What is Personality Psychology?

Introduction

Personality psychology is a branch of psychology that examines personality and its variation among individuals. It aims to show how people are individually different due to psychological forces. Its areas of focus include:

  • Construction of a coherent picture of the individual and their major psychological processes;
  • Investigation of individual psychological differences; and
  • Investigation of human nature and psychological similarities between individuals.

“Personality” is a dynamic and organised set of characteristics possessed by an individual that uniquely influences their environment, cognition, emotions, motivations, and behaviours in various situations. The word personality originates from the Latin persona, which means “mask”.

Personality also pertains to the pattern of thoughts, feelings, social adjustments, and behaviours persistently exhibited over time that strongly influences one’s expectations, self-perceptions, values, and attitudes. Personality also predicts human reactions to other people, problems, and stress. Gordon Allport (1937) described two major ways to study personality: the nomothetic and the idiographic. Nomothetic psychology seeks general laws that can be applied to many different people, such as the principle of self-actualisation or the trait of extraversion. Idiographic psychology is an attempt to understand the unique aspects of a particular individual.

The study of personality has a broad and varied history in psychology, with an abundance of theoretical traditions. The major theories include dispositional (trait) perspective, psychodynamic, humanistic, biological, behaviourist, evolutionary, and social learning perspective. Many researchers and psychologists do not explicitly identify themselves with a certain perspective and instead take an eclectic approach. Research in this area is empirically driven – such as dimensional models, based on multivariate statistics such as factor analysis – or emphasizes theory development, such as that of the psychodynamic theory. There is also a substantial emphasis on the applied field of personality testing. In psychological education and training, the study of the nature of personality and its psychological development is usually reviewed as a prerequisite to courses in abnormal psychology or clinical psychology.

Philosophical Assumptions

Many of the ideas conceptualised by historical and modern personality theorists stem from the basic philosophical assumptions they hold. The study of personality is not a purely empirical discipline, as it brings in elements of art, science, and philosophy to draw general conclusions. The following five categories are some of the most fundamental philosophical assumptions on which theorists disagree:

AssumptionOutline
Freedom versus DeterminismThis is the question of whether humans have control over their own behaviour and understand the motives behind it, or if their behaviour is causally determined by forces beyond their control. Behaviour is categorised as being either unconscious, environmental or biological by various theories.
Heredity (Nature) versus Environment (Nurture)Personality is thought to be determined largely either by genetics and biology, or by environment and experiences. Contemporary research suggests that most personality traits are based on the joint influence of genetics and environment. One of the forerunners in this arena is C. Robert Cloninger, who pioneered the Temperament and Character model.
Uniqueness versus UniversalityThis question discusses the extent of each human’s individuality (uniqueness) or similarity in nature (universality). Gordon Allport, Abraham Maslow, and Carl Rogers were all advocates of the uniqueness of individuals. Behaviourists and cognitive theorists, in contrast, emphasize the importance of universal principles, such as reinforcement and self-efficacy.
Active versus ReactiveThis question explores whether humans primarily act through individual initiative (active) or through outside stimuli. Traditional behavioural theorists typically believed that humans are passively shaped by their environments, whereas humanistic and cognitive theorists believe that humans play a more active role. Most modern theorists agree that both are important, with aggregate behaviour being primarily determined by traits and situational factors being the primary predictor of behaviour in the short term.
Optimistic versus PessimisticPersonality theories differ with regard to whether humans are integral in the changing of their own personalities. Theories that place a great deal of emphasis on learning are often more optimistic than those that do not.

Personality Theories

Type Theories

Personality type refers to the psychological classification of people into different classes. Personality types are distinguished from personality traits, which come in different degrees. There are many theories of personality, but each one contains several and sometimes many sub theories. A “theory of personality” constructed by any given psychologist will contain multiple relating theories or sub theories often expanding as more psychologists explore the theory. For example, according to type theories, there are two types of people, introverts and extroverts. According to trait theories, introversion and extroversion are part of a continuous dimension with many people in the middle. The idea of psychological types originated in the theoretical work of Carl Jung, specifically in his 1921 book Psychologische Typen (Psychological Types) and William Marston.

Building on the writings and observations of Jung during World War II, Isabel Briggs Myers and her mother, Katharine C. Briggs, delineated personality types by constructing the Myers-Briggs Type Indicator. This model was later used by David Keirsey with a different understanding from Jung, Briggs and Myers. In the former Soviet Union, Lithuanian Aušra Augustinavičiūtė independently derived a model of personality type from Jung’s called socionics. Later on many other tests were developed on this model e.g. Golden, PTI-Pro and JTI.

Theories could also be considered an “approach” to personality or psychology and is generally referred to as a model. The model is an older and more theoretical approach to personality, accepting extroversion and introversion as basic psychological orientations in connection with two pairs of psychological functions:

  • Perceiving functions: sensing and intuition (trust in concrete, sensory-oriented facts vs. trust in abstract concepts and imagined possibilities).
  • Judging functions: thinking and feeling (basing decisions primarily on logic vs. deciding based on emotion).

Briggs and Myers also added another personality dimension to their type indicator to measure whether a person prefers to use a judging or perceiving function when interacting with the external world. Therefore, they included questions designed to indicate whether someone wishes to come to conclusions (judgement) or to keep options open (perception).

This personality typology has some aspects of a trait theory: it explains people’s behavior in terms of opposite fixed characteristics. In these more traditional models, the sensing/intuition preference is considered the most basic, dividing people into “N” (intuitive) or “S” (sensing) personality types. An “N” is further assumed to be guided either by thinking or feeling and divided into the “NT” (scientist, engineer) or “NF” (author, humanitarian) temperament. An “S”, in contrast, is assumed to be guided more by the judgment/perception axis and thus divided into the “SJ” (guardian, traditionalist) or “SP” (performer, artisan) temperament. These four are considered basic, with the other two factors in each case (including always extraversion/introversion) less important. Critics of this traditional view have observed that the types can be quite strongly stereotyped by professions (although neither Myers nor Keirsey engaged in such stereotyping in their type descriptions), and thus may arise more from the need to categorise people for purposes of guiding their career choice. This among other objections led to the emergence of the five-factor view, which is less concerned with behaviour under work conditions and more concerned with behaviour in personal and emotional circumstances (The MBTI is not designed to measure the “work self”, but rather what Myers and McCaulley called the “shoes-off self.”).

Type A and Type B personality theory: During the 1950s, Meyer Friedman and his co-workers defined what they called Type A and Type B behaviour patterns. They theorised that intense, hard-driving Type A personalities had a higher risk of coronary disease because they are “stress junkies.” Type B people, on the other hand, tended to be relaxed, less competitive, and lower in risk. There was also a Type AB mixed profile.

John L. Holland’s RIASEC vocational model, commonly referred to as the Holland Codes, stipulates that six personality types lead people to choose their career paths. In this circumplex model, the six types are represented as a hexagon, with adjacent types more closely related than those more distant. The model is widely used in vocational counselling.

Eduard Spranger’s personality-model, consisting of six (or, by some revisions, 6 +1) basic types of value attitudes, described in his book Types of Men (Lebensformen; Halle (Saale): Niemeyer, 1914; English translation by P.J.W. Pigors – New York: G. E. Stechert Company, 1928).

The Enneagram of Personality, a model of human personality which is principally used as a typology of nine interconnected personality types. It has been criticised as being subject to interpretation, making it difficult to test or validate scientifically.

Perhaps the most ancient attempt at personality psychology is the personality typology outlined by the Indian Buddhist Abhidharma schools. This typology mostly focuses on negative personal traits (greed, hatred, and delusion) and the corresponding positive meditation practices used to counter those traits.

