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1 – 10 of 309Anna Mooney, Naomi Crafti and Jillian Broadbear
Borderline personality disorder (BPD) is a debilitating illness characterised by a pervasive pattern of emotional instability, interpersonal difficulties and impulsive behaviour…
Abstract
Purpose
Borderline personality disorder (BPD) is a debilitating illness characterised by a pervasive pattern of emotional instability, interpersonal difficulties and impulsive behaviour in association with repeated self-injury and chronic suicidal ideation. People diagnosed with BPD also have high rates of co-occurring psychopathology, including disorders associated with disturbed impulse control, such as substance use disorder (SUD) and disordered eating behaviours. The co-occurrence of BPD and impulse control disorders contributes to the severity and complexity of clinical presentations and negatively impacts the course of treatment and recovery. This study qualitatively documents aspects of the lived experience and recovery journeys of people diagnosed with BPD and co-occurring SUD and/or disordered eating. This study aims to identify similarities with respect to themes reported at different stages of the recovery process, as well as highlight important factors that may hinder and/or foster recovery.
Design/methodology/approach
In-person, in-depth, semi-structured interviews were conducted with 12 specialist service consumers within a clinical setting. Ten women and two men (22–58 years; mean: 35.5 years) were recruited. Interview transcripts were analysed using thematic analysis principles.
Findings
As expected, participants with co-occurring disorders experienced severe forms of psychopathology. The lived experience descriptions aligned with the proposition that people with BPD engage in impulsive behaviours as a response to extreme emotional states. Key emergent themes and sub-themes relating to recovery comprised three domains: factors hindering adaptive change; factors assisting adaptive change and factors that constitute change. An inability to regulate negative affect appears to be an important underlying mechanism that links the three disorders.
Practical implications
This study highlights the potential shortcomings in the traditional approach of treating co-occurring disorders of BPD, SUD and eating disorders as separate diagnoses. The current findings strongly support the adoption of an integrative approach to treating complex mental health issues while concurrently emphasising social connection, support and general health and lifestyle changes.
Originality/value
The findings of this study contribute to the burgeoning BPD recovery literature. A feature of the current study was its use of in-depth face-to-face interviews, which provided rich, many layered, detailed and nuanced data, which is a major goal of qualitative research (Fusch and Ness, 2015). Furthermore, the interviews were conducted within a safe clinical setting with engagement facilitated by a clinically trained professional. There was also a genuine willingness among participants to share their stories in the belief that doing so would inform effective future clinical practice. Their willingness and engagement as participants may reflect their progress along the path to recovery in comparison to others with similar diagnoses. Finally, most of the interviewees were engaging in dialectical behavioural therapy (DBT)-style therapies; two were receiving mentalisation-based therapy treatment, and most had previously engaged in cognitive behavioural therapy or acceptance and commitment therapy-based approaches. The predominance of DBT-style therapy may have influenced the ways that themes were articulated. Future studies could supplement this area of research by interviewing participants receiving therapeutic interventions other than DBT for the treatment of BPD and heightened impulsivity.
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Tinna Dögg Sigurdardóttir, Adrian West and Gisli Hannes Gudjonsson
This study aims to examine the scope and contribution of Forensic Clinical Psychology (FCP) advice from the National Crime Agency (NCA) to criminal investigations in the UK to…
Abstract
Purpose
This study aims to examine the scope and contribution of Forensic Clinical Psychology (FCP) advice from the National Crime Agency (NCA) to criminal investigations in the UK to address the gap in current knowledge and research.
Design/methodology/approach
The 36 FCP reports reviewed were written between 2017 and 2021. They were analysed using Toulmin’s (1958) application of pertinent arguments to the evaluation process. The potential utility of the reports was analysed in terms of the advice provided.
Findings
Most of the reports involved murder and equivocal death. The reports focused primarily on understanding the offender’s psychopathology, actions, motivation and risk to self and others using a practitioner model of case study methodology. Out of the 539 claims, grounds were provided for 99% of the claims, 91% had designated modality, 62% of the claims were potentially verifiable and 57% of the claims were supported by a warrant and/or backing. Most of the reports provided either moderate or high insight into the offence/offender (92%) and potential for new leads (64%).
Practical implications
The advice provided relied heavily on extensive forensic clinical and investigative experience of offenders, guided by theory and research and was often performed under considerable time pressure. Flexibility, impartiality, rigour and resilience are essential prerequisites for this type of work.
