Abstract Objectives This study examined how adults diagnosed with Dissociative Identity Disorder (DID) experience and make sense of “inner worlds”: recurrent, internally experienced spatial settings associated with dissociative parts, events and relationships. Design A qualitative study was conducted using Interpretative Phenomenological Analysis (IPA). Methods Five adults who reported pre‐existing DID diagnoses made by adult psychiatry specialists participated in in‐depth semi‐structured interviews. Interviews examined the sensory, embodied, spatial, temporal, relational and agentic qualities of inner‐world experience. Transcripts were analysed idiographically before patterns of convergence and divergence were examined across cases. Results Four superordinate themes were generated: (1) inner worlds as lived, multisensory and embodied environments; (2) architectures of containment and passage; (3) awareness without authorship, distributed agency and internal governance; and (4) the internal community, comprising roles, relations and forms of selfhood. Across themes, places, boundaries and relationships regulated containment, access, communication and possibilities for action. Participants could be aware of internal events without experiencing themselves as able to initiate, stop or alter them. Conclusions Inner worlds were experienced as embodied, spatially and relationally organised environments rather than as uniformly voluntary constructions. The separation of awareness from authorship identifies the distribution of perceived agency within one whole person as an important phenomenological dimension. Clinically, these experiences warrant collaborative and non‐leading exploration; their comparative and diagnostic significance requires direct investigation rather than inference from vividness or reduced control alone.
Abstract Aim Somatization is frequently observed in patients with borderline personality disorder (BPD). BPD is characterized by difficulties in mentalizing capacity. This study aimed to examine somatization in BPD patients compared with a healthy control group, focusing on the roles of self‐ and other‐mentalizing in the relationship between attachment insecurity and somatic symptoms. Method A total of 164 individuals, including 82 patients diagnosed with BPD and 82 healthy controls, participated in our study between August 2023 and March 2024. Somatization Scale, Experiences in Close Relationships‐Revised, Trait Meta‐Mood Scale, Mentalization Scale, Reading the Mind in the Eyes Test were used to assess somatization, dimensions of attachment insecurity, self‐ and other‐mentalizing. Moderated mediation analysis was conducted using Model 15 in the PROCESS macro added to SPSS. Results Somatization was observed to be more pronounced in patients with BPD compared to healthy controls. Self‐ and other‐mentalizing were closely related to somatization in BPD patients. It was demonstrated with moderated mediation analysis that clarity of feelings and mind‐reading ability mediated the association between attachment anxiety and somatization in BPD patients. In healthy controls, only clarity of feelings partially mediated this association. Conclusion Our findings suggest that self‐ and other‐mentalizing may serve as protective factors against the increased somatization observed in patients with BPD. Deficiencies in these mentalizing abilities may be linked to somatization due to difficulties in interpreting bodily signals and dealing with emotional distress from unstable relationships.
INTRODUCTION:Self-harm is common in people who experience disordered eating. It is unclear whether those who self-harm with disordered eating have distinct characteristics and needs compared to those who self-harm without co-occurring disordered eating. METHODS:Data were obtained from the Manchester Self-Harm Project. Information was extracted for people who were seen by psychiatric clinicians following an emergency department presentation for self-harm, between 2011 and 2017. Mortality follow-up was available until 2019. A total of 312 cases, where evidence of disordered eating was identified, were matched 1:5 (on age, gender and date of presentation) with 1560 controls. RESULTS:Being a student (odds ratio [OR] = 2.3, 95% confidence interval [CI] = 1.6-3.2), living in affluent areas (OR = 1.1, 95% CI = 1.1-1.2), work/study problems (OR = 1.4, 95% CI = 1.1-1.9), physical health problems (OR = 2.0, 95% CI = 1.5-2.8) and previous psychiatric support (OR = 2.2, 95% CI 1.6-3.0) were associated with higher odds of a co-occurring disordered eating alongside self-harm. No differences were observed in self-harm repetition. CONCLUSION:People who self-harm with evidence of disordered eating have differences in perceived problems, previous psychiatric support and demographic differences (e.g. student status and affluence) compared to controls. This group has distinct clinical needs and may benefit from targeted interventions.
BACKGROUND:Men exposed to child sexual abuse (CSA) have recently received increased research attention. Most studies have emphasised barriers to disclosure, given that non-disclosure is common in men and contributes to isolation, confusion and distress following CSA. However, beyond identifying barriers, little is known about men's experiences of disclosure itself, particularly in healthcare contexts. METHOD:Interviews were conducted with 14 men throughout Australia who had experienced CSA and engaged in therapy (i.e., psychology, psychiatry, counselling). Interviews explored pathways to, and experiences of, disclosing CSA to therapists and were analysed using interpretative phenomenological analysis. RESULTS:Three themes were developed. In Searching for intrapersonal meaning, disclosures were largely self-motivated and linked to men's recognition of CSA, breaking patterns of avoidance and desires to live authentically. Echoes of disclosure described resounding impacts of CSA disclosures, which shaped men's understandings of CSA and subsequent disclosures. Echoes of trauma explored ways trauma itself interacted with men's therapeutic disclosures, shaping provider preferences and embodied trauma reminders during disclosures. IMPLICATIONS:Findings suggest CSA disclosures in therapy are situated within men's long-term searches for meaning, truth-telling and authenticity-extending beyond problem-solving or symptom reduction. These insights advance early evidence regarding men's experiences following CSA and may impact how clinicians approach, invite and respond to disclosures. Findings offer clinicians valuable insights into men's lived experiences of disclosing CSA in therapy. Therapists may play roles in supporting men to recognise, accept and process CSA, but also risk reinforcing stigma and silence. Therapists demonstrating attunement and care supported safe, meaningful disclosures.
OBJECTIVES:Nature exposure may support young women in improving their relationship with their body, enhancing positive body image. However, the mechanisms remain still largely underexplored. A few qualitative studies provided valuable insights, but they lacked generalizability to the broader population of young women, since they often relied on similar samples (e.g. North American individuals, individuals recovering from an eating disorder) or did not accurately represent young women (e.g. too broad age range). Therefore, the current study aimed to qualitatively explore how nature exposure could improve positive body image relying on a sample of young women recruited from the general Italian population, who self-report to expose themselves to natural environments. DESIGN:A qualitative study using focus groups composed of young women who expose themselves to natural environments. METHODS:Six focus groups were conducted with 19 young Italian women (Mdnage = 25 years; range = 22-35 years). The transcripts were analysed using reflexive thematic analysis. RESULTS:Three main themes were developed: (1) Nature strengthens a connection with the body, (2) nature reduces emphasis on appearance and (3) nature as a catalyst for self-(re)connection. These three themes suggest novel possible mechanisms involved in the relationship between nature exposure and positive body image (e.g. positive embodiment) and capture some cultural nuances (e.g. the role of beaches). CONCLUSIONS:Overall, this study offers meaningful directions for future studies, which could quantitatively examine the identified mechanisms. Moreover, it informs prevention strategies and psychological interventions aimed at improving young women's relationship with their bodies utilizing nature exposure.
