Clinical Inventory (MACI) to adolescent drug abusers”, Rev. Med. Chil., 137(4): 466-74
  66. Volkan V., Kernberg O. (1976) Primitive Internalized Object Relations: A Clinical Study of Schizophrenic, Borderline, and Narcissistic Patients, International Universities Press, 1st edition (1976)
  67. Westen D., Defife J.A., Malone J.C., Dilallo J. (2014) “An empirically derived classification of adolescent personality disorders”, J. Am. Acad. Child Adolesc. Psychiatry, 53(5): 528-49

Giuseppe Nicolò, Antonino Carcione, Trattare i disturbi di personalità dopo il dsm 5. Problemi aperti e modelli a confronto in "PSICOBIETTIVO" 2/2014, pp 29-45, DOI: 10.3280/PSOB2014-002003