The role of maladaptive anger in self-criticism: A quasi-experimental study on emotional processes

Kramer, Uëli; Pascual‐Leone, Antonio

doi:10.1080/09515070.2015.1090395

Cited by 34 publications

(46 citation statements)

References 47 publications

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“…Pre-post treatment decrease in arousal was associated with symptom reduction, whereas the arousal peaked at both assessment points right after the imagery task in the behavioral assessment of emotional processing (sub-step 1 of the self-criticism task). This result is consistent with an earlier study using a similar assessment procedure (i.e., a two-chair dialogue for emotion-focused therapy; Kramer and Pascual-Leone (2016). This pattern -withinassessment increase in arousal and between-assessments decrease in arousal -has already been observed in research on emotional processing, using a repeated expressive writing paradigm for traumatic memories .…”

Section: Neurobehavioral Change In Bpd 18supporting

confidence: 91%

“…The second sub-step involves the patient adopting the stance of the inner self-critical voice and express self-criticism (from a different chair, the "self-critical" one), addressed to the self, as imagined on the initial chair (Whelton & Greenberg, 2005;Greenberg, 2002). The third sub-step involved for the patient (and back again on the initial chair) describes her current emotional reaction to the self-criticism (for a complete description of the two-chair dialogue used in research, see Kramer and Pascual-Leone (2016). This assessment lasted 30 minutes and was conducted pre-and post-therapy.…”

Section: Methodsmentioning

confidence: 99%

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Change in Emotional and Theory of Mind Processing in Borderline Personality Disorder

Kramer¹,

Kolly

Maillard³

et al. 2018

J Nerv Ment Dis

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Changes in emotion processing (EP) and in theory of mind (TOM) are central across treatment approaches for patients with borderline personality disorder (BPD). Whilst the assessment of EP relies on the observation patient's self-criticism in a two-chair dialogue, individual's TOM assessments is made based on responses to humorous stimuli based on false beliefs. For this pilot study, we assessed eight patients with BPD before and after a three-month long psychiatric treatment, using functional magnetic resonance imaging (fMRI) and behavioral tasks. We observed arousal increase within session of the two-chair dialogue (d = 0.36), paralleled by arousal decrease between sessions (d = 0.80). We found treatment associated trends for neural activity reduction in brain areas central for EP and TOM. Our exploratory findings using an integrative assessment procedure of changes in EP and TOM point towards evidence for treatment effects at the brain systems level related to behavioral modulation.

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Section: Neurobehavioral Change In Bpd 18supporting

confidence: 91%

Section: Methodsmentioning

confidence: 99%

Change in Emotional and Theory of Mind Processing in Borderline Personality Disorder

Kramer¹,

Kolly

Maillard³

et al. 2018

J Nerv Ment Dis

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“…It was shown that this process relates to healthy functioning and a good outcome from psychotherapy [34], in particular the flexibility of emotional experiences [47]. The relevance of this dynamic conception of emotion processing to BPD was supported in terms of change in anger processing [48] and in terms of change in undifferentiated global distress [27]. It was shown to also be of relevance in narcissistic and histrionic PDs [49,50].…”

Section: Mechanisms Of Change In Treatments For Borderline Personalitmentioning

confidence: 91%

“…This transformation conception may explain the resolution of harsh self-criticism, a central clinical feature of BPD [48,[51][52][53]. Whelton and Greenberg (2005) proposed a paradigm of studying emotion transformation related to self-criticism using the empty-chair dialogue.…”

Section: Mechanisms Of Change In Treatments For Borderline Personalitmentioning

confidence: 99%

Mechanisms of change in brief treatments for borderline personality disorder: a protocol of a randomized controlled trial

