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Objective: According to psychoanalytic theory, interpretation of transference leads to increased insight that again leads to improved interpersonal functioning over time. In this study, we performed a full mediational analysis to test whether insight gained during treatment mediates the long-term effects of transference interpretation in dynamic psychotherapy. Method: This study is a randomized clinical trial with a dismantling design. One hundred outpatients seeking psychotherapy for depression, anxiety, personality disorders, and interpersonal problems were randomly assigned to 1 year of weekly sessions of dynamic psychotherapy with transference interpretation or to the same type and duration of treatment with the same therapists but without the use of transference interpretation. Interpersonal functioning and insight were measured pretreatment, posttreatment, and 1 year and 3 years after treatment termination. Results: Contrary to common expectation, patients with a life-long pattern of low quality of object relations and personality disorder pathology profited more from therapy with transference interpretation than from therapy with no transference interpretation. This long-term effect was mediated by an increase in the level of insight during treatment. Conclusions: Insight seems to be a key mechanism of change in dynamic psychotherapy. Our results bridge the gap between clinical theory and empirical research. (Contains 3 tables and 4 figures.)

Objective: According to psychoanalytic theory, interpretation of transference leads to increased insight that again leads to improved interpersonal functioning over time. In this study, we performed a full mediational analysis to test whether insight gained during treatment mediates the long-term effects of transference interpretation in dynamic psychotherapy. Method: This study is a randomized clinical trial with a dismantling design. One hundred outpatients seeking psychotherapy for depression, anxiety, personality disorders, and interpersonal problems were randomly assigned to 1 year of weekly sessions of dynamic psychotherapy with transference interpretation or to the same type and duration of treatment with the same therapists but without the use of transference interpretation. Interpersonal functioning and insight were measured pretreatment, posttreatment, and 1 year and 3 years after treatment termination. Results: Contrary to common expectation, patients with a life-long pattern of low quality of object relations and personality disorder pathology profited more from therapy with transference interpretation than from therapy with no transference interpretation. This long-term effect was mediated by an increase in the level of insight during treatment. Conclusions: Insight seems to be a key mechanism of change in dynamic psychotherapy. Our results bridge the gap between clinical theory and empirical research. Keywords: dynamic psychotherapy, transference interpretation, insight, long-term outcome DOI: 10.1037/a0019245

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Objective: To examine whether men and women respond differentially to brief dynamic psychotherapy, with or without transference interpretations. Method: Data from the First Experimental Study of Transference Interpretation were used. Patients (n = 100) were randomized to receive 2 different dynamic psychotherapies during 1 year, with either a moderate level of transference interpretations or no transference interpretations. We used the following outcome measures: the Psychodynamic Functioning Scales, Inventory of Interpersonal Problems-Circumplex Version, Global Assessment of Functioning (GAF), and total mean score of Symptom Checklist-90-Revised (Global Severity Index [GSI]). Change was assessed using linear-mixed models. Results: On average, men and women responded equally across treatments. The moderator analyses, using the 2 secondary outcome measures, GAF and GSI, demonstrated that women responded better to therapy with transference interpretations, compared with men, whereas men responded better to therapy without transference interpretations, compared with women. When the moderator sex was combined with the moderator quality of object relations (QOR), a strong effect emerged: men with high QOR showed a large negative effect of transference interpretations, and women with low QOR showed a large positive effect. Conclusions: In terms of symptom change, women responded better to therapy with transference interpretations, while men responded better to therapy without transference interpretations. Patient sex showed moderator effects over and above the moderator effects of QOR. [ABSTRACT FROM AUTHOR]

BackgroundHealth care personnel need access to updated information anywhere and at any time, and a Personal Digital Assistant (PDA) has the potential to meet these requirements. A PDA is a mobile tool which has been employed widely for various purposes in health care practice, and the level of its use is expected to increase. Loaded with suitable functions and software applications, a PDA might qualify as the tool that personnel and students in health care need. In Sweden today, despite its leadership role in mobile technologies, PDAs are not commonly used, and there is a lack of suitable functions and software applications. ObjectiveThe aim of the present review was to obtain an overview of existing research on the use of PDAs among personnel and students in health care. MethodsThe literature search included original peer-reviewed research articles written in English and published from 1996 to 2008. All study designs were considered for inclusion. We excluded reviews and studies focusing on the use of PDAs in classroom situations. From March 2006 to the last update in May 2008, we searched PubMed, CINAHL, Cochrane, IngentaConnect, and a local search engine (ELIN@Kalmar). We conducted a content analysis, using Nielsen’s Model of System Acceptability as a theoretical framework in structuring and presenting the results. ResultsFrom the 900 references initially screened, 172 articles were selected and critically assessed until 48 articles remained. The majority originated in North-America (USA: n=24, Canada: n=11). The categories which emerged from our content analysis coincided to a certain extent to Nielsen’s Model of System Acceptability (social and practical acceptability), including usefulness (utility and usability) subcategories such as learnability, efficiency, errors, and satisfaction. The studies showed that health care personnel and students used PDAs in patient care with varied frequency. Most of the users were physicians. There is some evidence that the use of a PDA in health care settings might improve decision-making, reduce the numbers of medical errors, and enhance learning for both students and professionals, but the evidence is not strong, with most studies being descriptive, and only 6 randomized controlled trials. Several special software programs have been created and tested for PDAs, and a wide range of situations for their use have been reported for different patient groups. Drug and medical information were commonly accessed by PDA users, and the PDA was often viewed as the preferred tool when compared to paper-based documents. Some users regarded the PDA easy to operate, while others found it difficult in the beginning. ConclusionsThis overview of the use of PDAs revealed a positive attitude towards the PDA, which was regarded as a feasible and convenient tool. The possibility of immediate access to medical information has the potential to improve patient care. The PDA seems to be a valuable tool for personnel and students in health care, but there is a need for further intervention studies, randomized controlled trials, action research, and studies with various health care groups in order to identify its appropriate functions and software applications.

