Changes in the mental representations of relational behavior in depressive patients

Groß, Sarah; Stasch, Michael; Schmal, Helmut; Hillenbrand, Erwin; Cierpka, Manfred

doi:10.1080/10503300701320629

Cited by 4 publications

(5 citation statements)

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“…Subjects received no instruction to regulate their emotions, but were instructed to allow spontaneous thoughts, emotions and memories come to mind. According to the logic of the OPD Axis II, the four sentences comprising the dysfunctional interpersonal relation form one complex that should activate a specific and disorder-related mental representation [13] . Therefore, the four sentences were modelled as a whole in fMRI analyses.…”

Section: Methodsmentioning

confidence: 99%

“…In order to further enhance the ecological validity of neuroimaging studies of depression, the aim of the current investigation was to expose patients with depression to individually tailored stimuli that specifically activate one significant component leading to or maintaining their depression [13] . Most depressive patients have dysfunctional interpersonal relations as a main feature of their disorder.…”

Section: Introductionmentioning

confidence: 99%

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Individualized and Clinically Derived Stimuli Activate Limbic Structures in Depression: An fMRI Study

et al. 2011

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ObjectivesIn the search for neurobiological correlates of depression, a major finding is hyperactivity in limbic-paralimbic regions. However, results so far have been inconsistent, and the stimuli used are often unspecific to depression. This study explored hemodynamic responses of the brain in patients with depression while processing individualized and clinically derived stimuli.MethodsEighteen unmedicated patients with recurrent major depressive disorder and 17 never-depressed control subjects took part in standardized clinical interviews from which individualized formulations of core interpersonal dysfunction were derived. In the patient group such formulations reflected core themes relating to the onset and maintenance of depression. In controls, formulations reflected a major source of distress. This material was thereafter presented to subjects during functional magnetic resonance imaging (fMRI) assessment.ResultsIncreased hemodynamic responses in the anterior cingulate cortex, medial frontal gyrus, fusiform gyrus and occipital lobe were observed in both patients and controls when viewing individualized stimuli. Relative to control subjects, patients with depression showed increased hemodynamic responses in limbic-paralimbic and subcortical regions (e.g. amygdala and basal ganglia) but no signal decrease in prefrontal regions.ConclusionsThis study provides the first evidence that individualized stimuli derived from standardized clinical interviewing can lead to hemodynamic responses in regions associated with self-referential and emotional processing in both groups and limbic-paralimbic and subcortical structures in individuals with depression. Although the regions with increased responses in patients have been previously reported, this study enhances the ecological value of fMRI findings by applying stimuli that are of personal relevance to each individual's depression.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Individualized and Clinically Derived Stimuli Activate Limbic Structures in Depression: An fMRI Study

et al. 2011

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“…Os padrões relacionais disfuncionais caracterizados por formas de relacionamento limitadas, pouco flexíveis e estereotipadas provocam tensão e geram conflito. Por exemplo, os casos depressivos caracterizados pela pressão social, redução das capacidades sociais e limitada capacidade para formar e manter relações traduzem-se pela inibição de impulsos agressivos, altruísmo, submissão e auto desvalorização (Gross et al, 2007). A mudança nos padrões relacionais implica portanto uma redução ou alteração nos conflitos externos e internos da paciente.…”

Section: Discussionunclassified

“…O processo de orientação do diagnóstico, segundo o manual OPD Task Force (2008), visa a formulação, identificação e planeamento do tratamento -descrever as principais problemáticas, identificar os recursos e competências do paciente -, para além de ser uma ferramenta de avaliação de mudança na análise de estudos empíricos de processos e resultados terapêuticos (Schneider, Mendler, Heuft & Burgmer, 2008). O OPD-2 na última década tem sido fundamentalmente aplicado em estudos que comprovam a validade e fiabilidade do instrumento (Cierpka, Stasch, Dahlbender & Grupo de Trabajo OPD, 2006;Cierpka, Grande, Rudolf, von der Tann & Stasch, 2007;Schneider et al, 2008;Gross, Stasch, Schmal, Hillenbrand & Cierpka, 2007).…”

Section: Introductionunclassified

Operacionalização Psicodinâmica de Diagnóstico (OPD-2) numa psicanálise

Paulo

Pires

2013

Psicol. clin.

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A investigação em psicoterapia psicanalítica é apontada como tendo um elevado nível de abstração, falta de clareza e de consenso entre os clínicos na operacionalização de constructos e na análise de resultados fiáveis. Um diagnóstico psicodinâmico rigoroso e fiável que permita uma homogeneização de critérios de avaliação aumenta a comunicação dentro da comunidade científica e aproxima a investigação à prática. O OPD2 - Operationalized Psychodynamic Diagnosis - objetiva operacionalizar os constructos psicanalíticos, através de entrevistas semiestruturadas, e formular um diagnóstico psicodinâmico multiaxial baseado em 5 eixos: experiência da doença e pré-requisitos para o tratamento (Eixo I); relações interpessoais (Eixo II); conflito (Eixo III); estrutura (Eixo IV); perturbações mentais e psicossomáticas (Eixo V). O OPD-2 foi aplicado neste estudo com o objetivo de testar a avaliação diagnóstica através de notas de sessões numa paciente seguida em psicanálise. A realização do diagnóstico multiaxial foi, de uma forma geral, bem-sucedida e registraram-se mudanças nos focos formulados no diagnóstico.

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“…Regarding the dysfunctional relational pattern , many studies have shown that they are a major reason why patients seek help ( Strupp and Binder, 1991 ). They are also fundamental to psychotherapy because a change in the patient’s mental representations result in a more flexible way of dealing with others, in turn providing more satisfaction with their interpersonal relationships ( Cierpka et al, 2007 ; Gross et al, 2007 ). The OPD evaluates the relational pattern as a circular matrix of interaction and stands apart from other instruments because of its comprehensiveness, intermediate complexity, and inclusion of the interviewer’s subjective experience in the identification of the interactional pattern ( Dagnino, 2012 ).…”

Section: Introductionmentioning

confidence: 99%

Tracking Psychodynamic Foci: Trajectories Through the Therapeutic Process

Dagnino

Calderón²

2022

Front. Psychol.

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Brief psychodynamic psychotherapy has gained importance in current clinical practice. To achieve brevity, a focus must be established and worked through. Different conceptualizations have emphasized the relational patterns and/or conflict foci as central but adopting a mono-schematic approach. However, patients come to treatment with more than one issue that must be addressed. Thus, another focus must be included because of its relevance, i.e., personality functioning. The aims of this study were to identify the presence and depth level of three foci (relational pattern, conflict, and personality functioning) in episodes of change throughout the process, and to evaluate the relationship of each focus with the complexity of patients’ change. Initial OPD foci and the presence and depth of each were evaluated in 13 successful brief psychodynamic therapies. Change episodes of those therapies were analyzed as well. Results showed differences between foci in the initial phase with a higher presence of conflict focus. Throughout the process, only the presence and level of personality functioning improved. Also, complexity of patients’ change was related to conflict focus, specifically on the emergence of competence feelings. The results provide evidence and enrich process research of brief psychodynamic therapies.

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Changes in the mental representations of relational behavior in depressive patients

Cited by 4 publications

References 22 publications

Individualized and Clinically Derived Stimuli Activate Limbic Structures in Depression: An fMRI Study

Individualized and Clinically Derived Stimuli Activate Limbic Structures in Depression: An fMRI Study

Operacionalização Psicodinâmica de Diagnóstico (OPD-2) numa psicanálise

Tracking Psychodynamic Foci: Trajectories Through the Therapeutic Process

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