Skip to main content
Top
Gepubliceerd in: Cognitive Therapy and Research 6/2023

27-08-2023 | Original Article

Changes in Perspective-Taking During Cognitive Behavioral Therapy in a Partial Hospital Setting

Auteurs: Chloe C. Hudson, Emily M. Bowers, Thröstur Björgvinsson, Courtney Beard

Gepubliceerd in: Cognitive Therapy and Research | Uitgave 6/2023

Log in om toegang te krijgen
share
DELEN

Deel dit onderdeel of sectie (kopieer de link)

  • Optie A:
    Klik op de rechtermuisknop op de link en selecteer de optie “linkadres kopiëren”
  • Optie B:
    Deel de link per e-mail

Abstract

Objective

Perspective-taking deficits are thought to perpetuate interpersonal dysfunction across different forms of mental illness. Although psychotherapeutic treatments are thought to target perspective-taking deficits, there is a dearth of research supporting this claim. In the current naturalistic study, we investigated whether perspective-taking frequency changed over the course of a two-week cognitive behavioral therapy (CBT) partial hospital treatment program.

Method

Participants were 421 adults with severe and complex mental illness that included mood, anxiety, and psychotic-spectrum disorders. Perspective-taking was assessed at admission and discharge using the 7-item Interpersonal Reactivity Index subscale.

Results

Results indicated improvements in perspective-taking from admission to discharge that did not vary as a function of participants diagnostic status or symptom severity. More severe autism spectrum disorder and borderline personality disorder symptoms were associated with less frequent perspective-taking across both time points.

Conclusions

These findings provide preliminary evidence to suggest that CBT may promote perspective-taking. Future research is needed to determine whether changes in perspective-taking are causally related to CBT, and if so, whether perspective-taking is a mechanism of change in psychotherapy.
Bijlagen
Alleen toegankelijk voor geautoriseerde gebruikers
Voetnoten
1
Individuals with borderline personality disorder have also been theorized to “hypermentalize”, defined as the tendency to overattribute extreme mental states to other (Sharp & Vanwoerden, 2015). Further, hypermentalization has recently been proposed as a transdiagnostic feature of psychopathology (McLaren et al., 2022). Importantly, individuals can have both a reduced tendency to engage in perspective-taking and demonstrate a pattern of hypermentalization when they engage in perspective-taking.
 
Literatuur
go back to reference Allen, J. G., Fonagy, P., & Bateman, A. W. (2008). Mentalizing in clinical practice. American Psychiatric Publishing, Inc. Allen, J. G., Fonagy, P., & Bateman, A. W. (2008). Mentalizing in clinical practice. American Psychiatric Publishing, Inc.
go back to reference Allison, C., Auyeung, B., & Baron-Cohen, S. (2012). Toward brief “Red Flags” for Autism Screening: The short Autism Spectrum Quotient and the short quantitative checklist in 1,000 cases and 3,000 controls. Journal of the American Academy of Child and Adolescent Psychiatry, 51(2), 202–212. www.jaacap.org.CrossRefPubMed Allison, C., Auyeung, B., & Baron-Cohen, S. (2012). Toward brief “Red Flags” for Autism Screening: The short Autism Spectrum Quotient and the short quantitative checklist in 1,000 cases and 3,000 controls. Journal of the American Academy of Child and Adolescent Psychiatry, 51(2), 202–212. www.​jaacap.​org.CrossRefPubMed
go back to reference Beck, J. (2011). Cognitive behavior therapy: Basics and beyond. Guilford Press. Beck, J. (2011). Cognitive behavior therapy: Basics and beyond. Guilford Press.
go back to reference Block-Lerner, J., Adair, C., Plumb, J. C., Rhatigan, D. L., & Orsillo, S. M. (2007). The case for mindfulness‐based approaches in the cultivation of empathy: Does nonjudgmental, present‐moment awareness increase capacity for perspective‐taking and empathic concern? Journal of marital and family therapy, 33(4), 501–516.CrossRefPubMed Block-Lerner, J., Adair, C., Plumb, J. C., Rhatigan, D. L., & Orsillo, S. M. (2007). The case for mindfulness‐based approaches in the cultivation of empathy: Does nonjudgmental, present‐moment awareness increase capacity for perspective‐taking and empathic concern? Journal of marital and family therapy, 33(4), 501–516.CrossRefPubMed
go back to reference Clark, D. A. (2013). Cognitive restructuring. In S. G. Hoffman (Eds.) The Wiley handbook of cognitive behavioral therapy (pp. 1–22). Clark, D. A. (2013). Cognitive restructuring. In S. G. Hoffman (Eds.) The Wiley handbook of cognitive behavioral therapy (pp. 1–22).
go back to reference Cusi, A. M., MacQueen, G. M., & McKinnon, M. C. (2012). Patients with bipolar disorder show impaired performance on complex tests of social cognition. Psychiatry research, 200(2–3), 258–264. Cusi, A. M., MacQueen, G. M., & McKinnon, M. C. (2012). Patients with bipolar disorder show impaired performance on complex tests of social cognition. Psychiatry research, 200(2–3), 258–264.
go back to reference Cusi, A. M., MacQueen, G. M., Spreng, R. N., & McKinnon, M. C. (2011). Altered empathic responding in major depressive disorder: Relation to symptom severity, illness burden, and psychosocial outcome. Psychiatry research, 188(2), 231–236.CrossRefPubMed Cusi, A. M., MacQueen, G. M., Spreng, R. N., & McKinnon, M. C. (2011). Altered empathic responding in major depressive disorder: Relation to symptom severity, illness burden, and psychosocial outcome. Psychiatry research, 188(2), 231–236.CrossRefPubMed
go back to reference Davis, M. H. (1980). A multidimensional approach to individual differences in empathy. JSAS Catalog of Selected Documents in Psychology, 10(85). Davis, M. H. (1980). A multidimensional approach to individual differences in empathy. JSAS Catalog of Selected Documents in Psychology, 10(85).
go back to reference Day, A., Howells, K., Mohr, P., Schall, E., & Gerace, A. (2008). The development of CBT programmes for anger: The role of interventions to promote perspective-taking skills. Behavioural and Cognitive Psychotherapy, 36(3), 299–312.CrossRef Day, A., Howells, K., Mohr, P., Schall, E., & Gerace, A. (2008). The development of CBT programmes for anger: The role of interventions to promote perspective-taking skills. Behavioural and Cognitive Psychotherapy, 36(3), 299–312.CrossRef
go back to reference Derntl, B., Seidel, E. M., Schneider, F., & Habel, U. (2012). How specific are emotional deficits? A comparison of empathic abilities in schizophrenia, bipolar and depressed patients. Schizophrenia research, 142(1–3), 58–64.CrossRefPubMed Derntl, B., Seidel, E. M., Schneider, F., & Habel, U. (2012). How specific are emotional deficits? A comparison of empathic abilities in schizophrenia, bipolar and depressed patients. Schizophrenia research, 142(1–3), 58–64.CrossRefPubMed
go back to reference Dinsdale, N., & Crespi, B. J. (2013). The borderline empathy paradox: Evidence and conceptual models for empathic enhancements in borderline personality disorder. J Pers Disord, 27(2), 172–195.CrossRefPubMed Dinsdale, N., & Crespi, B. J. (2013). The borderline empathy paradox: Evidence and conceptual models for empathic enhancements in borderline personality disorder. J Pers Disord, 27(2), 172–195.CrossRefPubMed
