The vertical dimension of mental functioning

Summary A hierarchical, six-level model of human intelligence is described. The first four levels, which correspond to those found in Bernstein's theory of motor control, are concerned with palaeokinetic regulations (A), synergies (B), the spatial field (C), and object actions (D). The two levels of the higher symbolic coordinations embody conceptual structures (E) and metacognitive coordinations (F). The model is supported by experimental results from several subfields of cognitive research: e.g., different types of learning are specifically connected with the components of this hierarchical structure. Learning by the restructuring of existing knowledge proceeds by means of the metaprocedures of level F. The incremental accumulation of factual information is connected with the conceptual base of level E. Proceduralization of this knowledge results in the build-up of perceptual automatisms of skilled action (level D), as is often case in the formation of expert knowledge. Arguments for the hierarchical architecture of perception, attention, memory, understanding, thinking, and imagination are provided, and some parallels are drawn with the organization of emotional and motivational processes. It is argued that general, interdisciplinary questions on the nature and sources of mental functioning must be approached with a kind of pluralistic methodology. These questions cannot be answered in an equally general vein, because the localization of mental processes on the vertical dimension of cognitive architecture is to be taken into account.     

Supportive interventions and nonsymbolic mental functioning

The author aims to show how supportive interventions are the analyst's most relevant therapeutic means to helping patients with a feeble symbolic system transform nonsymbolic episodes and reestablish symbolic mental functioning. Symbolic and nonsymbolic modes of mental functioning are first outlined. Supportive interventions are redefined as an analyst's effort at improving a patient's nonsymbolic mental functioning, by using principally pragmatic or interactive aspects of communication to deal with her or his patient's nonsymbolic in-session experiences. These interventions are psychoanalytic when transference focused, in so far as they foster the symbolization and transformation of more primitive (nonsymbolic) layers of the transference. Some probable mechanisms underlying the effect of supportive interventions on nonsymbolic functioning include the modification of mental procedures. Supportive interventions also help restore symbolic mental elaboration through the gratification of a basic ego or self-need, bringing about a temporary relief from psychic pain, with increased affect tolerance and a renewed capacity to use symbols. This soothing effect accounts for a missing link in Bion's model of the elaborative effect of the analyst's reverie.     

Domains of mental functioning: An introduction

Summary An introduction is given to the Thematic Issue on Domains of Mental Functioning: Attempts at a Synthesis. First, some of the efforts that have been made at charting the territory of Cognitive Science are reviewed. The second section considers the emerging new consensus on certain conceptual issues such as representation, intentionality, functionalism, and symbol systems. Finally, some types of synthesis between approaches to mental functioning are discussed.     

Chronic stress, cognitive functioning and mental health

This review aims to discuss the evidence supporting the link between chronic stress, cognitive function and mental health. Over the years, the associations between these concepts have been investigated in different populations. This review summarizes the findings that have emerged from older populations as well as from populations suffering from pathological aging, namely Mild Cognitive Impairment and Alzheimer's Disease. Although older adults are an interesting population to study in terms of chronic stress, other stress-related diseases can occur throughout the lifespan. The second section covers some of these stress-related diseases that have recently received a great deal of attention, namely burnout, depression, and post-traumatic stress disorder. Given that chronic stress contributes to the development of certain pathologies by accelerating and/or exacerbating pre-existing vulnerabilities that vary from one individual to the other, the final section summarizes data obtained on potential variables contributing to the association between chronic stress and cognition.     

The mental functioning axis of the psychodynamic diagnostic manual: an adolescent case study

We describe the assessment of a troubled adolescent boy to demonstrate the use of the Shedler-Westen Assessment Profile for Adolescents (Westen, Dutra, & Shedler, 2005) and the Social Cognition and Object Relations Scale-Global (Westen, 1995) to formulate the Mental Functioning for Children and Adolescents Axis (MCA) of the Psychodynamic Diagnostic Manual (PDM Task Force, 2006). The assessment made possible a meaningful psychodynamic therapy.     

Father and mother contributions to family functioning when the child has a mental delay

Less is known about the father's than the mother's role in family adaptation to children with disabilities. The purpose of this study was to examine relationships of both father and mother use of coping strategies and perceptions of the child with measures of family functioning style. Subjects were 26 families of 30-month-old children with a mental delay and a comparison group of 26 families of same-aged children with no delay. Functioning style for study families showed a balance of cohesion and adaptability; comparison families were more chaotically flexible on the adaptability scale. Mothers and fathers agreed on family functioning style. Study parents made the greatest use of external coping strategies, while in both groups mothers used more external and fathers more internal coping strategies. Relationships between coping and family functioning varied by parent and by group. Results suggest the need for further exploration of the separate needs of fathers and mothers in maintaining balanced family functioning.     

Meta-analysis of cognitive-behavioral interventions on HIV-positive persons' mental health and immune functioning.

OBJECTIVE: To evaluate the efficacy of cognitive-behavioral interventions (CBIs) for improving the mental health and immune functioning of people living with HIV (PLWH). DESIGN: Comprehensive searches of electronic databases from 1988 to 2005, hand searches of journals, reference lists of articles, and contacts with researchers. Meta-analytic approaches were used in synthesizing findings. MAIN OUTCOME MEASURES: Intervention effects on symptoms of depression, anxiety, and anger, stress, and CD4 cell counts were assessed. RESULTS: Data from 15 controlled trials were analyzed. Significant intervention effects were observed for improving symptoms of depression (d = 0.33), anxiety (d = 0.30), anger (d = 1.00), and stress (d = 0.43). There is limited evidence suggesting intervention effects on CD4 cell counts (d = 0.08). The aggregated effect size estimates for depression and anxiety were statistically significant in trials that provided stress management skills training and had more than 10 intervention sessions. CONCLUSION: CBIs are efficacious in improving various psychological states of PLWH. Future research should examine the relationship among interventions, psychological states, medication adherence, and immune functions, and identify other relevant factors associated with intervention effects.     

Infants' meaning-making and the development of mental health problems

We argue that infant meaning-making processes are a central mechanism governing both typical and pathological outcomes. Infants, as open dynamic systems, must constantly garner information to increase their complexity and coherence. They fulfill this demand by making nonverbal "meaning"-affects, movements, representations-about themselves in relation to the world and themselves into a "biopsychosocial state of consciousness," which shapes their ongoing engagement with the world. We focus on the operation of the infant-adult communication system, a dyadic, mutually regulated system that scaffolds infants' engagement with the world of people, things, and themselves, and consequently their meaning-making. We argue that infant mental health problems emerge when the meanings infants make in the moment, which increase their complexity and coherence and may be adaptive in the short run, selectively limit their subsequent engagement with the world and, in turn, the growth of their state of consciousness in the long run. When chronic and iterative, these altered meanings can interfere with infants' successful development and heighten their vulnerability to pathological outcomes. Cultural variations in meaning-making and implications for clinical practice are discussed.