Psychoanalytical Theories

Psychoanalytic theories explain human behaviour in terms of the interaction of various components of personality. Sigmund Freud was the founder of this school of thought. He drew on the physics of his day (thermodynamics) to coin the term psychodynamics. Based on the idea of converting heat into mechanical energy, Freud proposed psychic energy could be converted into behaviour. His theory places central importance on dynamic, unconscious psychological conflicts.

Freud divides human personality into three significant components: the id, ego and super-ego. The id acts according to the pleasure principle, demanding immediate gratification of its needs regardless of external environment; the ego then must emerge in order to realistically meet the wishes and demands of the id in accordance with the outside world, adhering to the reality principle. Finally, the superego (conscience) inculcates moral judgment and societal rules upon the ego, thus forcing the demands of the id to be met not only realistically but morally. The superego is the last function of the personality to develop, and is the embodiment of parental/social ideals established during childhood. According to Freud, personality is based on the dynamic interactions of these three components.

The channelling and release of sexual (libidal) and aggressive energies, which ensues from the “Eros” (sex; instinctual self-preservation) and “Thanatos” (death; instinctual self-annihilation) drives respectively, are major components of his theory. It is important to note that Freud’s broad understanding of sexuality included all kinds of pleasurable feelings experienced by the human body.

Freud proposed five psychosexual stages of personality development. He believed adult personality is dependent upon early childhood experiences and largely determined by age five. Fixations that develop during the infantile stage contribute to adult personality and behaviour.

One of Sigmund Freud’s earlier associates, Alfred Adler, agreed with Freud that early childhood experiences are important to development, and believed birth order may influence personality development. Adler believed that the oldest child was the individual who would set high achievement goals in order to gain attention lost when the younger siblings were born. He believed the middle children were competitive and ambitious. He reasoned that this behaviour was motivated by the idea of surpassing the firstborn’s achievements. He added, however, that the middle children were often not as concerned about the glory attributed to their behaviour. He also believed the youngest would be more dependent and sociable. Adler finished by surmising that an only child loves being the centre of attention and matures quickly but in the end fails to become independent.

Heinz Kohut thought similarly to Freud’s idea of transference. He used narcissism as a model of how people develop their sense of self. Narcissism is the exaggerated sense of self in which one is believed to exist in order to protect one’s low self-esteem and sense of worthlessness. Kohut had a significant impact on the field by extending Freud’s theory of narcissism and introducing what he called the ‘self-object transferences’ of mirroring and idealisation. In other words, children need to idealize and emotionally “sink into” and identify with the idealised competence of admired figures such as parents or older siblings. They also need to have their self-worth mirrored by these people. Such experiences allow them to thereby learn the self-soothing and other skills that are necessary for the development of a healthy sense of self.

Another important figure in the world of personality theory is Karen Horney. She is credited with the development of “Feminist Psychology”. She disagrees with Freud on some key points, one being that women’s personalities are not just a function of “Penis Envy”, but that girl children have separate and different psychic lives unrelated to how they feel about their fathers or primary male role models. She talks about three basic Neurotic needs “Basic Anxiety”, “Basic Hostility” and “Basic Evil”. She posits that to any anxiety an individual experiences they would have one of three approaches, moving toward people, moving away from people or moving against people. It is these three that give us varying personality types and characteristics. She also places a high premium on concepts like Overvaluation of Love and romantic partners.

Behaviourist Theories

Behaviourists explain personality in terms of the effects external stimuli have on behaviour. The approaches used to evaluate the behavioural aspect of personality are known as behavioural theories or learning-conditioning theories. These approaches were a radical shift away from Freudian philosophy. One of the major tenets of this concentration of personality psychology is a strong emphasis on scientific thinking and experimentation. This school of thought was developed by B.F. Skinner who put forth a model which emphasized the mutual interaction of the person or “the organism” with its environment. Skinner believed children do bad things because the behaviour obtains attention that serves as a reinforcer. For example: a child cries because the child’s crying in the past has led to attention. These are the response, and consequences. The response is the child crying, and the attention that child gets is the reinforcing consequence. According to this theory, people’s behaviour is formed by processes such as operant conditioning. Skinner put forward a “three term contingency model” which helped promote analysis of behaviour based on the “Stimulus – Response – Consequence Model” in which the critical question is: “Under which circumstances or antecedent ‘stimuli’ does the organism engage in a particular behavior or ‘response’, which in turn produces a particular ‘consequence’?”

Richard Herrnstein extended this theory by accounting for attitudes and traits. An attitude develops as the response strength (the tendency to respond) in the presences of a group of stimuli become stable. Rather than describing conditionable traits in non-behavioural language, response strength in a given situation accounts for the environmental portion. Herrstein also saw traits as having a large genetic or biological component, as do most modern behaviourists.

Ivan Pavlov is another notable influence. He is well known for his classical conditioning experiments involving dogs, which led him to discover the foundation of behaviourism.

Social Cognitive Theories

In cognitive theory, behaviour is explained as guided by cognitions (e.g. expectations) about the world, especially those about other people. Cognitive theories are theories of personality that emphasize cognitive processes, such as thinking and judging.

Albert Bandura, a social learning theorist suggested the forces of memory and emotions worked in conjunction with environmental influences. Bandura was known mostly for his “Bobo doll experiment”. During these experiments, Bandura video taped a college student kicking and verbally abusing a bobo doll. He then showed this video to a class of kindergarten children who were getting ready to go out to play. When they entered the play room, they saw bobo dolls, and some hammers. The people observing these children at play saw a group of children beating the doll. He called this study and his findings observational learning, or modelling.

Early examples of approaches to cognitive style are listed by Baron (1982). These include Witkin’s (1965) work on field dependency, Gardner’s (1953) discovering people had consistent preference for the number of categories they used to categorise heterogeneous objects, and Block and Petersen’s (1955) work on confidence in line discrimination judgments. Baron relates early development of cognitive approaches of personality to ego psychology. More central to this field have been:

  • Attributional style theory dealing with different ways in which people explain events in their lives. This approach builds upon locus of control, but extends it by stating we also need to consider whether people attribute to stable causes or variable causes, and to global causes or specific causes.

Various scales have been developed to assess both attributional style and locus of control. Locus of control scales include those used by Rotter and later by Duttweiler, the Nowicki and Strickland (1973) Locus of Control Scale for Children and various locus of control scales specifically in the health domain, most famously that of Kenneth Wallston and his colleagues, The Multidimensional Health Locus of Control Scale. Attributional style has been assessed by the Attributional Style Questionnaire, the Expanded Attributional Style Questionnaire, the Attributions Questionnaire, the Real Events Attributional Style Questionnaire and the Attributional Style Assessment Test.

  • Achievement style theory focuses upon identification of an individual’s Locus of Control tendency, such as by Rotter’s evaluations, and was found by Cassandra Bolyard Whyte to provide valuable information for improving academic performance of students. Individuals with internal control tendencies are likely to persist to better academic performance levels, presenting an achievement personality, according to Cassandra B. Whyte.

Recognition that the tendency to believe that hard work and persistence often results in attainment of life and academic goals has influenced formal educational and counselling efforts with students of various ages and in various settings since the 1970s research about achievement. Counselling aimed toward encouraging individuals to design ambitious goals and work toward them, with recognition that there are external factors that may impact, often results in the incorporation of a more positive achievement style by students and employees, whatever the setting, to include higher education, workplace, or justice programming.

Walter Mischel (1999) has also defended a cognitive approach to personality. His work refers to “Cognitive Affective Units”, and considers factors such as encoding of stimuli, affect, goal-setting, and self-regulatory beliefs. The term “Cognitive Affective Units” shows how his approach considers affect as well as cognition.

Cognitive-Experiential Self-Theory (CEST) is another cognitive personality theory. Developed by Seymour Epstein, CEST argues that humans operate by way of two independent information processing systems: experiential system and rational system. The experiential system is fast and emotion-driven. The rational system is slow and logic-driven. These two systems interact to determine our goals, thoughts, and behaviolr.

Personal construct psychology (PCP) is a theory of personality developed by the American psychologist George Kelly in the 1950s. Kelly’s fundamental view of personality was that people are like naïve scientists who see the world through a particular lens, based on their uniquely organised systems of construction, which they use to anticipate events. But because people are naïve scientists, they sometimes employ systems for construing the world that are distorted by idiosyncratic experiences not applicable to their current social situation. A system of construction that chronically fails to characterise and/or predict events, and is not appropriately revised to comprehend and predict one’s changing social world, is considered to underlie psychopathology (or mental illness). From the theory, Kelly derived a psychotherapy approach and also a technique called The Repertory Grid Interview that helped his patients to uncover their own “constructs” with minimal intervention or interpretation by the therapist. The repertory grid was later adapted for various uses within organisations, including decision-making and interpretation of other people’s world-views.

Humanistic Theories

Humanistic psychology emphasizes that people have free will and that this plays an active role in determining how they behave. Accordingly, humanistic psychology focuses on subjective experiences of persons as opposed to forced, definitive factors that determine behaviour. Abraham Maslow and Carl Rogers were proponents of this view, which is based on the “phenomenal field” theory of Combs and Snygg (1949). Rogers and Maslow were among a group of psychologists that worked together for a decade to produce the Journal of Humanistic Psychology. This journal was primarily focused on viewing individuals as a whole, rather than focusing solely on separate traits and processes within the individual.

Robert W. White wrote the book The Abnormal Personality that became a standard text on abnormal psychology. He also investigated the human need to strive for positive goals like competence and influence, to counterbalance the emphasis of Freud on the pathological elements of personality development.

Maslow spent much of his time studying what he called “self-actualizing persons”, those who are “fulfilling themselves and doing the best they are capable of doing”. Maslow believes all who are interested in growth move towards self-actualizing (growth, happiness, satisfaction) views. Many of these people demonstrate a trend in dimensions of their personalities. Characteristics of self-actualisers according to Maslow include the four key dimensions:

DimensionOutline
Awarenessmaintaining constant enjoyment and awe of life. These individuals often experienced a “peak experience”. He defined a peak experience as an “intensification of any experience to the degree there is a loss or transcendence of self”. A peak experience is one in which an individual perceives an expansion of themselves, and detects a unity and meaningfulness in life. Intense concentration on an activity one is involved in, such as running a marathon, may invoke a peak experience.
Reality and Problem CentredHaving a tendency to be concerned with “problems” in surroundings.
Acceptance/SpontaneityAccepting surroundings and what cannot be changed.
Unhostile Sense of Humour/DemocraticDo not take kindly to joking about others, which can be viewed as offensive. They have friends of all backgrounds and religions and hold very close friendships.

Maslow and Rogers emphasized a view of the person as an active, creative, experiencing human being who lives in the present and subjectively responds to current perceptions, relationships, and encounters. They disagree with the dark, pessimistic outlook of those in the Freudian psychoanalysis ranks, but rather view humanistic theories as positive and optimistic proposals which stress the tendency of the human personality toward growth and self-actualization. This progressing self will remain the centre of its constantly changing world; a world that will help mould the self but not necessarily confine it. Rather, the self has opportunity for maturation based on its encounters with this world. This understanding attempts to reduce the acceptance of hopeless redundancy. Humanistic therapy typically relies on the client for information of the past and its effect on the present, therefore the client dictates the type of guidance the therapist may initiate. This allows for an individualised approach to therapy. Rogers found patients differ in how they respond to other people. Rogers tried to model a particular approach to therapy – he stressed the reflective or empathetic response. This response type takes the client’s viewpoint and reflects back their feeling and the context for it. An example of a reflective response would be, “It seems you are feeling anxious about your upcoming marriage”. This response type seeks to clarify the therapist’s understanding while also encouraging the client to think more deeply and seek to fully understand the feelings they have expressed.

Biopsychological Theories

Biology plays a very important role in the development of personality. The study of the biological level in personality psychology focuses primarily on identifying the role of genetic determinants and how they mould individual personalities. Some of the earliest thinking about possible biological bases of personality grew out of the case of Phineas Gage. In an 1848 accident, a large iron rod was driven through Gage’s head, and his personality apparently changed as a result, although descriptions of these psychological changes are usually exaggerated.

In general, patients with brain damage have been difficult to find and study. In the 1990s, researchers began to use electroencephalography (EEG), positron emission tomography (PET), and more recently functional magnetic resonance imaging (fMRI), which is now the most widely used imaging technique to help localise personality traits in the brain.

Genetic Basis of Personality

Ever since the Human Genome Project allowed for a much more in depth comprehension of genetics, there has been an ongoing controversy involving heritability, personality traits, and environmental vs. genetic influence on personality. The human genome is known to play a role in the development of personality.

Previously, genetic personality studies focused on specific genes correlating to specific personality traits. Today’s view of the gene-personality relationship focuses primarily on the activation and expression of genes related to personality and forms part of what is referred to as behavioural genetics. Genes provide numerous options for varying cells to be expressed; however, the environment determines which of these are activated. Many studies have noted this relationship in varying ways in which our bodies can develop, but the interaction between genes and the shaping of our minds and personality is also relevant to this biological relationship.

DNA-environment interactions are important in the development of personality because this relationship determines what part of the DNA code is actually made into proteins that will become part of an individual. While different choices are made available by the genome, in the end, the environment is the ultimate determinant of what becomes activated. Small changes in DNA in individuals are what leads to the uniqueness of every person as well as differences in looks, abilities, brain functioning, and all the factors that culminate to develop a cohesive personality.

Cattell and Eysenck have proposed that genetics have a powerful influence on personality. A large part of the evidence collected linking genetics and the environment to personality have come from twin studies. This “twin method” compares levels of similarity in personality using genetically identical twins. One of the first of these twin studies measured 800 pairs of twins, studied numerous personality traits, and determined that identical twins are most similar in their general abilities. Personality similarities were found to be less related for self-concepts, goals, and interests.

Twin studies have also been important in the creation of the five factor personality model: neuroticism, extraversion, openness, agreeableness, and conscientiousness. Neuroticism and extraversion are the two most widely studied traits. Individuals scoring high in trait extraversion more often display characteristics such as impulsiveness, sociability, and activeness. Individuals scoring high in trait neuroticism are more likely to be moody, anxious, or irritable. Identical twins, however, have higher correlations in personality traits than fraternal twins. One study measuring genetic influence on twins in five different countries found that the correlations for identical twins were .50, while for fraternal they were about .20. It is suggested that heredity and environment interact to determine one’s personality.

Evolutionary Theory

Charles Darwin is the founder of the theory of the evolution of the species. The evolutionary approach to personality psychology is based on this theory. This theory examines how individual personality differences are based on natural selection. Through natural selection organisms change over time through adaptation and selection. Traits are developed and certain genes come into expression based on an organism’s environment and how these traits aid in an organism’s survival and reproduction.

Polymorphisms, such as gender and blood type, are forms of diversity which evolve to benefit a species as a whole. The theory of evolution has wide-ranging implications on personality psychology. Personality viewed through the lens of evolutionary psychology places a great deal of emphasis on specific traits that are most likely to aid in survival and reproduction, such as conscientiousness, sociability, emotional stability, and dominance. The social aspects of personality can be seen through an evolutionary perspective. Specific character traits develop and are selected for because they play an important and complex role in the social hierarchy of organisms. Such characteristics of this social hierarchy include the sharing of important resources, family and mating interactions, and the harm or help organisms can bestow upon one another.

