The aim of the present study was to assess the effect of initial level of psychiatric severity on treatment outcome in psychodynamic therapy and dialectical behavior therapy (DBT) for borderline personality disorder (BPD). It was hypothesized that DBT would lead to better outcome for patients with high psychiatric severity, whereas dynamic treatment would lead to better outcome for patients with lower psychiatric severity. Data from the 5th-year follow-up of the Stockholm City Council's and the Karolinska Institute's Psychotherapy Project were used in the present study. A total of 106 female patients diagnosed with BPD with at least 2 past suicide attempts were randomized into object-relational psychotherapy (ORP; based on transference-focused psychotherapy), DBT, and treatment as usual. Patients' baseline global severity index was used as a moderator. Global Assessment of Functioning (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition [American Psychiatric Association, 1994]) was used to examine outcome. There was a significant 3-way interaction of Time × Treatment × Severity. Post hoc analyses suggested that patients with lower levels of severity had significantly better outcomes in object-relational psychotherapy. For patients with higher severity, the 3 treatments resulted in similar outcomes in terms of level of functioning. Outcome of treatment for BPD might differ significantly for patients depending on their initial levels of overall psychiatric severity. If our findings are replicated for patients with low severity and supported for a high-severity sample, psychiatric severity can be used as a low-cost and effective tool to match patients with BPD to optimal treatments. (PsycINFO Database Record

Personality disorders (PD) carry high psychosocial dysfunction and are associated with treatment resistance in nonspecialized care. Psychodynamic therapies (PDT) are often used to treat PDs, but there has never been a systematic meta-analysis of PDT trials for PD. To evaluate the evidence base for PDTs for PDs across multiple outcome domain, a systematic search for PDT for PD trials was conducted through PubMed and PsycINFO. Sixteen trials were identified, comprising 19 dynamic, 8 active, and 9 control groups predominantly reflecting treatment of borderline and mixed Cluster C PDs, and a random effects meta-analysis was undertaken. PDTs were superior to controls in improving core PD symptoms (g = −0.63; 95% confidence interval [CI; −0.87, −0.41]), suicidality (g = −0.79, p = .02; 95% CI [−1.38, −0.20]), general psychiatric symptoms (g = −0.47; 95% CI [−0.69, −0.25]), and functioning (g = −0.66; 95% CI [−1.01, −0.32]), but not for interpersonal problems due to heterogeneity (g = −1.25; 95% CI [−3.22, 0.71]). Outcomes for PDTs were not different from other active treatments in core PD (g = 0.05; 95% CI [−0.25, 0.35]) or other symptoms. This pattern continued into posttreatment follow-up (average 14 months). Study quality was generally rated as adequate and was unrelated to outcomes. Compared with other treatments, PDTs do not have different acute effects and are superior to controls, although only trials treating BPD employed active controls and non-BPD trials were of lower quality. Underresearched areas include narcissistic PD, specific Cluster C disorders, and personality pathology as a continuous construct.

Most measures of psychotherapy outcome focus on symptomatic change. However, clients often report other changes through therapy, such as increased self-acceptance. This study reports on the development and validation of the Complementary Measure of Psychotherapy Outcome (COMPO) that assesses different areas of psychological functioning deemed important by clients and therapists. Items were written based on a literature review of client-reported change and feedback from experienced therapists. Exploratory factor analysis was conducted on the initial 42-item COMPO administered to 264 psychotherapy clients. Iterative item reduction resulted in the final 12-item, four-factor solution, with factors named self-acceptance, selfknowledge, relationship quality, and consideration of others. This factor structure, along with a bifactor model that contains a general factor and the four domain-specific factors, was replicated on a sample of 571 adults in the community. The 12-item COMPO exhibits convergent validity with measures of self-esteem, insight, social support, and empathy; demonstrates 2-week test-retest reliability; and predicts life satisfaction. The 12-item COMPO was further administered to 28 clients in short-term psychodynamic therapy for depression. Except for consideration of others, COMPO subscales and total scale scores improved from pre-to posttherapy. Posttherapy COMPO scores were also higher among clients who experienced clinically significant change compared to those who did not. The COMPO was negatively associated with depressive symptoms and impairments in functioning across the three samples. The brevity of the COMPO makes it a convenient tool to supplement symptom-based measures for a more comprehensive assessment of outcome in psychotherapy. Public Significance StatementThe goal of psychotherapy does not only include the reduction of psychological symptoms, yet most outcome measures focus on symptom change. A new measure is developed to assess nonsymptomatic changes that patients and therapists care about in therapies across theoretical orientations.

The present study aims to investigate the mechanical properties of base materials [polymethyl methacrylate (PMMA)/polyether ether ketone (PEEK)] fabricated with computeraided design/computer-aided manufacturing (CAD/CAM) and heatpolymerized conventional base materials. Material and Methods: Two different base polymers milled with CAD/CAM (Yamahachi PMMA Disk and Juvora Dental Disk PEEK) and heat-polymerized acrylic resin (Meliodent PMMA) were used in this study. A total of 120 specimens were prepared with 10 specimens in each subgroup of the test materials. Half of the test specimens were stored in distilled water, while the other half were subjected to a thermal cycle. After the thermal cycle, the flexural strength, elasticity module, and, surface hardness of all test specimens was evaluated. The Mann-Whitney U and Kruskal-Wallis tests were used in the analysis of the data. Results: According to the findings of flexural strength and elasticity module of the test specimens, the highest to lowest value ranking was as follows: CAD/CAM PEEK>CAD/CAM PMMA>heat-polymerized PMMA. In the PMMA group produced with CAD/CAM, surface hardness values were significantly higher in the thermocycle applied test specimens compared to those stored in distilled water (p<0.001). Conclusion: CAD/CAM PMMA and PEEK materials were compared with the heat-polymerized test specimens found to show better mechanical properties.

yüksek lisans ve doktora) öğrencinin görüşü alınmıştır. Araştırma sonucunda uzaktan eğitime yönelik öğrencilerin eğitim öğretimin niteliği, uzaktan eğitimle ilgili önerilerinin, kavram algıları ile ilgili fikirlerinin farklılaştığı tespit edilmiştir. Ayrıca, öğrencilerin büyük çoğunluğunun uzaktan eğitimle ilgili olumsuz görüş bildirdiği gözlemlenmiş ve bu konuda birtakım öneriler geliştirdikleri görülmüştür.