Upcoming ESSPD events in 2024

ESSPD Webinar: Antisocial personality disorder and psychopathy – novel and neurochemical probes

Organized by the ESSPD Section on antisocial behavior: Steven Gillespie and Carlo Garofalo

Men with antisocial personality disorder (ASPD) with or without psychopathy (+/-P) are responsible for most violent crime in society. Development of effective treatments is hindered by poor understanding of the neurochemical underpinnings of the condition. In this talk, I will outline the key findings from the OXYASP study, which explored two neurochemical aspects of ASPD: responsivity to oxytocin and Glutamate/GABA. In a placebo-controlled, randomized crossover design, 34 violent offenders (19 ASPD+P; 15 ASPD-P) and 24 healthy non-offenders received 40IU intranasal oxytocin or placebo and then completed an fMRI morphed faces task examining the implicit processing of fearful facial expressions. Increasing intensity of fearful facial expressions failed to appropriately modulate activity in the bilateral mid-cingulate cortex in violent offenders with ASPD+P, compared with those with ASPD-P. Oxytocin abolished these group differences. In the second experiment, we investigated striatal glutamate: GABA ratio using Magnetic Resonance Spectroscopy in 30 violent offenders (16 ASPD-P, 14 ASPD+P) and 21 healthy non-offenders. Men with ASPD+/-P had a significant reduction in striatal glutamate : GABA ratio compared to non-offenders. This represents the first evidence of neurochemical modulation of the empathic processing of others’ distress in psychopathy, and the first evidence of striatal Glutamate/GABA dysregulation in ASPD+/-P. I will discuss the implications of these findings, and how future studies using fMRI, MRS, and other methodologies may enhance future pharmacoimaging and work and apply neurochemical insights.

Fees

Participation fee:
€35

Reduced fee for ESSPD members:
€30

Past events

You can now view many previous webinars on demand. Please click the “Access webinar” button under the webinar description to purchase access.

ESSPD Webinar: Understanding interpersonal dysfunctions in Personality Disorders through Social Cognition

In the recent Webinar hosted in January 2024 by the ESSPD, Christopher Hopwood illustrated how the most distinctive and clinically important feature of personality disorders (PD) is the difficulty to establish and maintain supportive social networks because of core interpersonal difficulties.

He therefore argued that PD would be better qualified by the term “interpersonal disorders”: “individuals with PD have difficulties establishing and maintaining functional mental models of self and other and attendant difficulties establishing and maintaining adaptive and functional social relationships”.

The view of the primary role of interpersonal dysfunction in driving PD pathology is consistent DSM-5 Alternative Model for PD, which states that PD are characterized by impairment in the Self and Interpersonal Domains and that evaluating the level of functioning across these domains is central to make any PD diagnosis. Focusing on interpersonal dysfunction is also timely for clinical practice: research has demonstrated that psychosocial dysfunction represents an enduring and difficult to treat aspect of Personality Disorders (PD) psychopathology, which does not seem to be significantly affected by symptomatic improvement over time and existing empirically supported psychotherapies.

Within this context, the present Webinar of the ESSPD Section of Social Cognition and Interpersonal functioning in PD aims to provide some perspectives about the potential social-cognitive mechanisms underlying PD patient’s views of self and others. The founders of the Section will focus on three diverse domains of social cognition relevant for understanding PD patients’ interpersonal difficulties.

Stefanie Lis will address the question how social cognition is conceptualized and why it might be an important domain of functioning to inform clinical work. Chiara De Panfilis will address the implications of the rejection sensitivity dynamics for PD.  Finally, Zsolt Unoka will talk about the “ego-centric” social network of patients with borderline personality disorder.

Overall, this webinar will discuss how PD patients’ unique ways of perceiving, interpreting, and responding to the intentions, attitudes and behaviours of the others may shape their interpersonal dysfunction and thus may represent potential foci of clinical attention and intervention.

ESSPD Webinar: Psychobiological mechanisms of psychotherapy in personality disorders

Psychotherapy research no longer aims to develop comprehensive disorder-specific programs but modules that influence processes that mediate change. These processes may reflect basal learning effects as well as specific change processes. A mechanistic approach starting from functional analysis of impairments in addition to symptoms and assessing physiological changes beyond self-report/questionnaires will provide insight into mediators of therapeutic change and serve as a scientific platform for future development of psychotherapeutic interventions. This webinar will start with some ideas on the conceptualization of modular, mechanism-based psychotherapy for borderline personality disorder and dimensional conceptions of personality disorders. Then, we will present fMRI studies on mechanistic change in pre/post designs as well as behavioural tasks that were designed to capture treatment effects. At the end we will discuss the many open questions needed to be pursued in the future to arrive at higher treatment effects.