Originality/value
To the best of the authors’ knowledge, this study is the first to systematically evaluate forensic clinical psychology reports from the NCA. It shows the pragmatic, dynamic and varied nature of FCP contributions to investigations and its potential utility.
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Kim Lie Sam Foek-Rambelje, Kirsten Copier, Robert Didden, Esmay Haacke, Paul van der Heijden and Jos Egger
This study aims to investigate the distinctive personality traits and characteristics of individuals with borderline intellectual functioning (BIF) and mild intellectual…
Abstract
Purpose
This study aims to investigate the distinctive personality traits and characteristics of individuals with borderline intellectual functioning (BIF) and mild intellectual disability (MID) within specialized centers for MID-BIF treatment and care compared with individuals without MID-BIF diagnosis gathered from general mental health care (GMH) settings.
Design/methodology/approach
Patients classified with MID-BIF (n = 58), most with comorbid psychopathology, were thoroughly interviewed by trained clinicians who afterward completed the Shedler–Westen Assessment Procedure (SWAP-200) about the patient. The authors compared SWAP-200 profiles of MID-BIF patients with profiles of GMH individuals. In addition, the authors have compared these profiles for the MID and BIF groups (differentiated based on previously known intelligence quotient scores).
Findings
Results show significantly higher scores for the MID-BIF group than the GMH group on scales encompassing emotional instability, impulsivity and antagonism. On scales containing constraint and healthy traits, significantly lower scores were found for the MID-BIF group than for the GMH group. Importance of including SWAP-200 personality assessment for a more comprehensive understanding and treatment planning for individuals with MID-BIF is discussed.
Originality/value
This study offers insights into personality within individuals with an MID-BIF diagnosis, compared with individuals in a GMH setting.
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Scott A. Davis, Daniel Frayne, Jessica McSurdy, Annabel O. Franz and David Mark McCord
In the USA, integrated care remains largely aspirational; a majority of Americans receive mental health care entirely within the primary medical care outpatient setting. A new…
Abstract
Purpose
In the USA, integrated care remains largely aspirational; a majority of Americans receive mental health care entirely within the primary medical care outpatient setting. A new instrument, the Multidimensional Behavioral Health Screen (MBHS) ( McCord, 2020) was developed specifically to address this gap by systematically screening for a broad array of mental health issues in every patient, every visit. The goal of this current feasibility study was to evaluate the perceptions of the primary medical care providers regarding the usefulness and practicality of the MBHS, a necessary step toward broad-based implementation.
Design/methodology/approach
The MBHS was given to 101 consenting patients in a primary medical outpatient setting, each of whom was then seen by one of six participating primary care providers (PCPs). Providers completed a brief survey rating the ease of use, understandability, helpfulness and perceived accuracy of the MBHS after each patient visit and a final summary survey at the conclusion of the study.
Findings
Ratings were very positive overall, and the MBHS was clearly preferred to the traditional screening measures (Patient Health Questionnaire-9 [PHQ-9] and Generalized Anxiety Disorder-7 [GAD-7]). Providers offered suggestions for improvement and particularly for implementation.
Research limitations/implications
The small sample size (101 patients and 6 PCPs) and limited geographical reach may limit generalizability. Surveying providers using similar methodology should be done with larger numbers of providers and more diverse primary medical care settings.
Practical implications
This study provides evidence that the MBHS may be significantly effective in operationalizing the integrated care model in United States (US) healthcare systems.
Social implications
The MBHS, a new behavioral health screening tool, was perceived by providers as useful in identifying mental health issues and guiding treatment decisions in the primary care setting.
Originality/value
This paper identifies a novel screening instrument that implements new and emerging models of psychological dysfunction in a practical way in primary medical care, making integrated care a reality rather than an aspiration.
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Lisa H. Rosen, Shannon Scott and Briana E. Paulman
This study aims to examine whether peer victimization predicted disordered eating behaviors during emerging adulthood, and if this relationship was mediated by perceived stress.
Abstract
Purpose
This study aims to examine whether peer victimization predicted disordered eating behaviors during emerging adulthood, and if this relationship was mediated by perceived stress.
Design/methodology/approach
Participants included undergraduate females from a diverse university in the Southwestern USA who reported on their experiences of peer victimization, perceived stress and eating behaviors.