Drive Theories

In the 1930s, John Dollard and Neal Elgar Miller met at Yale University, and began an attempt to integrate drives, into a theory of personality, basing themselves on the work of Clark Hull. They began with the premise that personality could be equated with the habitual responses exhibited by an individual – their habits. From there, they determined that these habitual responses were built on secondary, or acquired drives.

Secondary drives are internal needs directing the behaviour of an individual that results from learning. Acquired drives are learned, by and large in the manner described by classical conditioning. When we are in a certain environment and experience a strong response to a stimulus, we internalise cues from the said environment. When we find ourselves in an environment with similar cues, we begin to act in anticipation of a similar stimulus. Thus, we are likely to experience anxiety in an environment with cues similar to one where we have experienced pain or fear – such as the dentist’s office.

Secondary drives are built on primary drives, which are biologically driven, and motivate us to act with no prior learning process – such as hunger, thirst or the need for sexual activity. However, secondary drives are thought to represent more specific elaborations of primary drives, behind which the functions of the original primary drive continue to exist. Thus, the primary drives of fear and pain exist behind the acquired drive of anxiety. Secondary drives can be based on multiple primary drives and even in other secondary drives. This is said to give them strength and persistence. Examples include the need for money, which was conceptualised as arising from multiple primary drives such as the drive for food and warmth, as well as from secondary drives such as imitativeness (the drive to do as others do) and anxiety.

Secondary drives vary based on the social conditions under which they were learned – such as culture. Dollard and Miller used the example of food, stating that the primary drive of hunger manifested itself behind the learned secondary drive of an appetite for a specific type of food, which was dependent on the culture of the individual.

Secondary drives are also explicitly social, representing a manner in which we convey our primary drives to others. Indeed, many primary drives are actively repressed by society (such as the sexual drive). Dollard and Miller believed that the acquisition of secondary drives was essential to childhood development. As children develop, they learn not to act on their primary drives, such as hunger but acquire secondary drives through reinforcement. Friedman and Schustack describe an example of such developmental changes, stating that if an infant engaging in an active orientation towards others brings about the fulfilment of primary drives, such as being fed or having their diaper changed, they will develop a secondary drive to pursue similar interactions with others – perhaps leading to an individual being more gregarious. Dollard and Miller’s belief in the importance of acquired drives led them to reconceive Sigmund Freud’s theory of psychosexual development. They found themselves to be in agreement with the timing Freud used but believed that these periods corresponded to the successful learning of certain secondary drives.

Dollard and Miller gave many examples of how secondary drives impact our habitual responses – and by extension our personalities, including anger, social conformity, imitativeness or anxiety, to name a few. In the case of anxiety, Dollard and Miller note that people who generalise the situation in which they experience the anxiety drive will experience anxiety far more than they should. These people are often anxious all the time, and anxiety becomes part of their personality. This example shows how drive theory can have ties with other theories of personality – many of them look at the trait of neuroticism or emotional stability in people, which is strongly linked to anxiety.

Personality Tests

There are two major types of personality tests, projective and objective.

Projective tests assume personality is primarily unconscious and assess individuals by how they respond to an ambiguous stimulus, such as an ink blot. Projective tests have been in use for about 60 years and continue to be used today. Examples of such tests include the Rorschach test and the Thematic Apperception Test.

The Rorschach Test involves showing an individual a series of note cards with ambiguous ink blots on them. The individual being tested is asked to provide interpretations of the blots on the cards by stating everything that the ink blot may resemble based on their personal interpretation. The therapist then analyses their responses. Rules for scoring the test have been covered in manuals that cover a wide variety of characteristics such as content, originality of response, location of “perceived images” and several other factors. Using these specific scoring methods, the therapist will then attempt to relate test responses to attributes of the individual’s personality and their unique characteristics. The idea is that unconscious needs will come out in the person’s response, e.g. an aggressive person may see images of destruction.

The Thematic Apperception Test (TAT) involves presenting individuals with vague pictures/scenes and asking them to tell a story based on what they see. Common examples of these “scenes” include images that may suggest family relationships or specific situations, such as a father and son or a man and a woman in a bedroom. Responses are analysed for common themes. Responses unique to an individual are theoretically meant to indicate underlying thoughts, processes, and potentially conflicts present within the individual. Responses are believed to be directly linked to unconscious motives. There is very little empirical evidence available to support these methods.

Objective tests assume personality is consciously accessible and that it can be measured by self-report questionnaires. Research on psychological assessment has generally found objective tests to be more valid and reliable than projective tests. Critics have pointed to the Forer effect to suggest some of these appear to be more accurate and discriminating than they really are. Issues with these tests include false reporting because there is no way to tell if an individual is answering a question honestly or accurately.

The Myers-Briggs Type Indicator (also known as the MBTI) is self-reporting questionnaire based on Carl Jung’s Type theory. However, the MBTI modified Jung’s theory into their own by disregarding certain processes held in the unconscious mind and the impact these have on personality.

Personality Theory Assessment Criteria

  • Verifiability – the theory should be formulated in such a way that the concepts, suggestions and hypotheses involved in it are defined clearly and unambiguously, and logically related to each other.
  • Heuristic value – to what extent the theory stimulates scientists to conduct further research.
  • Internal consistency – the theory should be free from internal contradictions.
  • Economy – the fewer concepts and assumptions required by the theory to explain any phenomenon, the better it is Hjelle, Larry (1992). Personality Theories: Basic Assumptions, Research, and Applications.

Psychology has traditionally defined personality through its behavioural patterns, and more recently with neuroscientific studies of the brain. In recent years, some psychologists have turned to the study of inner experiences for insight into personality as well as individuality. Inner experiences are the thoughts and feelings to an immediate phenomenon. Another term used to define inner experiences is qualia. Being able to understand inner experiences assists in understanding how humans behave, act, and respond. Defining personality using inner experiences has been expanding due to the fact that solely relying on behavioural principles to explain one’s character may seem incomplete. Behavioural methods allow the subject to be observed by an observer, whereas with inner experiences the subject is its own observer.

Methods Measuring Inner Experience

Descriptive Experience Sampling (DES)Developed by psychologist Russel Hurlburt. This is an idiographic method that is used to help examine inner experiences. This method relies on an introspective technique that allows an individual’s inner experiences and characteristics to be described and measured. A beep notifies the subject to record their experience at that exact moment and 24 hours later an interview is given based on all the experiences recorded. DES has been used in subjects that have been diagnosed with schizophrenia and depression. It has also been crucial to studying the inner experiences of those who have been diagnosed with common psychiatric diseases.
Articulated Thoughts in Stimulated Situations (ATSS)ATSS is a paradigm which was created as an alternative to the TA (think aloud) method. This method assumes that people have continuous internal dialogues that can be naturally attended to. ATSS also assesses a person’s inner thoughts as they verbalise their cognitions. In this procedure, subjects listen to a scenario via a video or audio player and are asked to imagine that they are in that specific situation. Later, they are asked to articulate their thoughts as they occur in reaction to the playing scenario. This method is useful in studying emotional experience given that the scenarios used can influence specific emotions. Most importantly, the method has contributed to the study of personality. In a study conducted by Rayburn and Davison (2002), subjects’ thoughts and empathy toward anti-gay hate crimes were evaluated. The researchers found that participants showed more aggressive intentions towards the offender in scenarios which mimicked hate crimes.
Experimental MethodThis method is an experimental paradigm used to study human experiences involved in the studies of sensation and perception, learning and memory, motivation, and biological psychology. The experimental psychologist usually deals with intact organisms although studies are often conducted with organisms modified by surgery, radiation, drug treatment, or long-standing deprivations of various kinds or with organisms that naturally present organic abnormalities or emotional disorders. Economists and psychologists have developed a variety of experimental methodologies to elicit and assess individual attitudes where each emotion differs for each individual. The results are then gathered and quantified to conclude if specific experiences have any common factors. This method is used to seek clarity of the experience and remove any biases to help understand the meaning behind the experience to see if it can be generalised.

