Feeling Worse Before Feeling Better: A Case of Increased Disorganized Mental States Following Group Psychotherapy
Why this work is in the frame
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Bibliographic record
Abstract
Is group therapy effective if it results in members revealing greater unresolved/disorganized mental states related to childhood trauma? That is, do patients have to more fully experience partially disavowed trauma before they get better? We found a small proportion of patients whose pre-treatment Adult Attachment Interview (AAI) transcripts were not coded as Unresolved/Disorganized at the start of group treatment, but were coded as such at the end. In one case report, we examined pre- and six months post-AAI transcripts and group therapy interactions to document the emergence of an unresolved/disorganized mental state. Despite the increase in disorganization, the patient showed some symptom improvement and improved reflective functioning. The 16-week psychodynamic group therapy allowed the patient to reflect on her traumatic experiences and their impact on her life. However, this also resulted in a disorganizing effect on her mental state. Longer-term therapy may be necessary to improve interpersonal functioning and affect regulation in patients who experienced early trauma.
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Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it