Findings
Mediation analysis revealed that perceived stress partially mediated the association between peer victimization and perceived stress. Peer victimization significantly predicted eating behaviors even after controlling for perceived stress. An exploratory analysis of the EAT-26 subscales was also conducted.
Research limitations/implications
The present study adds to the literature on peer victimization, eating behaviors and stress by allowing researchers to understand the complexity of these relationships within an emerging adulthood population. The present results can assist individuals working with this population in interventions to prevent instances of victimization, reduce stress and provide psychoeducation for eating disorders.
Originality/value
The present study adds to the literature on peer victimization, eating behaviors and stress by allowing researchers to understand the complexity of these relationships within a college population.
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José Muller-Dugic, Pascal Beckers and Mario Braakman
Syrian refugees in the Netherlands frequently suffer from mental health problems. It is argued that mental health not only consists of the absence of psychiatric disorders but…
Abstract
Purpose
Syrian refugees in the Netherlands frequently suffer from mental health problems. It is argued that mental health not only consists of the absence of psychiatric disorders but also of the presence of mental well-being. However, there is little attention to the mental well-being of refugees, and no intervention exists that focuses on fostering the mental well-being of refugees. Therefore, the new culturally sensitive positive psychology intervention “Mosaic” was developed and implemented in collaboration with the target audience and local partners. Mosaic is offered in the Arabic language, and the content is focused on (re)finding purpose in life and (re)discovering life values and subsequently acting upon these values. The purpose of this study is to assess the effect of Mosaic on the mental well-being of Syrians in the Netherlands.
Design/methodology/approach
The effect of Mosaic on the mental well-being of Syrians in the Netherlands is assessed by conducting a randomized controlled trial (RCT) with a waitlist control group.
Findings
Postintervention within sample t-tests showed that the intervention group (n = 66) experienced significantly more overall mental well-being, emotional well-being and purpose in life right after participating in the intervention when compared to the preintervention measurement. The effect on purpose in life persisted six months later. These improvements were not found among the control group (n = 60).
Originality/value
Mosaic is the first positive psychology intervention in the Netherlands that was developed for and in collaboration with Syrian refugees. To the best of the authors’ knowledge, this study is also the first study in the Netherlands and one of the first ones in Europe that assesses the effect of positive psychology for refugees specifically.
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This review aims to examine the literature on refugees’ and asylum seekers’ resilience, its historical evolution, key principles, assumptions and recommendations, while focusing…
Abstract
Purpose
This review aims to examine the literature on refugees’ and asylum seekers’ resilience, its historical evolution, key principles, assumptions and recommendations, while focusing on the Canadian context.
Design/methodology/approach
A narrative literature review has been applied to this manuscript. This approach allows the integration of a wide scope of literature and perspectives, from academic literature to grey literature (e.g. governmental reports and dissertations). Nevertheless, the limitations of this type of review were also discussed.
Findings
In spite of the gaining popularity of the resilience lens, which emphasizes an individual’s ability to overcome adversities and stressful events, more work is required for its effective integration into health practice, programs and policies, particularly as it relates to refugees’ and asylum seekers’ mental health care.
Originality/value
Careful consideration of refugees’ and asylum seekers’ mental health needs and Canadian mental health service delivery and policies is a critical first step in reaching such a goal.
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Michelle Y. Martin Romero, Dorcas Mabiala Johnson, Esther Mununga and Gabriela Livas Stein
This paper aims to explore the intersection of cultural processes and immigration in parental understanding of adolescent mental health and mental health seeking behaviors among…
Abstract
Purpose
This paper aims to explore the intersection of cultural processes and immigration in parental understanding of adolescent mental health and mental health seeking behaviors among African immigrants in Western countries. The present study examines the perspectives of Congolese immigrant parents on adolescent mental health in Brussels, Belgium, and Raleigh, North Carolina, USA – two geographic regions with relatively large Congolese migrant populations. This study highlights a needed understanding of cultural and acculturative context in shaping the beliefs of Congolese immigrants and explores potential barriers of seeking health services. Additionally, it recognizes health issues among this underrepresented and underserved population.