On This Day … 17 March

People (Births)

  • 1877 – Otto Gross, Austrian-German psychoanalyst and philosopher (d. 1920).
  • 1922 – Patrick Suppes, American psychologist and philosopher (d. 2014).

People (Deaths)

  • 1917 – Franz Brentano, German philosopher and psychologist (b. 1838).

Otto Gross

Otto Hans Adolf Gross (17 March 1877 to 13 February 1920) was an Austrian psychoanalyst. A maverick early disciple of Sigmund Freud, he later became an anarchist and joined the utopian Ascona community.

His father Hans Gross was a judge turned pioneering criminologist. Otto initially collaborated with him, and then turned against his determinist ideas on character.

A champion of an early form of anti-psychiatry and sexual liberation, he also developed an anarchist form of depth psychology (which rejected the civilising necessity of psychological repression proposed by Freud). He adopted a modified form of the proto-feminist and neo-pagan theories of Johann Jakob Bachofen, with which he attempted to return civilization to a ‘golden age’ of non-hierarchy. Gross was ostracized from the larger psychoanalytic movement, and was not included in histories of the psychoanalytic and psychiatric establishments. He died in poverty.

Greatly influenced by the philosophy of Max Stirner and Friedrich Nietzsche and the political theories of Peter Kropotkin, he in turn influenced D.H. Lawrence (through Gross’s affair with Frieda von Richthofen), Franz Kafka and other artists, including Franz Jung and other founders of Berlin Dada. His influence on psychology was more limited. Carl Jung claimed his entire worldview changed when he attempted to analyse Gross and partially had the tables turned on him.

He became addicted to drugs in South America where he served as a naval doctor. He was hospitalized several times for drug addiction, sometimes losing his guardianship of himself to his father in the process. As a Bohemian drug user from youth, as well as an advocate of free love, he is sometimes credited as a founding grandfather of 20th-century counterculture.

Patrick Suppes

Patrick Colonel Suppes (17 March 1922 to 17 November 2014) was an American philosopher who made significant contributions to philosophy of science, the theory of measurement, the foundations of quantum mechanics, decision theory, psychology and educational technology. He was the Lucie Stern Professor of Philosophy Emeritus at Stanford University and until January 2010 was the Director of the Education Program for Gifted Youth also at Stanford.

Franz Brentano

Franz Clemens Honoratus Hermann Josef Brentano (16 January 1838 to 17 March 1917) was an influential German philosopher, psychologist, and former Catholic priest (withdrawn in 1873 due to the definition of papal infallibility in matters of Faith) whose work strongly influenced not only students Edmund Husserl, Sigmund Freud, Tomáš Masaryk, Rudolf Steiner, Alexius Meinong, Carl Stumpf, Anton Marty, Kazimierz Twardowski, and Christian von Ehrenfels, but many others whose work would follow and make use of his original ideas and concepts.

What is Benzatropine?

Introduction

Benzatropine (an international non-proprietary name, INN), known as benztropine in the United States and Japan, is a medication used to treat a type of movement disorder due to antipsychotics known as dystonia and parkinsonism.

It is not useful for tardive dyskinesia. It is taken by mouth or by injection into a vein or muscle. Benefits are seen within two hours and last for up to ten hours.

Common side effects include dry mouth, blurry vision, nausea, and constipation. Serious side effect may include urinary retention, hallucinations, hyperthermia, and poor coordination. It is unclear if use during pregnancy or breastfeeding is safe. Benzatropine is an anticholinergic which works by blocking the activity of the muscarinic acetylcholine receptor.

Benzatropine was approved for medical use in the United States in 1954. It is available as a generic medication. In 2017, it was the 226th most commonly prescribed medication in the United States, with more than two million prescriptions. It is sold under the brand name Cogentin among others.

Medical Uses

Benzatropine is used to reduce extrapyramidal side effects of antipsychotic treatment. Benzatropine is also a second-line drug for the treatment of Parkinson’s disease. It improves tremor, and may alleviate rigidity and bradykinesia. Benzatropine is also sometimes used for the treatment of dystonia, a rare disorder that causes abnormal muscle contraction, resulting in twisting postures of limbs, trunk, or face.

Adverse Effects

These are principally anticholinergic:

  • Dry mouth.
  • Blurred vision.
  • Cognitive changes.
  • Drowsiness.
  • Constipation.
  • Urinary retention.
  • Tachycardia.
  • Anorexia.
  • Severe delirium and hallucinations (in overdose).

While some studies suggest that use of anticholinergics increases the risk of tardive dyskinesia (a long-term side effect of antipsychotics), other studies have found no association between anticholinergic exposure and risk of developing tardive dyskinesia, although symptoms may be worsened.

Drugs that decrease cholinergic transmission may impair storage of new information into long-term memory. Anticholinergic agents can also impair time perception.

Pharmacology

Benzatropine is a centrally acting anticholinergic/antihistamine agent. It is a selective M1 muscarinic acetylcholine receptor antagonist. Benzatropine partially blocks cholinergic activity in the basal ganglia and has also been shown to increase the availability of dopamine by blocking its reuptake and storage in central sites, and as a result, increasing dopaminergic activity. Animal studies have indicated that anticholinergic activity of benzatropine is approximately one-half that of atropine, while its antihistamine activity approaches that of mepyramine. Its anticholinergic effects have been established as therapeutically significant in the management of Parkinsonism. Benzatropine antagonises the effect of acetylcholine, decreasing the imbalance between the neurotransmitters acetylcholine and dopamine, which may improve the symptoms of early Parkinson’s disease.

Benzatropine analogues are atypical dopamine reuptake inhibitors, which might make them useful for people with akathisia secondary to antipsychotic therapy.

Benzatropine also acts as a functional inhibitor of acid sphingomyelinase (FIASMA).

Benzatropine has been also identified, by a high throughput screening approach, as a potent differentiating agent for oligodendrocytes, possibly working through M1 and M3 muscarinic receptors. In preclinical models for multiple sclerosis, benzatropine decreased clinical symptoms and enhanced re-myelination.

Other Animals

In veterinary medicine, benzatropine is used to treat priapism in stallions.

Naming

Since 1959, benzatropine is the official INN name of the medication under the INN scheme, the medication naming system coordinated by the World Health Organisation (WHO); it is also the British Approved Name (BAN) given in the British Pharmacopoeia, and has been the official non-proprietary name in Australia since 2015. Regional variations of the “a” spelling are also used in French, Italian, Portuguese, and Spanish, as well as Latin (all medications are assigned a Latin name by WHO).

“Benztropine” is the official United States Adopted Name (USAN), the medication naming system coordinated by the USAN Council, co-sponsored by the American Medical Association (AMA), the United States Pharmacopeial Convention (USP), and the American Pharmacists Association (APhA). It is also the Japanese Accepted Name (JAN) and was used in Australia until 2015, when it was harmonised with the INN.

Both names may be modified to account for the methanesulfonate salt as which the medication is formulated: the modified INN (INNm) and BAN (BANM) is benzatropine mesilate, while the modified USAN is benztropine mesylate. The modified JAN is a hybrid form, benztropine mesilate.

The misspelling benzotropine is also occasionally seen in the literature.

What is Organic Personality Disorder?

Introduction

Organic personality disorder (OPD), irrespective of the apparent nomenclature, is not included in the group of personality disorders.

For this reason, the symptoms and diagnostic criteria of the organic personality disorder are different from those of the other mental health disorders included in this various group. According to the Tenth Revision of the International Classification of Diseases (ICD-10) organic personality disorder is associated with a “significant alteration of the habitual patterns of premorbid behaviour”. There are crucial influences on emotions, impulses and personal needs because of this disorder.

