Grandjean, Loris Noël (2022). Individualisation in Psychotherapy Research: Personality Disorders Spearheading the Way. (Thesis). Universität Bern, Bern
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Abstract
Decades of research could find no conclusive evidence that “mental disorders” exist as natural separated entities. Not only have epidemiological studies pointed out excessively high rates of comorbidity as well as short-term diagnostic instability, but the current nosology has also demonstrated its inability to clearly delimit “normal” from “abnormal” — or to use its vocabulary — “sane” from “sick”. As a result, the biomedical paradigm and its ensuing categorical classification have proven unfit to investigate, comprehend and accurately describe psychological distress. Since issues with the current categorical taxonomy considerably affect research and treatment development, it is paramount to move beyond categorical models and improve the conceptualisation, studying and classification of psychological distress. In this regard, personality disorders (PDs) provide a great opportunity since the very nature of the concept makes shortcomings of a categorical paradigm arguably even more salient: either someone’s personality is inherently ill (disordered) or it is healthy. Yet, research has demonstrated the superior validity of a dimensional approach where individual differences in personality are continuously distributed and do not consist of two discrete categories (ill vs. healthy). As a result, the field of PDs is taking a leading role in the integration of alternative approaches to provide fully accurate descriptions of people’s difficulties rather than forcing individuals into imprecise categories. In psychotherapy research, the field follows a similar rationale and draws from the dimensional paradigm to focus on the individualisation of methods. The aim of the present doctoral dissertation is to demonstrate the theoretical and methodological potential of said individualised and integrated approaches on the basis of three articles in the field of PDs. The first article illustrates how the individualisation of stimuli and the integration of the field of research in psychotherapy with neuroimaging can enhance our understanding of changes during psychotherapy for Borderline Personality Disorder (BPD). The second article presents the elaboration of a prototypical Plan Analysis of Narcissistic Personality Disorder (NPD) from individual case formulations and its implications for treatment. Finally, the third article is a study investigating the differences in emotional arousal between participants with a BPD and controls during an individualised experiential task focusing on self-criticism. The discussion reviews and analyses the findings of each article and addresses the limits as well as the broader theoretical and practical implications of their designs for psychotherapy research. The thesis concludes with a summary and an outline of future directions of the field of PDs and mental health.
| Item Type: | Thesis |
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| Dissertation Type: | Cumulative |
| Date of Defense: | 28 June 2022 |
| Subjects: | 100 Philosophy > 150 Psychology 600 Technology > 610 Medicine & health |
| Institute / Center: | 07 Faculty of Human Sciences > Institute of Psychology > Clinical Psychology and Psychotherapy |
| Depositing User: | Sarah Stalder |
| Date Deposited: | 15 Aug 2022 07:43 |
| Last Modified: | 28 Jun 2023 22:25 |
| URI: | https://boristheses.unibe.ch/id/eprint/3697 |
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