Transference-focused psychotherapy (TFP) is an evidence-based, psychodynamic psychotherapy empirically validated for patients with borderline personality disorder (BPD) and successfully adapted for the treatment of narcissistic personality disorder (NPD). Personality disorders are characterized by the behavioral and affective dysregulation associated with pathological identity formation. Based on contemporary object relations theory (ORT), the goal of TFP is symptom relief through improvement in self and interpersonal functioning. The TFP treatment frame, established through an initial contracting phase and combined with the therapist’s technical neutrality, facilitates activation, identification and containment of affectively charged perceptions of self and other. These perceptions, or object relations dyads, are repeatedly identified, labeled and explored through the interpretative process. Over the course of treatment, the patient’s capacity for affect containment and reflection improves and a better integrated, realistic sense of self develops consistent with healthier personality functioning. Utilizing a compilation of several patients, the treatment of NPD with TPF is described and the evidence for the efficacy of TFP for NPD is summarized.

Introduction: The purpose of this study is to understand the role of suicide literacy and suicide stigma in laypeople’s intention to recommend professional help in Korea. Additionally, the study focuses on the role of expressive suppression as a sociocultural factor. Methods: Participants read vignettes depicting either subclinical distress or suicidal ideation and answered questions measuring suicide literacy, stigma, and expressive suppression. Mediated moderation analyses were used to examine the interactions between these factors. Results: The result found the significant effect of emotional suppression. The mediating effect of suicide stigma on the relationship between suicide literacy and recommendation of professional help was significant for those who do not suppress their emotions. This result indicates that when individuals were not hesitant to express negative emotions, high suicide literacy lowered suicide stigma and led to more willingness to recommend professional help. Conclusions: The results showed that emotional suppression acts as a barrier deterring Koreans from professional help for their mental health. The findings underscore the importance of sociocultural factors such as emotional suppression in developing suicide prevention strategies.

Objectives: Perinatal psychopathology can be damaging. This study examined the strength of the associations between risk factors and all perinatal mood and anxiety disorder symptoms while assessing the mediating effect of experiential avoidance. Method: Participants ( N =246) completed assessments during pregnancy (28-32 weeks) and the postpartum (6-8 weeks). Structural equation modeling (SEM) was used to examine associations between risk factors and latent factors: Distress (composed of depression, generalized anxiety, irritability, and panic symptoms); Fear (social anxiety, agoraphobia, specific phobia, and obsessive-compulsive); and Bipolar (mania and obsessive-compulsive). Results: During pregnancy, past psychiatric history, anxiety sensitivity, maladaptive coping, and age were significant risk factors. In the postpartum, negative maternal attitudes and past psychiatric history were only risk factors for symptoms that composed Distress. Experiential avoidance mediated the relation between maladaptive coping and symptoms that composed Fear. Conclusion: It is important to assess for psychological risk factors starting in pregnancy. This study identified critical risk factors that are associated with the underlying commonality among perinatal mood and anxiety symptoms. Some of the risk factors as well as the mediator are malleable (negative maternal attitudes, experiential avoidance), creating new possibilities for prevention and treatment of perinatal mood and anxiety disorder symptoms.

Objective: Interpersonal difficulties are salient among those with a history of NSSI and precede NSSI urges and behaviors. Yet, limited research has focused on identifying which aspects of interpersonal stress may confer risk for NSSI. Method: The current study aimed to leverage data from two samples (combined n=206; n=114 with NSSI history) of participant-driven interviews regarding a recent interpersonal stressor to enhance the field’s knowledge of interpersonal difficulties in relation to NSSI risk. Results: Using topic modeling to extract thematic information, analyses identified four main topics: daily difficulties; family members; adjectives/verbal fillers; and friendship/romantic relationships. Relationships between the topics and three predictors (i.e., NSSI history, emotion dysregulation, sample) were examined. In one sample, the proportion of ‘adjectives/verbal fillers’ was greater for participants with a NSSI history and at higher levels of emotion dysregulation. Across samples, for participants with a NSSI history, ‘adjectives/verbal fillers’ and ‘friendship/romantic partners’ increased with levels of emotion dysregulation. Conclusion: Findings highlight a greater use of adjectives and verbal fillers among individuals with a history of NSSI and higher levels of emotion dysregulation. This pattern of language may serve as an indicator of a specific aspect of emotion regulation difficulties that confers risk for NSSI.

Objective: Although life stress and adversity have emerged as risk factors for mental health problems and cognitive impairment among older adults, prior studies on this topic have been cross-sectional and based on relatively homogeneous samples. To address these issues, we examined prospective associations between lifetime adversity and symptoms of depression, anxiety, and cognitive impairment in a nationally representative, longitudinal sample of older adults in the U.S. Method: We analyzed data from the Health and Retirement Study (1992-2016). The sample included 3,496 individuals (59.9% female), aged ≥64 years old (M age=76.0 ±7.6 years). We used the individual-level panel data and ordinary least squares regressions to estimate associations between childhood and adulthood adversities and later-life depression, anxiety, and cognitive impairment. Results: Many participants experienced a significant early life (38%) or adulthood (79%) stressor. Second, experiencing a childhood adversity was associated with a 17.4% increased risk of experiencing an adulthood adversity. Finally, childhood and adulthood adversities both prospectively predicted more symptoms of late-life depression, anxiety, and cognitive impairment. Discussion: These findings are among the first to demonstrate prospective associations between lifetime adversity and symptoms of depression, anxiety, and cognitive impairment in older adults. Screening for lifetime stressors may thus help health care professionals and policymakers identify individuals who could benefit from interventions designed to reduce stress and enhance resilience.