Thus, all these definitions about the organic personality disorder support that this type of disorder is associated with changes in personality and behaviour.

Causes

Organic personality disorder is associated with “personality change due to general medical condition”. The organic personality disorder is included in a wide group of personality and behavioural disorders. This mental health disorder can be caused by disease, brain damages or dysfunctions in specific brain areas in frontal lobe. The most common reason for this profound change in personality is the traumatic brain injury (TBI). Children, whose brain areas have been injured or damaged, may present attention deficit hyperactivity disorder (ADHD), oppositional defiant disorder (ODD) and organic personality disorder. Moreover, this disorder is characterised as “frontal lobe syndrome”. This characteristic name shows that the organic personality disorder can usually be caused by lesions in three brain areas of frontal lobe. Specifically, the symptoms of organic personality disorder can also be caused by traumatic brain injuries in orbitofrontal cortex, anterior cingulate cortex and dorsolateral prefrontal cortex. It is worth mention that organic personality disorder may also be caused by lesions in other circumscribed brain areas.

Diagnosis and Symptoms

The ICD-10 includes a diagnostic guideline for the wide group of personality and behavioural disorders. However, every disorder has its own diagnostic criteria. In case of the organic personality disorder, patient has to show at least three of the following diagnostic criteria over a six or more months period. Organic personality disorder is associated with a large variety of symptoms, such as deficits in cognitive function, dysfunctional behaviours, psychosis, neurosis, emotional changes, alterations in expression function and irritability. Patients with organic personality disorder can present emotional lability that means their emotional expressions are unstable and fluctuating. In addition, patients show reduction in ability of perseverance with their goals and they express disinhibited behaviours, which are characterised by inappropriate sexual and antisocial actions. For instance, patients can show dissocial behaviours, like stealing. Moreover, according to diagnostic guideline of ICD-10, patients can suffer from cognitive disturbances and they present signs of suspiciousness and paranoid ideas. Additionally, patients may present alteration in process of language production that means there are changes in language rate and flow. Furthermore, patients may show changes in their sexual preference and hyposexuality symptoms.

Another common feature of personality of patients with organic personality disorder is their dysfunctional and maladaptive behaviour that causes serious problems in these patients, because they face problems with pursuit and achievement of their goals. It is worth to be mentioned that patients with organic personality disorder express a feeling of unreasonable satisfaction and euphoria. Also, the patients show aggressive behaviours sometimes and these serious dysfunctions in their behaviour can have effects on their life and their relationships with other people. Specifically patients show intense signs of anger and aggression because of their inability to handle their impulses. The type of this aggression is called “impulsive aggression”. Furthermore, it is worth to be mentioned that the pattern of organic personality disorder presents some similarities with pattern of temporal lobe epilepsy (TLE). Specifically patients who suffer from this chronic disorder type of epilepsy, express aggressive behaviours, likewise it happens to patients with organic personality disorder. Another similar symptom between Temporal lobe epilepsy and organic personality disorder is the epileptic seizure. The symptom of epileptic seizure has influence on patients’ personality that means it causes behavioural alterations”. The Temporal lobe epilepsy (TLE) is associated with the hyperexcitability of the medial temporal lobe (MTL) of patients. Finally, patients with organic personality disorder may present similar symptoms with patients, who suffer from the Huntington’s disease as well. The symptoms of apathy and irritability are common between these two groups of patients.

Treatment

As it has already been mentioned, patients with organic personality disorder show a wide variety of sudden behavioural changes and dysfunctions. There are not a lot of information about the treatment of this mental health disorder. The pharmacological approach is the most common therapy among patients with organic personality disorder. However, the choice of drug therapy relies on the seriousness of patient’s situation and what symptoms are shown. The choice and administration of specific drugs contribute to the reduction of symptoms of organic personality disorder. For this reason, it is crucial for patients’ treatment to be assessed by clinical psychologists and psychiatrists before the administration of drugs.

Additionally, the dysfunctions in expression of behaviour of patients with organic personality disorder and the development of symptom of irritability, which are caused by aggressive and self-injurious behaviours, can be dealt with the administration of carbamazepine. Moreover, the symptoms of this disorder can be decreased by the administration of valproic acid. Also, emotional irritability and signs of depression can be dealt with the use of nortriptyline and low-dose thioridazine. Except from the symptom of irritability, patients express aggressive behaviours. At the onset of drug therapy for effective treatment of anger and aggression, the drug of carbamazepine, phenobarbital, benztropine (or benzatropine) and haloperidol can be administrated in order to reduce the symptoms of patients with organic personality disorder. In addition, the use of propranolol may decrease the frequent behaviours of rage attacks.

Finally, it is important for patients to take part in psychotherapy during drug therapy. In this way, many of the adverse effects of the medications, both physiological and behavioural, can be lessened or avoided entirely. Furthermore, the clinicians can provide useful and helpful support to patients during these psychotherapy sessions. Thus, the combination of drug therapy with psychotherapy can lead to the reduction of symptoms of this disorder and the improvement of patients’ situation.

What is Oral Stage?

Introduction

In Freudian psychoanalysis, the term oral stage or hemiataxia denotes the first psychosexual development stage wherein the mouth of the infant is their primary erogenous zone.

Spanning the life period from birth to the age of 18 months, the oral stage is the first of the five Freudian psychosexual development stages:

  • The oral;
  • The anal;
  • The phallic;
  • The latent; and
  • The genital.

Moreover, because it is the infant’s first human relationship – biological (nutritive) and psychological (emotional) – its duration depends upon the child-rearing mores of the mother’s society. Sociologically speaking, the duration of infantile nursing is determined normatively; in some societies it is common for a child to be nursed by their mother for several years but in others this period is much shorter.

Oral-Stage Fixation

Psychologically, Sigmund Freud proposed that if the nursing child’s appetite were thwarted during any libidinal development stage, the anxiety would persist into adulthood as a neurosis (functional mental disorder). Therefore, an infantile oral fixation (oral craving) would be manifest as an obsession with oral stimulation; yet, if weaned either too early or too late, the infant might fail to resolve the emotional conflicts of the oral, first stage of psychosexual development and they might develop a maladaptive oral fixation.

The infant who is neglected (insufficiently fed) or who is over-protected (over-fed) in the course of being nursed, might become an orally-fixated person. Said oral-stage fixation might have two effects:

  • The neglected child might become a psychologically dependent adult continually seeking the oral stimulation denied in infancy, thereby becoming a manipulative person in fulfilling their needs, rather than maturing to independence; and
  • The over-protected child might resist maturation and return to dependence upon others in fulfilling their needs.

Theoretically, oral-stage fixations are manifested as garrulousness (talkativeness), smoking, continual oral stimulus (eating, chewing objects), and alcoholism. Psychologically, the symptoms include a sarcastic, oral sadistic personality, nail biting, oral sexual practices (fellatio, cunnilingus, analingus, irrumatio), et cetera.

Criticism

Since Freud’s presentation of the theory of psychosexual development in 1905, no evidence has confirmed that extended breast-feeding might lead to an oral-stage fixation, nor that it contributes to a person becoming maladjusted or to developing addictions (psychologic, physiologic). The paediatrician Jack Newman proposed that breast feeding a child until they choose to wean (c. 2-4 years of age) generally produces a more psychologically secure, and independent person. Contradicting the Freudian psychosexual development concept of oral-stage fixation, the Duration of Breast-feeding and the Incidence of Smoking (2003) study of 87 participants reported no causal relation between the breast-feeding period and whether or not a child matures into a person who smokes.

On This Day … 16 March

People (Births)

  • 1937 – Amos Tversky, Israeli-American psychologist and academic (d. 1996).