go back to reference Garber, J., Frankel, S. A., & Herrington, C. G. (2016). Developmental demands of cognitive behavioral therapy for depression in children and adolescents: Cognitive, social, and emotional processes. Annual review of clinical psychology, 12, 181.CrossRefPubMedPubMedCentral Garber, J., Frankel, S. A., & Herrington, C. G. (2016). Developmental demands of cognitive behavioral therapy for depression in children and adolescents: Cognitive, social, and emotional processes. Annual review of clinical psychology, 12, 181.CrossRefPubMedPubMedCentral
go back to reference Goodman, G., Midgley, N., & Schneider, C. (2016). Expert clinicians’ prototypes of an ideal child treatment in psychodynamic and cognitive-behavioral therapy: Is mentalization seen as a common process factor?. Psychotherapy Research, 26(5), 590–601. Goodman, G., Midgley, N., & Schneider, C. (2016). Expert clinicians’ prototypes of an ideal child treatment in psychodynamic and cognitive-behavioral therapy: Is mentalization seen as a common process factor?. Psychotherapy Research, 26(5), 590–601.
go back to reference Grzegorzewski, P., Kulesza, M., Pluta, A., Iqbal, Z., & Kucharska, K. (2019). Assessing self-reported empathy and altruism in patients suffering from enduring borderline personality disorder. Psychiatry Research, 273, 798–807.CrossRefPubMed Grzegorzewski, P., Kulesza, M., Pluta, A., Iqbal, Z., & Kucharska, K. (2019). Assessing self-reported empathy and altruism in patients suffering from enduring borderline personality disorder. Psychiatry Research, 273, 798–807.CrossRefPubMed
go back to reference Hayes, S. C. (2019). A liberated mind: How to pivot toward what matters. Penguin. Hayes, S. C. (2019). A liberated mind: How to pivot toward what matters. Penguin.
go back to reference Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (2012). Acceptance and commitment therapy: The Process and practice of mindful change (2nd ed.). Guilford Press. Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (2012). Acceptance and commitment therapy: The Process and practice of mindful change (2nd ed.). Guilford Press.
go back to reference Hendriks, A. L., Barnes-Holmes, Y., McEnteggart, C., De Mey, H. R., Witteman, C. L., Janssen, G. T., & Egger, J. I. (2016). The relationship between theory of mind and relational frame theory: Convergence of perspective-taking measures. Hendriks, A. L., Barnes-Holmes, Y., McEnteggart, C., De Mey, H. R., Witteman, C. L., Janssen, G. T., & Egger, J. I. (2016). The relationship between theory of mind and relational frame theory: Convergence of perspective-taking measures.
go back to reference Hom, M. A., Weiss, R. B., Millman, Z. B., Christensen, K., Lewis, E. J., Cho, S., & Björgvinsson, T. (2020). Development of a virtual partial hospital program for an acute psychiatric population: Lessons learned and future directions for telepsychotherapy. Journal of Psychotherapy Integration, 30(2), 366.CrossRef Hom, M. A., Weiss, R. B., Millman, Z. B., Christensen, K., Lewis, E. J., Cho, S., & Björgvinsson, T. (2020). Development of a virtual partial hospital program for an acute psychiatric population: Lessons learned and future directions for telepsychotherapy. Journal of Psychotherapy Integration, 30(2), 366.CrossRef
go back to reference Hudson, C. C., Klein, K. P., Ong, C. W., Handy, A. B., Swee, M. B., Lambert, H. K., & Björgvinsson, T. (2023). Treatment outcomes and patient satisfaction of a virtual partial hospital program: A mixed-method study. Psychotherapy Research, 33(2), 235–250.CrossRefPubMed Hudson, C. C., Klein, K. P., Ong, C. W., Handy, A. B., Swee, M. B., Lambert, H. K., & Björgvinsson, T. (2023). Treatment outcomes and patient satisfaction of a virtual partial hospital program: A mixed-method study. Psychotherapy Research, 33(2), 235–250.CrossRefPubMed
go back to reference Janssen, G., De Mey, H., Hendriks, A., Koppers, A., Kaarsemaker, M., Witteman, C., & Egger, J. (2014). Assessing deictic relational responding in individuals with social anxiety disorder: Evidence of perspective-taking difficulties. The Psychological Record, 64(1), 21–29.CrossRef Janssen, G., De Mey, H., Hendriks, A., Koppers, A., Kaarsemaker, M., Witteman, C., & Egger, J. (2014). Assessing deictic relational responding in individuals with social anxiety disorder: Evidence of perspective-taking difficulties. The Psychological Record, 64(1), 21–29.CrossRef
go back to reference Kang, J. I., Namkoong, K., Yoo, S. W., Jhung, K., & Kim, S. J. (2012). Abnormalities of emotional awareness and perception in patients with obsessive–compulsive disorder. Journal of affective disorders, 141(2–3), 286–293.CrossRefPubMed Kang, J. I., Namkoong, K., Yoo, S. W., Jhung, K., & Kim, S. J. (2012). Abnormalities of emotional awareness and perception in patients with obsessive–compulsive disorder. Journal of affective disorders, 141(2–3), 286–293.CrossRefPubMed
go back to reference Kim, H. W., Kang, J. I., Hwang, E. H., & Kim, S. J. (2018). Association between glutamate transporter gene polymorphisms and obsessive-compulsive disorder/trait empathy in a korean population. PloS one, 13(1), e0190593. Kim, H. W., Kang, J. I., Hwang, E. H., & Kim, S. J. (2018). Association between glutamate transporter gene polymorphisms and obsessive-compulsive disorder/trait empathy in a korean population. PloS one, 13(1), e0190593.
