Papers by Steinar Lorentzen
Group Analysis, Dec 1, 1990
Journal of Clinical Psychology, 2005
In a study of long-term (mean ϭ 32.5 months) analytic group psychotherapy we explored the relatio... more In a study of long-term (mean ϭ 32.5 months) analytic group psychotherapy we explored the relationships among six predictors shown to influence outcome in short-term group studies and five outcome variables (Global Assessment of Functioning [GAF], Global Symptom Index [GSI], Inventory of Interpersonal Problems-Circumplex [IIP-C], Global Improvement, and Chief Complaints), assessed after termination of therapy. In this study, we wanted to test whether the same variables also predicted patients' status at follow-up, 1 year after termination. Bivariate correlations and multiple regression analyses were used. Initial status and treatment duration up to 2.5 years turned out to be strong positive predictors of status at both time points. Contrary to findings from many short-term studies, presence of personality disorder, high initial severity, chronicity, and less optimistic expectations had no predictive power at either time. Higher age predicted a less favourable status at follow-up in secondary exploratory analyses. The findings suggest that different patients may benefit from long-term versus short-term group psychotherapy. More studies should examine patient aptitude and the significance of the time factor (Aptitude-Treatment Interaction [ATI-effects]).
Routledge eBooks, Jul 31, 2013
Routledge eBooks, Jan 20, 2022
The Journal of Clinical Psychiatry, Feb 8, 2011
The hypothalamic-pituitary-adrenal (HPA) axis seems dysregulated and part of the pathophysiology ... more The hypothalamic-pituitary-adrenal (HPA) axis seems dysregulated and part of the pathophysiology in bipolar disorder and schizophrenia, but the underlying mechanisms are unknown. Recent evidence indicates that systemic cortisol metabolism influences blood cortisol levels and HPA axis functioning. Our objective was to estimate systemic cortisol metabolism by means of the activity of 5α-reductase, 5β-reductase, and 11β-hydroxysteroid dehydrogenase (11β-HSD) in patients with bipolar disorder and schizophrenia spectrum disorders compared to healthy controls. Inpatients and outpatients aged 18 to 65 years with DSM-IV bipolar disorder (n = 69) or schizophrenia (n = 87) were consecutively recruited to the catchment area-based Thematically Organized Psychosis Research (TOP) study. Healthy controls (n = 169) were randomly selected from statistical records from the same catchment area and were contacted by letter inviting them to participate. Spot urine samples were collected in a cross-sectional manner from November 2006 to November 2008. Urinary free cortisol and cortisone and their metabolites were analyzed with liquid chromatography tandem mass spectrometry and used as indicators of 5α-reductase, 5β-reductase, and 11β-HSD activity. The combined patient group had increased activity of 5α-reductase, 5β-reductase, and 11β-HSD2 (all P < .001) compared to controls. Elevated systemic cortisol metabolism was present in both schizophrenia (5α-reductase, 5β-reductase, and 11β-HSD2; all P < .001) and bipolar disorder (5α-reductase [P = .016], 5β-reductase [P = .001], and 11β-HSD2 [P = .007]). The results indicate increased activity of cortisol metabolism in patients with bipolar disorder and schizophrenia compared to healthy controls and suggest that increased systemic cortisol metabolism is involved in the pathophysiology and stress vulnerability in these severe mental disorders. The findings should be explored further in terms of potential new drug targets, and they add to the physiologic rationale for stress coping strategies in these patient groups.
Routledge eBooks, Jan 20, 2022
Routledge eBooks, Jan 20, 2022
Routledge eBooks, Jan 20, 2022
The Scandinavian psychoanalytic review, Jul 3, 2018
The Scandinavian psychoanalytic review, 1990
Group Analysis, Dec 14, 2015
This article initially gives a broad presentation of mentalization-based therapy (MBT). This is a... more This article initially gives a broad presentation of mentalization-based therapy (MBT). This is a therapy with several components, mainly conjoint use of individual and group based therapies. According to the author, this group therapy has its roots in group analytic psychotherapy, but has been modified, in order to suit the treatment needs of patients with borderline personality disorder (BPD), who easily resort to prementalistic modes of thinking, serious problems with affect regulation, and an increased tendency of acting out. The main objective of MBT is to enhance patients’ inherent capacity for mentalizing, roughly defined by Bateman and Fonagy (2006), the pioneers of this treatment, as understanding oneself and others better. The purpose is to improve the patients’ intersubjective competence, and thereby enhancing their sense of self-cohesion and identity. 19 MBT principles are presented, of which the following nine are specific for the group module of MBT (MBT-G; Karterud, 2012): 1) Managing the boundaries of the group; 2) Regulating the phases of the group; 3) Initiating and fulfilling turn-taking; 4) Engaging the group members in mentalizing interpersonal events embedded in the narratives of the turn-taking; 5) Identifying and mentalizing events in the group; 6) Care for the group and each member; 7) Managing authority; 8) Stimulating and assisting the group in discussion on themes relevant for the group culture; and 9) Co-operating with the co-therapist. 623204 GAQ0010.1177/0533316415623204Group AnalysisLorentzen: Comment research-article2015
Group Dynamics: Theory, Research, and Practice, 2016