Kramer

Grandjean

Beuchat

et al. 2020

Trials

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Background: Borderline personality disorder (BPD) is one of the most frequent, most debilitating and lethal mental conditions and is associated with a serious burden of disease. Treatment for patients with BPD involves structured psychotherapy, and may involve brief psychiatric treatment as first-line intervention. No controlled study has assessed the effectiveness of such brief intervention. Whereas most psychotherapy studies in patients with BPD focus on the effectiveness of the intervention, we still lack an understanding of how and why these effects are produced from a patient process perspective. It is therefore of utmost importance to study the treatmentunderlying mechanisms of change. The present study plans to apply novel measurement methods for assessing change in two central psychobiological processes in BPD: emotion and socio-cognitive processing. The study uses theory-driven and ecologically valid experimental tasks, which take the patient's individual experience as the anchor, by integrating methodology from psychotherapy process and neurofunctional imagery research.Methods: The aim of this two-arm, randomized controlled study is to test the effects (i.e., symptom reduction) and the underlying mechanisms of change associated with a brief psychiatric treatment (10 sessions over 4 months), compared with treatment as usual. Participants (N = 80 patients with BPD) undergo assessments at four points (intake, 2 months, discharge, and 12-month follow up). In addition to symptom measures, individuals undergo a 2step assessment for the potential mechanisms of change (i.e., emotion and socio-cognitive processing): (1) behavioral and (2) (for a sub-sample) neurofunctional. We hypothesize that change in the mechanisms explains the treatment effects. Discussion: This study uses an easy-to-implement treatment of BPD, and a sophisticated assessment procedure to demonstrate the critical role of psychobiological change in emotion and socio-cognitive processing in brief treatments. It will help increase the effectiveness of brief treatment for BPD and help diminish the societal burden of disease related to BPD, in these early stages of treatment.(Continued on next page)

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“…In order to respond to the first implication above of a transdiagnostic approach to measurement of self‐contempt, Kramer and Pascual‐Leone () sought to assess self‐contempt as it appears during the clinical process, basing their criteria on prior work by Whelton and Greenberg (), Ekman and Friesen () and Gottman (). They used a 3‐point anchored Likert‐type scale, to be applied in session video as a continuous moment‐by‐moment assessment.…”

Section: Assessing Self‐contempt: Using Observation In Contextmentioning

confidence: 99%

Assessment of self‐contempt in psychotherapy: A neurobehavioural perspective

Kramer

Renevey

Pascual‐Leone

2020

Couns and Psychother Res

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Objective The aim of this methodological paper was to present self‐contempt, and its assessment, in a broad transdiagnostic framework of psychopathology and related to change in psychotherapy. Self‐contempt may be a central phenomenon in many psychological disorders. We outline methodological recommendations for the study of complex transdiagnostic phenomena which involve multilevel biobehavioural responses. Method We illustrate the assessment of self‐contempt as a complex transdiagnostic phenomenon with a study in which emotion‐eliciting two‐chair dialogues focused on the elaboration of self‐criticism, and an observer‐rated system was applied to assess each client's expressed self‐contempt at the moment of enacted self‐criticism. The client's own self‐contemptuous words were extracted from this self‐critical dialogue and then later presented as part of a functional magnetic resonance imaging paradigm. Results This assessment paradigm was applied to a brief treatment for clients with borderline personality disorder, and the results of pre–post change over time in markers of self‐contempt are presented. Conclusions The importance of the assessment of self‐contempt in an ecologically valid manner, by using individualised stimuli and taking into account multilevel activations, is discussed in the context of a transdiagnostic conception of psychopathology and in the context of change in psychotherapy.

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The role of maladaptive anger in self-criticism: A quasi-experimental study on emotional processes

Cited by 34 publications

References 47 publications

Change in Emotional and Theory of Mind Processing in Borderline Personality Disorder

Change in Emotional and Theory of Mind Processing in Borderline Personality Disorder

Mechanisms of change in brief treatments for borderline personality disorder: a protocol of a randomized controlled trial

Assessment of self‐contempt in psychotherapy: A neurobehavioural perspective

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