go back to reference Leary, T. (1957). Interpersonal diagnosis of personality. Ronald Press. Leary, T. (1957). Interpersonal diagnosis of personality. Ronald Press.
go back to reference Lecrubier, Y., Sheehan, D. V., Weiller, E., Amorim, P., Bonora, I., Sheehan, K. H., & Dunbar, G. C. (1997). The Mini International Neuropsychiatric interview (MINI). A short diagnostic structured interview: Reliability and validity according to the CIDI. European Psychiatry, 12(5), 224–231. https://doi.org/10.1016/S0924-9338(97)83296-8CrossRef Lecrubier, Y., Sheehan, D. V., Weiller, E., Amorim, P., Bonora, I., Sheehan, K. H., & Dunbar, G. C. (1997). The Mini International Neuropsychiatric interview (MINI). A short diagnostic structured interview: Reliability and validity according to the CIDI. European Psychiatry, 12(5), 224–231. https://​doi.​org/​10.​1016/​S0924-9338(97)83296-8CrossRef
go back to reference Linehan, M. M. (2015). DBT skills training manual (2nd ed.). Guilford Press. Linehan, M. M. (2015). DBT skills training manual (2nd ed.). Guilford Press.
go back to reference McLaren, V., Gallagher, M., Hopwood, C. J., & Sharp, C. (2022). Hypermentalizing and borderline personality disorder: A meta-analytic review. American Journal of Psychotherapy, 75(1), 21–31.CrossRefPubMed McLaren, V., Gallagher, M., Hopwood, C. J., & Sharp, C. (2022). Hypermentalizing and borderline personality disorder: A meta-analytic review. American Journal of Psychotherapy, 75(1), 21–31.CrossRefPubMed
go back to reference Zanarini, M. C., Vujanovic, A. A., Parachini, E. A., Boulanger, J. L., Frankenburg, F. R., & Hennen, J. (2003). A Screening Measure for BPD: The McLean Screening Instrument for Borderline Personality Disorder (MSI-BPD). http://Dx.Doi.Org.Ezp-Prod1.Hul.Harvard.Edu/https://doi.org/10.1521/Pedi.17.6.568.25355, 17(6), 568–573. Zanarini, M. C., Vujanovic, A. A., Parachini, E. A., Boulanger, J. L., Frankenburg, F. R., & Hennen, J. (2003). A Screening Measure for BPD: The McLean Screening Instrument for Borderline Personality Disorder (MSI-BPD). http://​Dx.​Doi.​Org.​Ezp-Prod1.​Hul.​Harvard.​Edu/​https://​doi.​org/​10.​1521/​Pedi.​17.​6.​568.​25355, 17(6), 568–573.
go back to reference Mennin, D. S., Ellard, K. K., Fresco, D. M., & Gross, J. J. (2013). United we stand: Emphasizing commonalities across cognitive-behavioral therapies. Behavior therapy, 44(2), 234–248.CrossRefPubMedPubMedCentral Mennin, D. S., Ellard, K. K., Fresco, D. M., & Gross, J. J. (2013). United we stand: Emphasizing commonalities across cognitive-behavioral therapies. Behavior therapy, 44(2), 234–248.CrossRefPubMedPubMedCentral
go back to reference Mochrie, K. D., Lothes, J., Guender, I. I., E., & John, J. S. (2020). DBT-informed treatment in a partial hospital and intensive outpatient program: The role of step-down care. Research in Psychotherapy: Psychopathology Process and Outcome, 23(2), https://doi.org/10.4081/ripppo.2020.461 Mochrie, K. D., Lothes, J., Guender, I. I., E., & John, J. S. (2020). DBT-informed treatment in a partial hospital and intensive outpatient program: The role of step-down care. Research in Psychotherapy: Psychopathology Process and Outcome, 23(2), https://​doi.​org/​10.​4081/​ripppo.​2020.​461
go back to reference Montag, C., Heinz, A., Kunz, D., & Gallinat, J. (2007). Self-reported empathic abilities in schizophrenia. Schizophrenia research, 92(1–3), 85–89.CrossRefPubMed Montag, C., Heinz, A., Kunz, D., & Gallinat, J. (2007). Self-reported empathic abilities in schizophrenia. Schizophrenia research, 92(1–3), 85–89.CrossRefPubMed
go back to reference Muthén, L. K., & Muthén, B. O. (2017). 1998–2017. Mplus user’s guide. Muthén & Muthén. Muthén, L. K., & Muthén, B. O. (2017). 1998–2017. Mplus user’s guide. Muthén & Muthén.
go back to reference Sharp, C., & Vanwoerden, S. (2015). Hypermentalizing in borderline personality disorder: A model and data. Journal of Infant Child and Adolescent Psychotherapy, 14(1), 33–45.CrossRef Sharp, C., & Vanwoerden, S. (2015). Hypermentalizing in borderline personality disorder: A model and data. Journal of Infant Child and Adolescent Psychotherapy, 14(1), 33–45.CrossRef
go back to reference Sullivan, H. S. (1953). The interpersonal theory of Psychiatry. Norton. Sullivan, H. S. (1953). The interpersonal theory of Psychiatry. Norton.
Metagegevens
Titel
Changes in Perspective-Taking During Cognitive Behavioral Therapy in a Partial Hospital Setting
Auteurs
Chloe C. Hudson
Emily M. Bowers
Thröstur Björgvinsson
Courtney Beard
Publicatiedatum
27-08-2023
Uitgeverij
Springer US
Gepubliceerd in
Cognitive Therapy and Research / Uitgave 6/2023
Print ISSN: 0147-5916
Elektronisch ISSN: 1573-2819
DOI
https://doi.org/10.1007/s10608-023-10422-4

Andere artikelen Uitgave 6/2023

Cognitive Therapy and Research 6/2023 Naar de uitgave