I Don't Deserve Anything Good: Perfectionistic Self-Recrimination in a Case of Comorbid Personality and Eating Disorder.

IF 2.5 3区 心理学 Q2 PSYCHOLOGY, CLINICAL Journal of Clinical Psychology Pub Date : 2024-11-25 DOI:10.1002/jclp.23753
Simone Cheli, Veronica Cavalletti, Francesco Gazzillo, Martin Brüne, Paul L Hewitt
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Abstract

In this case study we present the course of the psychotherapy of Myriam, a 19-year old female with a severe personality disorder and comorbid eating disorder. During the initial assessment she reported high levels of neuroticism that parallel the diagnosis of obsessive-compulsive personality disorder, borderline personality disorder, and anorexia nervosa. Myriam showed a severely impaired personality functioning defined by perfectionism, self-criticism, interpersonal guilt and overcontrol. Her daily experience was shaped by a self-recriminative inner dialogue associated with maladaptive patterns in the form of food, water and sleep restrictions, self-harm behaviors, and suicidal ideation. She accessed an integrative treatment based on individual (Evolutionary Systems Therapy) and group psychotherapy (Mindful Compassion for Perfectionism). At the end of 14-month intervention she remitted from all the categorical diagnoses and showed reliable changes in several measures. These outcomes were maintained at 3-month follow-up. We describe the integrative conceptualization based on Myriam's perfectionistic self-recrimination patterns, and the consequent treatment that targeted these patterns rather than focusing on symptom reduction exclusively.

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我不配拥有任何美好:人格与饮食失调症并发病例中的完美主义自责》(Perfectionistic Self-Recrimination in a Case of Comborid Personality and Eating Disorder)。
在本案例研究中,我们介绍了一位患有严重人格障碍并合并有饮食失调症的 19 岁女性 Myriam 的心理治疗过程。在最初的评估中,她表现出高度的神经质,与强迫型人格障碍、边缘型人格障碍和神经性厌食症的诊断结果一致。Myriam 的人格功能严重受损,表现为完美主义、自我批评、人际内疚和过度控制。她的日常经历被一种自我批判的内心对话所左右,这种对话与食物、水和睡眠限制、自残行为和自杀意念等适应不良模式有关。她接受了以个人(进化系统疗法)和团体心理疗法(完美主义的心灵同情)为基础的综合治疗。在为期 14 个月的干预结束时,她的所有分类诊断都得到了缓解,并在多项测量指标上显示出可靠的变化。这些结果在 3 个月的随访中得以保持。我们介绍了基于迈里亚姆完美主义自我责备模式的综合概念,以及针对这些模式而非只关注症状缓解的治疗方法。
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来源期刊
Journal of Clinical Psychology
Journal of Clinical Psychology PSYCHOLOGY, CLINICAL-
CiteScore
5.40
自引率
3.30%
发文量
177
期刊介绍: Founded in 1945, the Journal of Clinical Psychology is a peer-reviewed forum devoted to research, assessment, and practice. Published eight times a year, the Journal includes research studies; articles on contemporary professional issues, single case research; brief reports (including dissertations in brief); notes from the field; and news and notes. In addition to papers on psychopathology, psychodiagnostics, and the psychotherapeutic process, the journal welcomes articles focusing on psychotherapy effectiveness research, psychological assessment and treatment matching, clinical outcomes, clinical health psychology, and behavioral medicine.
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