Design/methodology/approach
Fifteen Congolese immigrant parents, eight in the USA and seven in Belgium, participated in structured qualitative interviews using an adapted version of Kleinman Questions and behavioral scenarios on depression, post-traumatic stress disorder and oppositional defiant disorder. Interviews were audio recorded, and participants were assigned pseudonyms to de-identify responses. English interviews were transcribed verbatim by a trained team of undergraduate research assistants, and French interviews were transcribed verbatim by the first author and a graduate research assistant. Following transcription, the first and second authors used a rapid analytic approach (Hamilton, 2013). The first and second authors conducted a matrix analysis to observe thematic patterns.
Findings
Parents interpreted adolescent behavior to be more problematic when the scenarios were overtly outside of their cultural realm of values and beliefs. Parents preferred methods of intervention through religious practices and/or family and community efforts rather than seeking mental health services in their host countries as a secondary option. The authors’ findings provide an understanding of the values and beliefs of this underrepresented demographic, which may be useful to guide health professionals on how to support this community in a culturally responsive way.
Research limitations/implications
Limitations to the current study include the structured nature of the interview guide that did not allow for in-depth qualitative exploration. Interviewed participants had lived in their host countries for more than 10+ years. Thus, the authors’ findings are not reflective of new immigrants’ experiences. Parents’ perspectives were likely shaped by exposure to Western beliefs related to support for mental health (e.g. knowledge of psychologists). Future studies should focus on recent refugees due to exposure to traumatic events and experiences reflective of the Democratic Republic of Congo’s (DRC’s) current socio-political situation, and how these are understood in the context of adolescent mental health. Further, due to the hypothetical nature of the scenarios, the authors cannot be sure that participants would engage in the identified approaches with their children. Additionally, hearing from the youth’s perspective would provide a clearer insight on how mental health and seeking professional help is viewed in a parent–child relationship. Finally, the data for this study were collected in 2019, prior to the COVID-19 pandemic. Although the authors cannot speak directly to Congolese refugee and immigrant experiences during this significant historical period, given the rise in mental health concerns in refugee populations more broadly (Logie et al., 2022), the authors’ findings speak to how parents may have responded to increased mental health symptoms and point to additional barriers that these populations may have faced in accessing support. The authors’ study emphasizes the need for dedicating resources and attention to this population, especially the development of culturally tailored messaging that invites community members to support the mental health needs of their community.
Practical implications
The authors’ findings provide important implications for mental health professionals. This study provides a clearer understanding of how Congolese immigrant parents view mental health and help-seeking within their cultural frame. Although parents may seek professional help, a distrust of mental health services was expressed across both cohorts. This suggests that mental health professionals should acknowledge potential distrust among this population and clarify their role in supporting the mental health of adolescent immigrants. Clinicians should inquire about familial cultural beliefs that are parent- and child-centered and modify their interventions to fit these belief structures.
Originality/value
This paper addresses the gap in knowledge about mental health perspectives of Sub-Saharan African immigrant populations, specifically those from the DRC.
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The purpose of this paper was to explore the development of the professional identity of South African intern psychologists during the COVID-19 pandemic. This paper – that…
Abstract
Purpose
The purpose of this paper was to explore the development of the professional identity of South African intern psychologists during the COVID-19 pandemic. This paper – that presents a historical reflection borne from a significant moment in time – aimed to capture what the authors can learn from this specific cohort of intern psychologists and their experiences of work-based learning.
Design/methodology/approach
Through the lens of the interpretative phenomenological approach, the authors analysed seven semi-structured interviews. Data analysis involved a line-by-line analysis of each individual transcript, where after a thorough, in-depth analysis was conducted across all the cases.
Findings
Against the background of the COVID-19 pandemic, the findings demonstrated the interns' initial uncertainties, severe exhaustion, perceived gaps in their training, and resilience despite unusual and difficult circumstances in their WBL internship.
Research limitations
The study was limited to seven intern psychologists in South Africa.
Practical implications
The findings suggest that support – during and after the COVID-19 pandemic – is crucial throughout the training of psychologists and means to facilitate and develop professional identity and resilience. This will provide the opportunity to safeguard emerging healthcare professionals from burnout while simultaneously advocating for supportive WBL and continual professional development spaces protecting healthcare professionals and the public.
Originality/value
With this article, we explored the impact of the COVID-19 pandemic on the professional identity development of intern psychologists (psychologists in training). The authors expand on the aforementioned original contribution, since the authors situate their research within the Global South. More specifically, the authors explored how intern psychologists' developed their professional identities against the backdrop of a largely resource-scarce context of South Africa.
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