ESSPD Webinar: Contemporary interpersonal models of personality disorders

Personality disorders (PDs) are among the most common and severe classes of psychopathology. From a clinical perspective, it is challenging to help individuals with personality disorders because treatment ruptures, discontinuation, reversals, and failures are relatively common. An additional clinical challenge is that the model used to diagnose personality disorders is demonstrably incorrect. Recent efforts to improve diagnosis of personality disorders apply two criteria: the first distinguishes personality disorders from other kinds of psychopathology and the second distinguishes different types of personality disorders. However, this approach has been problematic in that, as currently operationalized, it does not provide a clear demarcation for personality disorders, and it uses a framework for individual differences that is more apt as a model of variation in psychopathology in general. This article proposes that the core of personality disorders involves difficulties understanding and relating to self and others, and thus the personality disorders should be recast as the interpersonal disorders. Interpersonal dysfunction explains extreme social challenges and treatment difficulties that are characteristic of this class of psychopathology. This approach provides a clearer model for distinguishing these kinds of problems, as demonstrated by reformulating traditional personality disorder symptoms from an interpersonal perspective.

ESSPD Webinar: Treating Borderline Personality Disorder within “general” psychiatric services

The webinar will offer three different perspectives on how to implement effective strategies to treat Borderline Personality Disorder (BPD) on a large scale, within various mental health systems. There are several empirical supported treatments (EST) for BPD. However, none of them has sufficient supply in whatever country, given the high number of treatment -seeking patients with BPD, who represent a substantial proportion of patients attending “general” psychiatric services. Therefore, structuring existing clinical services by providing well-organized, coherent generalist treatments may be more scalable across different health systems and patient populations than delivering specific types of EST.

Lois Choi-Kain will review the need for diverse steps or components of care for individuals with BPD beyond evidence-based psychotherapies that last typically one to two years. Good psychiatric management (GPM) is a flexible pragmatic approach to clinical management of BPD across acute, chronic, and remitted but not recovered states, which will meet the needs of patients who either cannot access or do not respond adequately to the specialist manualized psychotherapies.

Next, Joost Hutsebaut will discuss some basics of the Guideline-Informed Treatment for PDs (GIT-PD), a common factors approach that aims to upgrade ‘treatment as usual’ services by improving adherence to a set of principles at organizational, team and therapist level.

Finally, Chiara De Panfilis will illustrate how general psychiatric care for BPD can be implemented with principles of Transference-Focused Psychotherapy (TFP) – one of the empirically supported therapies for BPD-, which emphasizes treatment structure and frame. This initiative is part of the “applied” TFP approach, which applies key elements and insights of the TFP model to a variety of treatment settings outside the standard twice a week outpatient TFP.

ESSPD Webinar: Advances in the understanding and treatment of pathological narcissism

The webinar will offer an overview of current conceptualizations and new perspectives on the study of pathological narcissism. First, the conceptualization and pressing issues in relationship with dimensional conceptions of personality disorders will be discussed. Then, we will discuss principles of intervention which address pathological narcissism, the therapeutic strategies, and discuss research evidence on psychotherapy for pathological narcissism. Finally, the impact of pathological narcissism on the social interaction, family and peers will be discussed.

ESSPD Webinar: Parenting and mother-child interaction

Mothers with BPD are often unable to recognize and/or respond (to) their children’s needs, are inconsistent in their parenting styles and have difficulties in setting adequate limits. Difficulties in emotion regulation are a core feature of BPD and constitute a severe problem for parenting. As a result, children of mothers with BPD are often missing adequate role models and orientation – and are at high risk to develop dysfunctional behavior patterns themselves. The training “Parenting skills for mothers with BPD” aims to support these mothers to develop positive parenting strategies and thereby to interrupt the intergenerational transmission of dysfunctional emotion regulation strategies.

The webinar was prepared by prof. Babette Renneberg, Germany and dr. Charlotte Rosenbach, Germany and presented by dr. Rosenbach.

ESSPD Webinar: The ICD-11 Classification of Personality Disorders – Challenges and Opportunities

This second ESSPD webinar was devoted to informing European mental health professionals about the now released ICD-11 classification of personality disorders and how it may be used in clinical practice. Attendants watched three presentations by experts followed by a panel and audience discussion. The total length of the webinar is 1½ hour. In the first presentation, Mikaela Swales introduced and explained essential aspects of the new classification. In the second presentation, Bo Bach provided an overview of how the ICD-11 classification of personality disorder severity and trait domain specifiers may be carried out based on currently available instruments and different sources of information. In the third and final presentation, Sabine Herpertz gave a clinically-oriented overview and discussion of how the new classification may inform clinical practice and how established ICD-10 personality disorder types may be re-conceptualized within the ICD-11 new system. All three topics were eventually discussed, while pointing toward future research and implementation.

The following experts will be guiding you through the changes: