Working with the entitled patient

Entitled patients are described as those who derive gratification from indiscriminate and intense interpersonal relationships and who unconsciously do everything they can to resist the limits that psychoanalytic psychotherapy imposes on them. In this paper the dynamics of entitled patients are explained. Case histories illustrate the difficulties and significance of setting therapeutic limits on such patients.     

Bilingualism and adult differences in inhibitory mechanisms: evidence from a bilingual stroop task

The present investigation examined the functioning of inhibitory mechanisms in younger and older bilinguals using a bilingual version of the Stroop test. The study predicted different patterns of age related decline in inhibitory mechanisms (inter- and intralingual interference) in bilinguals depending on their level of proficiency. Consistent with expectations, older bilinguals were slower when they responded in their non-dominant language. Furthermore, older unbalanced bilinguals showed greater interlingual interference when they responded with their second language to visual stimuli written in their dominant language. Balanced bilinguals showed equivalent interference effects between all conditions. These findings suggest that manipulating two languages may enhance the efficiency of inhibitory mechanisms.     

A hierarchy of cortical responses to sequence violations in three-month-old infants

The adult human brain quickly adapts to regular temporal sequences, and emits a sequence of novelty responses when these regularities are violated. These novelty responses have been interpreted as error signals that reflect the difference between the incoming signal and predictions generated at multiple cortical levels. Do infants already possess such a hierarchy of violation-detection mechanisms? Using high-density recordings of event-related potentials during an auditory local–global violation paradigm, we show that three-month-old infants process novelty in temporal sequences at two distinct levels. Violations of local expectancies, such as perceiving a deviant vowel “a” after repeated presentation of another vowel i-i-i, elicited an early auditory mismatch response. Conversely, violations of global expectancies, such as hearing the rare sequence a-a-a-a instead of the frequent sequence a-a-a-i, modulated this early mismatch response and led to a late frontal negative slow wave, whose cortical sources included the left inferior frontal region. These results suggest that the infant brain already possesses two dissociable systems for temporal sequence learning.     

Plea for a Measure of Imagination: Commentary on Paper by Harvey Peskin

In responding to Harvey Peskin's important paper, “Man Is a Wolf to Man,” I further deconstruct his proposition “what therapeutic neutrality is to psychic reality, the therapeutic witness is to the recovery of social reality.” This statement calls into question two principles of the orthodox Freudian canon, one theoretical and one technical. Beyond the stimulus barrier, traumatic reality collapses psychic reality, conscious and unconscious fold into one another, reality and fantasy merge, and nightmares are made flesh. In attempting to impose psychic reality on a traumatic experience, then, classical psychoanalysts disavow a significant portion of human experience. Technically, the analyst's neutrality or failure to acknowledge the significance of historical reality condemns the survivor to further dehumanization as her dehumanizing experiences go unmarked in treatment. Peskin contends that the need to have experience validated, to have a witnessing analyst before an interpreting one, arises not only in matters of extreme traumatization but in everyday life. Illustrating the importance of this claim with an example from my own life, I propose that extreme traumatization takes a different kind of therapeutic engagement, one that is beyond professional obligation; a moral imperative that requires imagination when recognition is not enough. I add a further caveat that in cases of extreme traumatization, rather than privileging a search for psychic reality or even historical reality, some contemporary analysts privilege an exploration of the treatment relationship, failing to recognize that in such cases historical reality must initially take precedence over an emphasis on the intersubjective.     

The interpretation of a test validity coefficient in terms of increased efficiency of a selected group of personnel

The predictive efficiency of a test used to select personnel is defined in terms of total effectiveness of the group thus selected, as compared with chance selection. The formula developed requires the use of an estimate of the ratio of average effectiveness of men selected to the average effectiveness of men not selected by the test. The predictive efficiency of the test varies directly with the magnitude of this ratio and also directly with the percentage rejected.     

Alone in the Crowd: I Failed the ABGC Certification Exam

The American Board of Genetic Counseling (ABGC) certification examination (often referred to as “the board exam”) has become a milestone within the field of genetic counseling. For many, it is the final standardized test taken and indicates the examinee has met “the standards of minimal competence to practice as a genetic counselor” (Bulletin 2015). Although voluntary, certification is strongly encouraged, and in some employment situations, required. Although recent statistics indicate the majority of those who take the test pass, each year there are those who sit for the test unsuccessfully. Despite this fact, exam failure and tools for dealing with this experience are not often broached in the literature. This essay recalls my experiences with a failed exam attempt and the subsequent emotional turmoil. It also aims to start the conversation regarding the difficulty of coping with the “secret” shame of public, professional failure, and suggests there is room for further discussion and resource development in this area.     

Ethical,legal and societal considerations on Zika virus epidemics complications in scaling-up prevention and control strategies

Much of the fear and uncertainty around Zika epidemics stem from potential association between Zika virus (ZIKV) complications on infected pregnant women and risk of their babies being born with microcephaly and other neurological abnormalities. However, much remains unknown about its mode of transmission, diagnosis and long-term pathogenesis. Worries of these unknowns necessitate the need for effective and efficient psychosocial programs and medical-legal strategies to alleviate and mitigate ZIKV related burdens. In this light, local and global efforts in maintaining fundamental health principles of moral, medical and legal decision-making policies, and interventions to preserve and promote individual and collectiveHuman Rights, autonomy, protection of the most vulnerable, equity, dignity, integrity and beneficence that should not be confused and relegated by compassionate humanitarian assistance and support. This paper explores the potential medical and ethical-legal implications of ZIKV epidemics emergency response packages and strategies alongside optimizing reproductive and mental health policies, programs and best practice measures. Further long-term cross-borders operational research is required in elucidating Zika-related population-based epidemiology, ethical-medical and societal implications in guiding evidence-based local and global ZIKV maternal-child health complications related approaches and interventions. Core programs and interventions including future Zika safe and effective vaccines for global Zika immunization program in most vulnerable and affected countries and worldwide should be prioritized.     

Prevalence of Internet addiction in Latino adolescents with psychiatric diagnosis

Internet addiction (IA) is particularly relevant in the adolescent population. The aim of this study was to describe the prevalence of IA in a clinical sample of Latino adolescents receiving ambulatory psychiatric treatment. The correlation between their pattern of Internet use and their respective psychiatric diagnosis was also studied. Adolescent patients from the Psychiatric Ambulatory Clinic at the Pediatric University Hospital (N=71) completed the Internet Addiction Test (IAT) and a questionnaire about Internet use. Information regarding demographic and diagnostic data was retrieved from their clinical records. None of the subjects presented severe IA. A total of 71.8% (n=51) of the adolescents obtained scores reflecting no problem related to IA. Only 11.6% (n=5) of subjects have discussed Internet use with their therapist. Mood disorders showed a statistically significant (p=0.044) correlation with a higher score on the IAT. Mental health care practitioners must consider questions on Internet use as an essential part of the patients' evaluation given its significant correlation with diagnosis of a mood disorder.     

The role of form and meaning in the processing of written morphology: A priming study in French developing readers

Three visual priming experiments using three different prime durations (60 ms in Experiment 1, 250 ms in Experiment 2, and 800 ms in Experiment 3) were conducted to examine which properties of morphemes (form and/or meaning) drive developing readers’ processing of written morphology. French third, fifth, and seventh graders and adults (the latter as a control group) performed lexical decision tasks in which targets were preceded by morphological (e.g., tablette–TABLE, “little table–table”), pseudoderived (e.g., baguette–BAGUE, “little stick–ring”), orthographic control (e.g., abricot–ABRI, “apricot–shelter”), and semantic control (e.g., Tulipe–FLEUR, “tulip–flower”) primes. Across all groups, different patterns of priming were observed in both morphological and orthographic/semantic control conditions, suggesting that they all process morphemes as units when reading. In developing readers, the processing of written morphology is triggered by the form properties of morphemes, and their semantic properties are activated later in the time course of word recognition. In adults, patterns of priming were similar except that the activation of the form properties of morphemes decreased earlier in the time course of word recognition. Taken together, these findings indicate that French developing readers process both the form and meaning properties of morphemes when reading and support a progressive quantitative change in the development of morphological processing over the course of reading development.