Objetivo: La interpretación de la transferencia continúa siendo un componente fundamental en la tradición psicodinámica, a pesar de la reducida demostración empírica de su efectividad. En este estudio, los autores analizaron los efectos a largo plazo de las interpretaciones de la transferencia. Método: Se trata de un ensayo comparativo y aleatorizado, de diseño desmantelado, más evaluaciones de seguimiento al cabo de 1 y 3 años de finalizar el tratamiento. Cien pacientes en régimen ambulatorio que solicitaron psicoterapia por depresión, ansiedad, trastornos de la personalidad y problemas interpersonales fueron derivados a los terapeutas del estudio. Los pacientes fueron asignados aleatoriamente a recibir sesiones con frecuencia semanal de psicoterapia dinámica durante 1 año con interpretaciones de la transferencia y sin ellas. Se evaluaron cinco sesiones completas de cada terapia para corroborar la fidelidad al tratamiento. Los criterios de valoración fueron las Escalas de Funcionamiento Psicodinámico (Psychodynamic Functioning Scales) (puntuadas por el médico) y el Cuestionario de Problemas Interpersonales (Inventory of Interpersonal Problems) (autoevaluación). Se presupuso que las puntuaciones en la Escala de Calidad de las Relaciones Objetales (Quality of Object Relations Scale) (patrón a lo largo de la vida) y la presencia de algún trastorno de la personalidad eran variables moderadoras de los efectos del tratamiento. El cambio a lo largo del tiempo se evaluó utilizando modelos lineales mixtos. Resultados: A pesar de no haber diferencias en la eficacia de los tratamientos, ambos tratamientos demostraron una mejoría significativa durante su aplicación y también después de finalizarlos. Sin embargo, los pacientes con un patrón de peores relaciones objetales a lo largo de la vida se beneficiaron más del año de terapia con interpretaciones de la transferencia que de la terapia sin interpretaciones de la transferencia. Este efecto se mantuvo a lo largo del período de estudio de 4 años. Conclusiones: El objetivo de la interpretación de la transferencia es mantener la mejoría de las relaciones del paciente fuera de la terapia. La interpretación de la transferencia parece especialmente importante en los pacientes que presentan problemas interpersonales de larga duración y más graves. [ABSTRACT FROM AUTHOR]

Purpose: Many patients and clinicians are worried that pregnancy after the diagnosis of Hodgkin lymphoma (HL) may increase the risk of relapse despite a lack of empirical evidence to support such concerns. We investigated if an association exists between pregnancy and relapse in women with a diagnosis of HL., Materials and Methods: Using Swedish healthcare registers combined with medical records, we included 449 women who received a diagnosis of HL between 1992 and 2009 and who were age 18 to 40 years at diagnosis. Follow-up started 6 months after diagnosis, when the patients' condition was assumed to be in remission. Pregnancy-associated relapse was defined as a relapse during pregnancy or within 5 years after delivery. Hazard ratios (HRs) with 95% CIs were estimated by using the Cox proportional hazards model., Results: Among the 449 women, 144 (32%) became pregnant during follow-up. Overall, 47 relapses were recorded, of which one was a pregnancy-associated relapse. The adjusted HR for the comparison of the pregnancy-associated relapse rate to the non-pregnancy-associated relapse rate was 0.29 (95% CI, 0.04 to 2.18). The expected number of relapses in women with a recent pregnancy, given that they would experience the same relapse rate as that of women without a recent pregnancy, was 3.76; the observed-to-expected ratio was 0.27 (95% exact CI, 0.01 to 1.51)., Conclusion: We found no evidence that a pregnancy after diagnosis increases the relapse rate among women whose HL is in remission. Survivors of HL need to consider a range of factors when deciding about future reproduction. However, given the results of this study, the risk of pregnancy-associated relapse does not need to be considered., (© 2015 by American Society of Clinical Oncology.)