Biomedical subjects

Stacy Shaw Welch

Publications and source records attributed to Stacy Shaw Welch.

3 recordsLinked to original sources

PubMed2006

A valence-dependent group-specific recall bias of retrospective self-reports: a study of borderline personality disorder in everyday life.

Recall is an active reconstruction process likely to distort past experiences. This distortion, known as recall bias, seems to manifest itself differently in sick and healthy people. A recall bias has been documented in several disorders, but never investigated in borderline personality disorder (BPD). To determine recall bias in BPD, we assessed momentary and retrospective ratings of specific emotions in 50 patients with BPD and 50 healthy controls (HCs), using the methodology of 24-hour ambulatory monitoring. Our data reveal a group-specific valence-dependent recall bias of retrospective self-report, indicated by a different overall recall pattern in HCs and BPD. BPD patients show an overall negative recall pattern, whereas HCs show a positive recall pattern. A traditional questionnaire approach does not distinguish between symptoms of the disorder and recall bias, although the pathological mechanisms underlying them as well as the appropriate treatment strategies may be different.

Affect↗

PubMed2002

Dialectical behavior therapy versus comprehensive validation therapy plus 12-step for the treatment of opioid dependent women meeting criteria for borderline personality disorder.

We conducted a randomized controlled trial to evaluate whether dialectical behavior therapy (DBT), a treatment that synthesizes behavioral change with radical acceptance strategies, would be more effective for heroin-dependent women with borderline personality disorder (N = 23) than Comprehensive Validation Therapy with 12-Step (CVT + 12S), a manualized approach that provided the major acceptance-based strategies used in DBT in combination with participation in 12-Step programs. In addition to psychosocial treatment, subjects also received concurrent opiate agonist therapy with adequate doses of LAAM (thrice weekly; modal dose 90/90/130 mg). Treatment lasted for 12 months. Drug use outcomes were measured via thrice-weekly urinalyses and self-report. Three major findings emerged. First, results of urinalyses indicated that both treatment conditions were effective in reducing opiate use relative to baseline. At 16 months post-randomization (4 months post-treatment), all participants had a low proportion of opiate-positive urinalyses (27% in DBT; 33% in CVT + 12S). With regard to between-condition differences, participants assigned to DBT maintained reductions in mean opiate use through 12 months of active treatment while those assigned to CVT + 12S significantly increased opiate use during the last 4 months of treatment. Second, CVT + 12S retained all 12 participants for the entire year of treatment, compared to a 64% retention rate in DBT. Third, at both post-treatment and at the 16-month follow-up assessment, subjects in both treatment conditions showed significant overall reductions in level of psychopathology relative to baseline. A noteworthy secondary finding was that DBT participants were significantly more accurate in their self-report of opiate use than were those assigned to CVT + 12S.

Adult↗

PubMed2002

High-risk situations associated with parasuicide and drug use in borderline personality disorder.

Both parasuicide and drug use continue to be difficult problems to treat in borderline personality disorder (BPD). One useful approach that has not yet been applied to BPD is to develop a taxonomy of triggering situations for these problems. Once these high-risk precipitants are identified, then the behaviors can be targeted with skills training. This model has been applied by Marlatt (1996) with very influential results. To examine high-risk situations for parasuicide and drug use in BPD, the current study examined women with BPD who came to treatment for two different primary problems: parasuicide (N = 75) and drug dependence (N = 47). Participants identified the situation associated with highest risk for relapse in either the parasuicide or drug category. A taxonomy is presented, which divides results into six main categories. Differences between high-risk situations for drugs and parasuicide were also explored. Parasuicide was significantly more likely to be linked to interpersonal problems, whereas drug use was more likely to be preceded by addiction cues (i.e., being near drugs or people who use drugs).

Adolescent↗