Structural differentiation of psychological performances in epilepsy patients

Investigating the specific of psychic performance disorders in epileptics structural aspects in addition to quantitative performance differences are considerable. We compared psychometrically obtained performance structures of epileptic children and adults and of parallelised healthy control persons. It became evident, that the performance differentiation hypothesis is to corroborate also in epileptic patients. The psychic performance structure of epileptics is characterized by a lower differentiation level of the basis functions underlining the performances. Our factor analytic investigations emphasize the importance of deceleration of psychic/psychomotoric speed in epileptics as primary basic disorder.     

The diagnostic value of computer-assisted psychometric procedures

Some test procedures of the computer assisted instrumentation system COMBITEST 2 were examined in order to evaluate the strength of diagnostical differentiation. For this purpose tests for evaluating the concentration capacity and the psychomotor performance, especially tapping, were used in a sample of 92 neurological patients (60 patients with and 32 without cerebral impairment). It became evident, that performance differentiations between patients with cerebral impairment and others are predominantly characterized by speed parameters (reaction time, duration of test), scarcely by parameters of accuracy (number of errors). Configuration - frequency - analyses emphasize deceleration of psychic/psychomotoric speed as diagnostic indicator in cerebral impaired patients: the best pattern was the "configuration" of reduced speed in concentration test and in tapping.     

Specific aspects of psychological disorders of performance in children with epilepsy

We examined 49 normal intelligent epileptic and parallelised in sex, age and intelligence just as much healthy and 14 minimal cerebral damaged children without seizures. Using a psychological test battery psychic/psychomotor speed, flexibility/preservation proneness, memory span and memory and concentration were registrated. Besides reduced memory performances we found a deceleration of psychic/psychomotor speed as primary basic disorder within the performance structure of epileptic children analogous to our previous examined adults. The tridimensional comparison suggests remarkable psychopathological differences among the two groups of patients.     

Relationship between automatically analyzed quantitative EEG data and psychological performance parameters in patients with epilepsy

A report is given on results of comprehensive studies in which significant positive correlations between automatically analysed parameters reflecting the frequency behaviour of the EEG background activity and psychometrically recorded relatively complex psychic and psychomotoric tempo performances as well as some partial aspects of the re-adjustment capability in epileptics were found. EEG indicator values could be ascertained which point to psychic performance disturbances in epileptics.     

Clinico-psychologic studies on the problem of functional psychotic deterioration in schizophrenia

Our concept of the functional-psychotic mental deterioration of schizophrenia approximately characterizes the same point of view as Kraepelin's terminus "Dementia praecox". The first result of our psychological examination on 225 schizophrenic persons with defect psychotic symptoms was the statement of the deficit in achievement between the former school education (average IQ of the school-type) and the results of examination of intelligence during our research. The functional-psychotic mental deterioration as well appears as a decrease of memory and psychomotoric speed deficiency, furthermore as mental deconcentration and increase of psychoorganic signs in the Rorschach-Test. The psychometric results of this research were statisticly significant.     

Differential indication of trimipramine - results of a controlled multiclinical study]

The antidepressants trimipramine and imipramine were compared within the framework of a multiclinical study performed under the conditions of a controlled clinical experiment. There has been found a time-different remission of affective und psychomotoric symptoms. The panthymoleptic action of trimipramine and other antidepressants is discussed with reference to these results. Trimipramine influences psychotic states, especially if in depression anxiety is combined with agitation, also in hypochondriac forms of depression.     

Are Motor Inhibition and Cognitive Flexibility Dead Ends in ADHD?

Executive dysfunction has been postulated as the core deficit in ADHD, although many deficits in lower order cognitive processes have also been identified. By obtaining an appropriate baseline of lower order cognitive functioning light may be shed on as to whether executive deficits result from problems in lower order and/or higher order cognitive processes. We examined motor inhibition and cognitive flexibility in relation to a baseline measure in 816 children from ADHD and control families. Multiple children in a family were tested in order to examine the familiality of the measures. No evidence was found for deficits in motor inhibition or cognitive flexibility in children with ADHD or their nonaffected siblings: Compared to their baseline speed and accuracy of responding, children with ADHD and their (non)affected siblings were not disproportionally slower or inaccurate when demands for motor inhibition or cognitive flexibility were added to the task. However, children with ADHD and their (non)affected siblings were overall less accurate than controls, which could not be attributed to differences in response speed. This suggests that inaccuracy of responding is characteristic of children having (a familial risk for) ADHD. Motor inhibition and cognitive flexibility as operationalized with mean reaction time were found to be familial. It is concluded that poorer performance on executive tasks in children with ADHD and their (non)affected siblings may result from deficiencies in lower order cognitive processes and not (only) from higher order cognitive processes/executive functions.     

