Abstracts
Résumé
Au Personality Disorders Institute, nous avons étudié l’efficacité de la psychothérapie focalisée sur le transfert (PFT), une psychothérapie psychodynamique manualisée qui se déroule deux fois par semaine à l’intention de personnes souffrant de troubles de personnalité limite (TPL). Nous avons comparé la PFT à la thérapie dialectique comportementale (TDC) et à la psychothérapie psychodynamique de soutien (PPS) dans un essai clinique randomisé auprès de 90 patients ayant un TPL. Dans un premier temps, nous présentons certains fondements à l’origine du développement des TPL, suivis d’une discussion des bases théoriques de la PFT. Nous abordons ensuite les caractéristiques des patients qui influent sur les résultats du traitement. Nous présentons des données à la fois cliniques et empiriques dans une discussion de cas individuels représentatifs de l’échantillon de patients borderline traités en PFT.
Abstract
At the Personality Disorders Institute we have been investigating the efficacy of Transference-Focused Psychotherapy (TFP), a twice weekly manualized psychodynamic psychotherapy for borderline personality disorder compared to Dialectical Behavior Therapy (DBT) and Supportive Psychotherapy (SP) in a randomized clinical trial of 90 borderline patients. We will first present some developmental foundations of BPD, followed by a discussion of the theoretical foundations of TFP. We will then discuss patient characteristics that have an impact on outcome. We will present both clinical and empirical data in a discussion of individual cases that were representative of a sample of borderline patients treated in Transference-Focused Psychotherapy (TFP).
Resumen
En el Personality Disorders Institute estudiamos la eficacia de la psicoterapia focalizada en la transferencia (PFT), una psicoterapia psicodinámica hecha manual, que se lleva a cabo dos veces por semana para las personas que sufren de trastornos de personalidad límite (TPL). Comparamos la PFT con la terapia dialéctica comportamental (TDC) y la psicoterapia psicodinámica de apoyo (PPS) en una prueba clínica aleatoria en 90 pacientes con TPL. En un primer momento, presentamos ciertos fundamentos al origen del desarrollo de las TPL, seguidos de una discusión de las bases teóricas de la PFT. Enseguida abordamos las características de los pacientes que influyen en los resultados del tratamiento. Presentamos los datos, a la vez clínicos y empíricos, en una discusión de casos individuales representativos de la muestra de pacientes límite tratados por medio de PFT.
Resumo
No Personality Disorders Institute, estudamos a eficácia da psicoterapia focalizada na transferência (PFT), uma psicoterapia psicodinâmica manualizada que é realizada duas vezes por semana com pessoas que sofrem de transtornos de personalidade borderline (TPB). Comparamos a PFT com a terapia comportamental dialética (TCD) e com a psicoterapia psicodinâmica de apoio (PPA) em um teste clínico randomizado junto a 90 pacientes que sofrem de um TPB. Primeiramente, apresentamos alguns fundamentos originários do desenvolvimento dos TPB, seguidos de uma discussão sobre as bases teóricas da PFT. Abordamos, em seguida, as características dos pacientes que influenciam os resultados do tratamento. Apresentamos dados, ao mesmo tempo clínicos e empíricos em uma discussão de casos individuais representativos da amostragem de pacientes borderline tratados em PFT.
Appendices
Références
- Bartholomew, K., Horowitz, L. M., 1991, Attachment styles among young adults : A test of a four-category model, Journal of Personality and Social Psychology, 61, 226-244.
- Bernstein, D. P., Fink, L., Handelsman, L., Foote, J., Lovejoy, M., Wenzel, K., Sapareto, E., Ruggiero, J., 1994, Initial reliability and validity of a new retrospective measure of child abuse and neglect, American Journal of Psychiatry, 151, 8, 1132-1136.
- Coccaro, E. F., Kavoussi, R. J., 1997, Fluoxetine and impulsive-aggression behavior in personality disordered subjects, Archives of General Psychiatry, 54, 1081-1088.
- Clarkin, J. F., Foelsch, P. A., Levy, K. N., Hull, J. W., Delaney, J. C., Kernberg, O. F., 2001, The development of a psychodynamic treatment for patients with borderline personality disorder : A preliminary study of behavioral change, Journal of Personality Disorders, 15, 6, 487-495.
- Clarkin, J. F., Levy, K. N., Lenzenweger, M. F., Kernberg, O. F., 2007, Evaluating three treatments for borderline personality disorder : A multiwave study, American Journal of Psychiatry, 164, 922-928.
- Fonagy, P., Target, M., 2003, Psychoanalytic Theories : Perspectives from developmental Psychopathology, Whurr Publishers, London, 270-282.
- Fonagy, P., Target, M., 1996, Playing with reality : I. Theory of mind and the normal development of psychic reality, International Journal of Psycho-Analysis, 77, 2, 217-233.
- George, C., Kaplan, N., Main, M., 1996, Adult Attachment Interview Protocol, 3rd Edition, University of California at Berkeley.
- Kernberg, O. F., 1976, Object Relations Theory and Clinical Psychoanalysis, Jason Aronson, New York.
- Kernberg, O. F., 1984, Severe Personality Disorders : Psychotherapeutic Strategies, Yale University Press, New Haven, Ct.
- Kernberg, O. F., Caligor, E., 2005, A psychoanalytic theory of personality disorders, in Lenzenweger, M. F., Clarkin, J. F. eds., Major Theories of Personality Disorder, 2nd Edition. Guilford, New York, 114-156.
- Kolb, L. C., 1982, Assertive traits foster social adaptation and creativity, Psychiatric Journal of University of Ottawa, 7, 219-225.
- Lenzenweger, M. F., Clarkin, J. F., Kernberg, O. F., Foelsch, P. A., 2001, The inventory of personality organization : psychometric properties, factorial composition, and criterion relation with affect, aggressive dyscontrol, psychosis proneness, and self-domains in a non-clinical sample, Psychol Assess, 13, 4, 577-591.
- Lenzenweger, M. F., Clarkin, J. F., Yeomans, F. E., Kernberg, O. F., Levy, K., (en preparation), Refining the borderline personality disorder phenotype : Resolving heterogeneity with finite mixture modeling.
- Patton, J. H., Stanford, M. S., Barratt, E. S., 1995, Factor structure of the Barratt Impulsiveness Scale, Journal of Clinical Psychology, 51, 768-774.
- Perry, J. C., Herman, J. L., 1993, Trauma and Defense in the Etiology of Borderline Personality Disorder, Borderline Personality Disorder : Etiology and Treatment, Edited by Paris, J. Washington DC, American Psychiatric Press, 123-139.
- Sperling, M. B., Sharp, J. L., Fishler, P. H., 1991, On the nature of attachment in borderline populations : a preliminary inventory, Psychological Report, 68, 2, 543-6.
- Stone, M. H., 1990, The Fate of Borderline Patients, The Guilford Press, NewYork.
- Stone, M. H., 1990a, Abuse and abusiveness in borderline personality disorder, in Links, P.S., ed., Family Environment and Borderline Personality Disorder, Washington, DC, American Psychiatric Press, 133-148.
- Stone, M. H., 1993, Abnormalities of Personality ; Within and beyond the Realm of Treatment, W.W. Norton and Company, New York.
- van-der-Kolk, B. A., Hostetler, A., Herron, N., Fisler, R., 1994, Trauma and the development of borderline personality disorder, Psychiatric Clinics of North America, 17, 4, 715-730.
- Zanarini, M., 2000, Childhood experience associated with development of borderline personality disorder, Psychiatric Clinics of North America, 23, 1, 89-101.