I want to express my deep gratitude to all the people that helped me during my work on this thesi... more I want to express my deep gratitude to all the people that helped me during my work on this thesis. I feel truly privileged to have been part of the SALT-GAP study, therefore my greatest thank goes to my supervisor Professor emeritus Steinar Lorentzen, who initiated, designed, and lead this project, together with Professor Torleif Ruud and Professor Emeritus Per Høglend. Steinar has patiently supervised and guided me through my work. With his extensive clinical knowledge and passion for group therapy, he has been a motivator and tremendous source of research know-how and of Group Analytic understanding for me. We have had many discussions along the way, enriched with his stories from the group therapy room. Without his support through this process, the fact that he never gave up on me (even when I fled the country), and for all the hours he spent revising and revising manuscripts I would never have made it to the end. I warmly thank also my other supervisor Per Høglend, who in addition to being a co-author of all three papers, has been a scientific supermentor, especially in helping me with Linear Mixed Model analyses. He also helped me find what interested me in this project from the very beginning. I am also grateful for having an extra supervisor in professor Erik Falkum, who gave me the help and encouragement I needed to finish the thesis, and for his valuable contributions to the manuscript. My thanks go to all the other co-authors of Paper II; Torleif Ruud, Alice Marble, Ole Klungsøyr, and Randi Ulberg for their essential contributions to the manuscript, and for their encouragements along the way. With the deepest respect I send my gratitude to all the patients, therapists, and coordinators engaged in this project, and for all the work they have done. I am indebted to the research group I have been honored to belong to at Gaustad. I want to thank a few, who gave especially valuable help along the way; Svein Friis, Theresa Wilberg, Egil Martinsen, Espen Bjerke, Pål Zeiner, Jan Ivar Røssberg and Benjamin Hummelen. I would never have made it without the support from my research friends Helen Bull, June U. Lystad, and Stig Evensen, thanks for all the laughter shared in the daily life at '2.etage'. A warm thank you to Sissel Staehr Nilsen for all your help and ability to create solutions when all seemed chaotic. Ørjan Berg and Martin Furan for all your technical support.
Group Analysis, Sep 1, 2000
The main purpose of this article is to underline the importance of doing clinical research on lon... more The main purpose of this article is to underline the importance of doing clinical research on long-term, dynamic group psychotherapy as it is carried out in practice (effectiveness study). After a review of the outcome literature, which mainly consists of experimental studies (efficacy studies), an effectiveness study from a private practice will be described with some preliminary results. Experiences from implementation of a research project in clinical practice are presented and the strengths and limitations of the two research methods are discussed.
Routledge eBooks, Jan 20, 2022
Background: Dysregulation of the cortisol system may be important in the pathophysiology of sever... more Background: Dysregulation of the cortisol system may be important in the pathophysiology of severe mental disorders. In schizophrenia cortisol has been related to disorganized, negative and positive symptoms, but there are few studies in bipolar disorder. The aim of the ...
Theoretical and technical elements which characterize the American approaches to psychoanalytic g... more Theoretical and technical elements which characterize the American approaches to psychoanalytic group psychotherapy.
Nordisk psykiatrisk tidsskrift. Nordic journal of psychiatry, 1983
... og sorn har skapt problemer for en rekke avdelinger som har tatt mil av seg ti1 A arbeide mil... more ... og sorn har skapt problemer for en rekke avdelinger som har tatt mil av seg ti1 A arbeide miljaterapeutisk (Lorentzen 1980 ... I et aktivt behandlingsmiljo med relativt mange ansatte og hoyt aktivitetsnivi, vil borderlinepasientens interpersonelle at-ferdsmonster raskt komme ti1 syne ...
Group Analysis, Dec 1, 2002
Given the complexity of analytic therapies and individual change, it seems desirable to introduce... more Given the complexity of analytic therapies and individual change, it seems desirable to introduce more objective and quantitative measures into the clinical situation in assessment of change. A traditional case study describes one patient's change pattern in symptomatic distress, interpersonal relations and self-esteem during 44 months of group analysis. We hypothesized that change described by repeated applications of self-report measures (SCL-90-R, HP, and SASB) would converge with the clinical narrative. This was confirmed for symptoms and interpersonal problems. However; in early and middle phase of therapy during periods of deterioration, negative aspects of her self-image at worst (self-attack, self-neglect) improved. During the same periods she suffered from a pronounced feeling of depersonalization. For the remaining part of the therapy; including a period after a miscarriage later in therapy, she was able to experience the negative aspects of her self-image at worst. The feeling of depersonalization was then much less pronounced. Her complex SASB-patterns may represent a split of internal self-representations, seen in certain personality disorders. More studies are needed.
Group Analysis, Sep 1, 2006
In this paper, I underline the challenges for group-analytic research by demonstrating the immens... more In this paper, I underline the challenges for group-analytic research by demonstrating the immense difference in the amount of research done in group psychotherapy in general as compared to group analysis. After presenting an overview of findings from empirical, quantitative outcome studies in group psychotherapy at large, I will discuss some trends in contemporary group psychotherapy research, and finally, I will give a rough sketch of group-analytic research. I will focus on quantitative research and I will see group analysis as a clinical enterprise - a theory, model, art and craft that has been developed and can be used to treat psychiatric disorders, and toameliorate psychological problems.
International Journal of Group Psychotherapy, Jul 1, 2008
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Papers by Steinar Lorentzen