UNASSIGNED: This paper explores a significant shift in the field of mental health in general and psychotherapy in particular following generative artificial intelligence\'s new capabilities in processing and generating humanlike language. Following Freud, this lingo-technological development is conceptualized as the \"fourth narcissistic blow\" that science inflicts on humanity. We argue that this narcissistic blow has a potentially dramatic influence on perceptions of human society, interrelationships, and the self. We should, accordingly, expect dramatic changes in perceptions of the therapeutic act following the emergence of what we term the artificial third in the field of psychotherapy. The introduction of an artificial third marks a critical juncture, prompting us to ask the following important core questions that address two basic elements of critical thinking, namely, transparency and autonomy: (1) What is this new artificial presence in therapy relationships? (2) How does it reshape our perception of ourselves and our interpersonal dynamics? and (3) What remains of the irreplaceable human elements at the core of therapy? Given the ethical implications that arise from these questions, this paper proposes that the artificial third can be a valuable asset when applied with insight and ethical consideration, enhancing but not replacing the human touch in therapy.

Over the past decades mental health services around the world are faced with a high number of patients with borderline personality disorder (BPD) which has resulted in a particular emphasis on research for specialist treatments for this class of disorders. At least 5 psychotherapeutic models are based on evidence from clinical trials that support their effectiveness. In this review we present the latest research evidence as well as a summary of the basic characteristics of Transference-Focused Psychotherapy and Mentalization Based Treatment, which are not yet widely used in Greece. The two modalities originate from the psychoanalytic tradition and they have various points of convergence and divergence with regards to their structure (individual, group, combined) the role of the therapist and their use of basic theoretical concepts (eg. attachment, aggression). Their descriptive presentation in the form of a treatment manual and the standardisation of their training model, makes them accessible for training therapists and allows their introduction in psychiatric training programmes. We present a clinical case as an example of the application of the two approaches, along with the clinical and research paradigm originating from DeanCross Personality Disorder Service in London and the Centre for Understanding Personality Disorder, in order to compare the basic theoretical and technical characteristics of the two therapeutic modalities in view of their unique application within one outpatient service in the community. DeanCross provides a mixed MBT model (group, individual) with psychiatric input, which has been updated by the introduction of TFP in individual and group formats. Our review aligns with the international current that does not regard the two models in competition with each other; instead, we present a successful paradigm of their compatibility and mutual enrichment. The successful introduction of these therapies in the British public healthcare system, which is similar in its characteristics to the Greek national health system, is an encouraging prognostic factor when it comes to the applicability of these models in the Greek paradigm. It is a necessary prerequisite that clinical and theoretical knowledge of services that care for populations with a high prevalence of BPD is updated, and the current review makes a contribution in this direction.

Narcissistic personality disorder is a pleomorphic entity that requires the psychodynamically oriented therapist to tailor the approach to the characteristics of the individual patient. Psychodynamic principles encompass a broad range of interventions depending on the patient\'s specific characteristics. The therapist\'s interventions range from interpretation of the transference to supportive approaches that emphasize empathic validation and direct advice. In the absence of systematic data on these variations, this article attempts to offer clinically based principles. Several themes are emphasized: the experience of shame, the predictable transference-countertransference developments, the role of comorbidity with other personality disorders and traits, and the approach to resistances.

Previous research has shown that antisocial, borderline, narcissistic and histrionic personality disorders, also known as the Cluster B personality disorders in the Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition (DSM-5), are commonly raised in lawsuits. Cluster B disorders are characterized by problems with emotion regulation, impulsivity and interpersonal conflicts. Without question, individuals diagnosed with a Cluster B disorder possess traits that make them more susceptible to becoming involved in litigation; however, to date there has been no research on how the disorders interact with the judicial system. This study surveyed litigant success of Cluster B personality disorders in United States federal and state case law. Results showed that both criminal and civil litigants tended to be unsuccessful in their cases. Overall, this study demonstrated that court opinions can provide a window into the psychology of trial litigants and how personality can affect trial outcomes.

The concept of psychopathy has shifted from people who commit crimes to those with a particular personality and deviant behaviors. Although antisocial personality disorder is associated with psychopathy, it also seems common in individuals with narcissistic personality traits. Psychopathy may be the expression of earlier, persistent patterns of individual characteristics as personality. The psychobiological model of personality can be useful for determining whether the expression of psychopathy differs in accordance with personality dimensions and specific personality disorders. The aim was to compare temperament and character dimensions between individuals with psychopathy with comorbid predominant antisocial or narcissistic personality traits and control subjects and to determine which dimensions distinguish these groups. Control subjects (n = 80) and individuals with psychopathy (n = 80) were assessed using the Psychopathy Checklist-Reviewed, the Structured Clinical Interview for DSM-IV Axis II disorders and the Temperament and Character Inventory-Revised. Reward dependence and Self-Directedness distinguish psychopathic individuals with predominant narcissistic personality traits whereas Novelty Seeking and Self-Transcendence characterize those with antisocial personality traits. Individuals with antisocial or narcissistic psychopathy could be identified by their temperament and character traits. The expression of psychopathy differed in accordance with biologically based, environmentally shaped personality traits.