People (Deaths)

  • 1841 – Félix Savart, French physicist and psychologist (d. 1791).

Amos Tversky

Amos Nathan Tversky (16 March 1937 to 02 June 1996) was an Israeli cognitive and mathematical psychologist and a key figure in the discovery of systematic human cognitive bias and handling of risk.

Much of his early work concerned the foundations of measurement. He was co-author of a three-volume treatise, Foundations of Measurement. His early work with Daniel Kahneman focused on the psychology of prediction and probability judgement; later they worked together to develop prospect theory, which aims to explain irrational human economic choices and is considered one of the seminal works of behavioural economics.

Six years after Tversky’s death, Kahneman received the 2002 Nobel Memorial Prize in Economic Sciences for the work he did in collaboration with Amos Tversky (The prize is not awarded posthumously). Kahneman told The New York Times in an interview soon after receiving the honour: “I feel it is a joint prize. We were twinned for more than a decade.”

Tversky also collaborated with many leading researchers including Thomas Gilovich, Itamar Simonson, Paul Slovic and Richard Thaler. A Review of General Psychology survey, published in 2002, ranked Tversky as the 93rd most cited psychologist of the 20th century, tied with Edwin Boring, John Dewey, and Wilhelm Wundt.

Felix Savart

Félix Savart (30 June 1791 to 16 March 1841) was a physicist and mathematician who is primarily known for the Biot–Savart law of electromagnetism, which he discovered together with his colleague Jean-Baptiste Biot.

His main interest was in acoustics and the study of vibrating bodies. A particular interest in the violin led him to create an experimental trapezoidal model. He gave his name to the savart, a unit of measurement for musical intervals, and to Savart’s wheel – a device he used while investigating the range of human hearing.

What was the National Registry of Evidence-Based Programmes and Practices (US)?

Introduction

National Registry of Evidence-Based Programmes and Practices (NREPP) Logo.

The National Registry of Evidence-based Programmes and Practices (NREPP) was a searchable online database of interventions designed to promote mental health or to prevent or treat substance abuse and mental disorders.

The registry was funded and administered by the Substance Abuse and Mental Health Services Administration (SAMHSA), part of the US Department of Health and Human Services. The goal of the Registry was to encourage wider adoption of evidence-based interventions and to help those interested in implementing an evidence-based intervention to select one that best meets their needs.

The NREPP website was phased out in 2018.

Background

In the behavioural health field, there is an ongoing need for researchers, developers, evaluators, and practitioners to share information about what works to improve outcomes among individuals coping with, or at risk for, mental disorders and substance abuse. Discussing how this need led to the development of NREPP, Brounstein, Gardner, and Backer (2006) write:

It is important to note that not all prevention programs work. Still other programs have no empirically based support regarding their effectiveness. […] Many others have empirical support, but the methods used to generate that support are suspect. This is another reason to highlight the need for and use of scientifically defensible, effective prevention programs. These are programs that clearly demonstrate that the program was well implemented, well evaluated, and produced a consistent pattern of positive results.

The focus of NREPP is on delivering an array of standardised, comparable information on interventions that are evidence based, as opposed to identifying programmes that are “effective” or ranking them in effectiveness. Its peer reviewers use specific criteria to rate the quality of an intervention’s evidence base as well as the intervention’s suitability for broad adoption. In addition, NREPP provides contextual information about the intervention, such as the population served, implementation history, and cost data to encourage a realistic and holistic approach to selecting prevention interventions.

As of 2010, the interventions reviewed by NREPP have been implemented successfully in more than 229,000 sites, in all 50 States and more than 70 countries, and with more than 107 million clients. Versions of ura review process and rating criteria have been adopted by the National Cancer Institute and the Administration on Aging.

The information NREPP provides is subject to certain limitations. It is not an exhaustive repository of all tested mental health interventions; submission is a voluntary process, and limited resources may preclude the review of some interventions even though they meet minimum requirements for acceptance. The NREPP home page prominently states that “inclusion in the registry does not constitute an endorsement.”

Submission Process

NREPP holds an open submission period that runs 01 November through 01 February. For an intervention to be eligible for a review, it must meet four minimum criteria:

  • The intervention has produced one or more positive behavioural outcomes (p ≤ .05) in mental health, mental disorders, substance abuse, or substance use disorders use among individuals, communities, or populations.
  • Evidence of these outcomes has been demonstrated in at least one study using an experimental or quasi-experimental design.
  • The results of these studies have been published in a peer-reviewed journal or other professional publication, or documented in a comprehensive evaluation report.
  • Implementation materials, training and support resources, and quality assurance procedures have been developed and are ready for use by the public.

Once reviewed and added to the Registry, interventions are invited to undergo a new review four or five years after their initial review.

Review Process

The NREPP review process consists of two parallel and simultaneous review tracks, one that looks at the intervention’s Quality of Research (QOR) and another that looks at the intervention’s Readiness for Dissemination (RFD). The materials used in a QOR review are generally published research articles, although unpublished final evaluation reports can also be included. The materials used in an RFD review include implementation materials and process documentation, such as manuals, curricula, training materials, and written quality assurance procedures.

The reviews are conducted by expert consultants who have received training on NREPP’s review process and rating criteria. Two QOR and two RFD reviewers are assigned to each review. Reviewers work independently, rating the same materials. Their ratings are averaged to generate final scores.

While the review process is ongoing, NREPP staff work with the intervention’s representatives to collect descriptive information about the intervention, such as the program goals, types of populations served, and implementation history.

The QOR ratings, given on a scale of 0.0 to 4.0, indicate the strength of the evidence supporting the outcomes of the intervention. Higher scores indicate stronger, more compelling evidence. Each outcome is rated separately because interventions may target multiple outcomes (e.g. alcohol use, marijuana use, behaviour problems in school), and the evidence supporting the different outcomes may vary. The QOR rating criteria are:

  • Reliability of measures.
  • Validity of measures.
  • Intervention fidelity.
  • Missing data and attrition.
  • Potential confounding variables.
  • Appropriateness of analysis.

The RFD ratings, also given on a scale of 0.0 to 4.0, indicate the amount and quality of the resources available to support the use of the intervention. Higher scores indicate that resources are readily available and of high quality. These ratings apply to the intervention as a whole. The RFD criteria are:

  • Availability of implementation materials.
  • Availability of training and support resources.
  • Availability of quality assurance procedures.

Reviewers

QOR reviewers are required to have a doctoral-level degree and a strong background and understanding of current methods of evaluating prevention and treatment interventions. RFD reviewers are selected from two categories: direct services experts (including both providers and consumers of services), or experts in the field of implementation. Direct services experts must have previous experience evaluating prevention or treatment interventions and knowledge of mental health or substance abuse prevention or treatment content areas.

Products and Publications

NREPP publishes an intervention summary for each intervention it adds to the Registry. The summaries, which are accessed through the Registry’s search engine, contain the following standardised information:

  • A brief description of the reviewed intervention, including targeted goals and theoretical basis.
  • Study populations (age, gender, race/ethnicity).
  • Study settings and geographical locations.
  • Implementation history.
  • Funding information.
  • Comparative evaluation research conducted with the intervention.
  • Adaptations.
  • Adverse effects.
  • List of studies and materials reviewed.
  • List of outcomes.
  • Description of measures and key findings for each outcome.
  • Research design of the studies reviewed.
  • Quality of Research and Readiness for Dissemination ratings.
  • Reviewer comments (Strengths and Weaknesses).
  • Costs.
  • Replication studies.
  • Contact information.

NREPP also maintains an online Learning Centre. Offerings include learning modules on implementation and preparing for NREPP submission; a research paper on evidence-based therapy relationships; and links to screening and assessment tools for mental health and substance use.