Previous studies that aimed to support emotion recognition deficits and alexithymia in B cluster personality disorders have mainly focused on borderline personality disorder (BPD), and resulted in mixed findings. In our study we examine emotion recognition and alexithymia in patients with histrionic (HPD), narcissistic (NPD) and borderline (BPD) personality disorders compared to each other and healthy controls. Furthermore, the possibility is investigated that it is not the type of PD but the severity of psychopathology which predicts the severity of emotion recognition deficits and alexithymia. Patients with HPD, NPD, BPD and healthy controls (N = 20 for each group) were examined by using the Ekman 60 Faces Test (FEEST) and the Toronto Alexithymia Scale (TAS-20). To measure the extent and severity of psychopathology, the Symptom-Checklist-90 Revised (SCL-90-R) was used. Patient groups performed significantly worse compared to healthy controls on the Ekman test and TAS-20, while we found no significant differences among patient groups in emotion recognition and alexithymia. Furthermore, higher scores on the SCL-90-R predicted poorer emotion recognition performance and higher alexithymic features. The empirical data supports the conclusion that the severity of psychopathology plays an important role in predicting emotion recognition deficits and alexithymia in borderline, narcissistic, and histrionic personality disorders.

BACKGROUND: The recent and rapidly popularized social phenomenon of selfie taking has been showing an increasing trend. It is thus imperative to assess the knowledge, attitude, and perception of the groups toward this phenomenon. Selfie taking is associated with younger age groups and hence, we aimed to explore the attitudes toward selfie taking and its relation toward body image and narcissism in medical college students.
METHODS: This was cross-sectional study and had two groups with Group A comprising 92 first year medical students and Group B including 103 postgraduate (PG) medical students from various specialties. They were interviewed in a single session using the scale of attitude toward selfie-taking questionnaire, Body Image Acceptance and Action Questionnaire (BIAAQ), and the narcissistic personality inventory. Scores obtained were computed using basic descriptive statistics and t-test where appropriate.
RESULTS: A strong positive favorable trend toward selfie taking was noticed among both groups (A = 56.5%, B = 45.6%). There was no difference in attitude between the two groups, or difference in the gender between those clicking their own selfies regularly within each group. BIAAQ reflected a significant difference among male subjects of the two groups with PG students was more concerned about body image (P = 0.001), whereas female subjects of both groups showed no such difference. The narcissism traits also showed a significant difference, only when males of both groups were compared again in favor of PG medical students (P = 0.022).
CONCLUSIONS: This study revealed that selfie-taking is popular among medical students both in their undergraduate and PG period. Further research in diverse clinical and nonclinical populations is warranted to explore the relation between this phenomenon and body image acceptance or narcissistic traits.

Personality with stable behavioural traits emerges in the adolescent and young adult years. Models of putatively distinct, but correlated, personality traits have been developed to describe behavioural styles including schizotypal, narcissistic, callous-unemotional, negative emotionality, antisocial and impulsivity traits. These traits have influenced the classification of their related personality disorders. We tested if a bifactor model fits the data better than correlated-factor and orthogonal-factor models and subsequently validated the obtained factors with mental health measures and treatment history.
A set of self-report questionnaires measuring the above traits together with measures of mental health and service use were collected from a volunteer community sample of adolescents and young adults aged 14 to 25 years (N = 2443).
The bifactor model with one general and four specific factors emerged in exploratory analysis, which fit data better than models with correlated or orthogonal factors. The general factor showed high reliability and validity.
The findings suggest that a selected range of putatively distinct personality traits is underpinned by a general latent personality trait that may be interpreted as a severity factor, with higher scores indexing more impairment in social functioning. The results are in line with ICD-11, which suggest an explicit link between personality disorders and compromised interpersonal or social function. The obtained general factor was akin to the overarching dimension of personality functioning (describing one\'s relation to the self and others) proposed by DSM-5 Section III.

The objective of the current paper is to report a new case of sexual murder involving human arson and summarize the literature on the phenomenon of sexual homicide. The present case study is unprecedented in Greece and a rarity in international literature due to the fact that the victim suffered genital mutilation and incineration while still alive. The evaluation consisted of 176 articles; 53 were reviewed by the authors. The results revealed sparse, but significant, research findings. The authors discuss the limitations regarding research, incidence of the phenomenon, crime-scene patterns, offender characteristics (killing methods, motive inferences, sociodemographic data, classifications, psychopathology, modus operandi), and victim selection. The incidence of the phenomenon is unclear (1-4%) due to non-standardized criteria. It is an expression of displaced anger or sexual sadism and/or a way to elude detection (ancillary benefit). Most offenders (in their first kill) and victims were in their late 20s to early 30s and belong to Caucasian populations. Personal weapons were commonly used against women, strangulation is the prevalent killing method against children, and firearms against men. Most of the sexual homicide perpetrators are non-psychotic at the time of the attack, but experience personality pathology, primitive defenses, pathological object relations, and withdrawal into fantasy in order to deal with social isolation.

Though primarily considered entertainment, cinema is a mirror of society. The portrayal of neurosciences is common in cinema, but none could do it better than Jack Nicholson. We give a brief overview of his contribution to neurosciences by analyzing his acting skills.