Predecessor System

The registry originated in 1997 and has gone through several changes since then. The predecessor to today’s NREPP was the National Registry of Effective Prevention Programmes (later renamed the National Registry of Effective Programmes and Practices), which was developed by SAMHSA’s Centre for Substance Abuse Prevention as part of the Model Programmes initiative. Procedures under this earlier registry were developed to review, rate, and designate programmes as Model, Effective, or Promising. Based on extensive input from scientific communities, service providers, expert panels, and the public, the procedures were revised. Reviews using the new NREPP system began in 2006, and the redesigned Web site debuted in March 2007.

Phase out in 2018

According to an email from SAMHSA:

“SAMHSA is committed to advancing the adoption of evidence-based interventions related to mental health and substance use. Consistent with the January 2018 announcement from the Assistant Secretary for Mental Health and Substance Use related to discontinuing the National Registry of Evidence-based Programs and Practices (NREPP), SAMHSA has now phased out the NREPP website, which has been in existence since 1997. In April 2018, SAMHSA launched the Evidence-Based Practices Resource Center (Resource Center) that aims to provide communities, clinicians, policy makers, and others in the field with the information and tools they need to incorporate evidence-based practices into their communities or clinical settings. The Resource Center contains a collection of science-based resources; however, it does not replace NREPP and does not contain all of the resources that were previously available on NREPP.

“The Resource Center is a component of SAMHSA’s new comprehensive approach to identify and disseminate clinically sound and scientifically based policy, practices, and programs. Under this new approach, we are continuing to develop and add additional resources to the Resource Center as they become available. In the meantime, please use our Resource Center as well as the SAMHSA Store to find information on evidence-based practices and other resources related to mental health and substance use. For products and resources not developed by SAMHSA, please contact the developers for more information.”

Further Reading

  • Hennessy, K., Finkbiner, R., & Hill, G. (2006) The National Registry of Evidence-Based Programs and Practices: A Decision-Support Tool to Advance the Use of Evidence-Based Services. International Journal of Mental Health. 35(2), pp.21-34. doi: 10.2753/IMH0020-7411350202.
  • Brounstein, P. J., Gardner, S. E., & Backer, T. (2006) Research to Practice: Efforts to Bring Effective Prevention to Every Community. Journal of Primary Prevention. 27(1), pp.91-109. doi: 10.1007/s10935-005-0024-6. PMID 16421654. These criteria and the accompanying rating anchors are unique to NREPP but share common elements with the types of standards used by other Federal agencies to assess evidence-based programmes.
  • Official Website (Phased Out in 2018): https://www.nrepp.samhsa.gov/.
  • SAMHSA Evidence-based Practices Resource Centre: https://www.samhsa.gov/resource-search/ebp.
  • SAMHSA: https://www.samhsa.gov/.

What is a Negative Therapeutic Reaction?

Introduction

The negative therapeutic reaction in psychoanalysis is the paradoxical phenomenon whereby a plausible interpretation produces, rather than improvement, a worsening of the analysand’s condition.

Freud’s Formulations

Freud first named the negative therapeutic reaction in The Ego and the Id of 1923, seeing its cause, not merely in the analysand’s desire to be superior to their analyst, but (more deeply) in an underlying sense of guilt: “the obstacle of an unconscious sense of guilt….they get worse during the treatment instead of getting better”. The following year he offered the alternative formulation of a need for punishment instead; but in his thirties summation it was again unconscious guilt to which he attributed “the negative therapeutic reaction which is so disagreeable from the prognostic point of view”.

Precursors to the idea can be found in his own article Criminals from a sense of guilt, as well as in Karl Abraham’s 1919 article on envy and narcissism as enemies of the analytic work.

Later Developments

The negative therapeutic reaction is unusual in psychoanalytic history in never being the subject of major controversy, while still be steadily worked on and reformulated in later analytic phases. These have added additional motivations behind the reaction to that singled out by Freud. Joan Riviere pointed to the neurotic’s fear of any change in condition, even from worse to better, while the desire to spite the analyst may also be a motive. Lacan highlighted the role of amour propre in the hatred of being helped by any outside force. Object relations theory has also pointed to the way that underdoing defences means the patient experiencing their underlying conflicts more fully, and reacting negatively to that.

What was the National Institute for Mental Health in England?

Introduction

National Institute for Mental Health in England (NIMHE) was an English medical organisation established in 2001 under the leadership of Professor Louis Appleby to “coordinate research, disseminate information, facilitate training and develop services”.

Background

The NIMHE was disbanded and a new body, the National Mental Health Development Unit was launched in 2009. The director of NIMHE, Ian MacPherson, became the director of NMHDU. The NMHDU was also disbanded in March 2011.

One of NIMHE’s first publications, titled Cases for Change, was funded by the Department of Health to review documents published since 1997 about adult mental health, and was undertaken in conjunction with the Department of General Practice.

What is a Mental Health Consumer?

Introduction

A mental health consumer (or mental health patient) is a person who is obtaining treatment or support for a mental disorder, also known as psychiatric or mental illness.

The term was coined by people who use mental health services in an attempt to empower those with mental health issues, historically considered a marginalised segment of society. The term suggests that there is a reciprocal contract between those who provide a service and those who use a service and that individuals have a choice in their treatment and that without them there could not exist mental health providers.

Brief History

In the 1970s the term “patient” was most commonly used. Mental Health activists of the civil rights times recognised, as did many other groups seeking self-definition, that such labels are metaphors that reflect how identities are perceived and constructed. In particular, in the mental health field they shape the nature of the relationship between the giver and receiver of psychiatric services, be it one with an emphasis on reciprocity or hierarchy. Users of psychiatric services repulsed the efforts of experts to define them and sought to develop ways to define themselves. In Australia, informal support groups of people who had recovered from episodes of mental ill health were formed during the first wave of moving patients out of psychiatric hospitals into the community in the 1960s. In the USA and other countries, radical movements to change service delivery and legislation began to be driven by consumers during the 1980s. Activists, such as Judi Chamberlain, pressed for alternatives to psychiatrist dominated and controlled systems of mental health provision. Chamberlain’s On Our Own: Patient Controlled Alternatives to the Mental Health System helped guide others intent on a more collaborative form of mental health healing.

In the 1980s with some funding from NIMH, small experimental groups flourished. In 1985 at the First Alternatives Conference attendees agreed upon the term “consumer” reflecting the patients’ choice of services. The term also implied assumptions of rationality and ability to make choices in one’s own best interests rather than be a passive incapacitated recipient of “expert” attention. In the 1990s many consumer groups were formed, such as Self Help Clearing House and the National Empowerment Centre. They continued to press for more peer involvement in alternatives treatments, pointing out that peers support and comfort, which may be in contrast to some therapists who just attempt to change the behaviour and thinking patterns.

Contemporary Usage

Today, the word mental health consumer has expanded in the popular usage of consumers themselves to include anyone who has received mental health services in the past, anyone who has a behavioural health diagnosis, or simply anyone who has experienced a mental or behavioural disorder. Other terms sometimes used by members of this community for empowerment through positive self-identification include “peers,” “people with mental health disabilities,” “psychiatric survivors,” “users,” individuals with “lived experience” and “ex-patients.” The term “service users,” is commonly used in the UK. In the US “consumer” is most frequently used by ex-patients and users of psychiatric and alternative services.

One can view this term, “consumer,” neutrally as a person who receives psychological services, perhaps from a psychologist, a psychiatrist or a social worker. It can be impersonal term relating to the use in the health sector of a large economy. It suggests that the consumer expects to have some influence on service delivery and provides feedback to the provider. Used in its more activist sense, consumer groups aim to correct perceived problems in mental health services and to promote consultation with consumers. Consumer theory was devised to interpret the special relationship between a service provider and service user in the context of mental health. Consumer theory examines the consequences and sociological meaning of the relationship.