Aerobic Exercise Enhances Cognitive Flexibility

Introduction Physical activity is believed to prevent cognitive decline and may enhance frontal lobe activity. Methods Subjects were 91 healthy adults enrolled in a wellness center. Over a 10 week intervention, controls were aerobically active 0–2 days per week. Half the intervention group was active 3–4 days/week and half 5–7 days/week. Outcome measures included memory, mental speed, reaction time, attention, and cognitive flexibility. Results Neurocognitive data were analyzed by repeated measures comparing minimal aerobic exercise (the control group) to moderate aerobic exercise (3–4 days/week), and to high aerobic exercise (5–7 days/week). Initial analyses noted significant improvements in mental speed (p = .03), attention (p = .047), and cognitive flexibility (p = .002). After controlling for age, gender, education, and changes in psychomotor speed, only cognitive flexibility still showed significant improvements (p = .02). Conclusion Over a 10 week period, increasing frequency of aerobic activity was shown to be associated with enhanced cognitive performance, in particular cognitive flexibility, a measure of executive function.     

Psychic reality in the psychoanalytic process.

The case is made for regarding psychic reality as synonymous with subjective (conscious) experience, which is inherently open to, but not reducible to, unconscious determinants. Both analyst and analysand engage in the analytic relation and interaction from the perspective of their respective psychic realities. Thus, components of the analytic relation--transference/countertransference, alliance, and real relation--are forms of psychic reality. The tensions of subjectivity and objectivity are discussed in relation to the analytic situation, especially with regard to whether the patient's or the analyst's psychic reality is to be given priority or preference. The same reality, situation, or relationship can be viewed from different perspectives and subjected to varying interpretations without any one being exclusively true or false-each may be partially true and/or partially false. The patient's recounting of his history is a part of the patient's psychic reality that intersects with a necessarily divergent account constructed by the analyst. The ensuing dialogue seeks a form of real coherence that is mutually realistic and makes realistic sense for both parties. Reliance on subjective psychic reality becomes a possible, but precarious and potentially misleading, basis for analytic understanding without other observational (verbal and behavioral) or objective data.     

Cornelia de Lange syndrome (I) with analgesia

The case of a boy, observed from 9-17 years of age, with de Lange syndrome is described. The typical symptoms of the de Lange syndrome (brachymicrocephalie, characteristic face, hypertrichosis, typical form of the hand, debility and proportioned shortening) were combined with intensivity to pain and psychomotoric epilepsy. He showed a strikingly aggressive behaviour and simultaneous masochism with self-mutilation as it is typical for analgesia congenita. The autopsy showed cortical heterotopias of the brain and slight microgyria.     

Oedipus complex and development of self

The emergence of oedipal object relations is a crucial stage in the development toward individuated adult mentation, distinguished from early stages of psychic life which are transindividual (as in Kohut's "selfobject transference"). The latter continue to function as deep layers of individual psychic life; but the development of oedipal/postoedipal object relations, and advanced psychic structure and functioning based on it, represents a norm in psychoanalytic psychology and therapy. The poet John Keats's ideas about the formation of the individual "soul" (identity as an individual) by the intervention of "circumstances" are cited to illustrate this aspect of the oedipus complex.     

抑郁性神经症患者精神创伤的临床调查与分析

通过调查与分析。希望进一步了解导致抑郁性神经症的精神创伤的性质和易感人群的年龄、教育程度和性别等方面的特点。为此类疾病的病因分析及其防治提供客观的依据。结果表明：1．不同的年龄、教育程度和性别均有各自敏感的生活事件,部分生活事件在任何年龄阶段、教育程度、性别的人群中都可构成精神创伤;2．家庭矛盾、个人发展、疾病、失去亲人等生活事件容易构成精神创伤,其中家庭矛盾尤为突出;3．不可控的生活事件是构成抑郁性神经症近、远期精神创伤的重要基础。可见,抑郁性神经症的发病与精神创伤关系密切;不同教育程度、年龄、性别对生活事件的体验及其导致精神创伤的程度不同。     

Chronification of neuroses--on the critical phase of the inpatient-ambulatory care transition

The contribution deals with the critical transition from ward treatment and follow-up care as an outpatient. Patients with primary psychic maldevelopment are compared with those of a secondary psychic development. Changes in symptoms and personality were measured with a battery of tests during a pre-post follow-up study (intervals of eight weeks between tests). Special attention is paid to changes after discharge from hospital and deterioration, which was common among the patients with secondary psychic maldevelopment, is discussed.     

Idealization,Splitting, and the Challenge of Homophobia

How can we account for the persistence of homophobia? What makes homophobia so resistant to change? In this paper we discuss the psychic and discursive persistence of homophobia by problematizing the political unconscious. Focusing on Freud's psychic defense mechanisms, idealization and splitting, we show how these forces can be thought of as the psychic work of discourse. To this end we interviewed fathers of homosexual sons who had initially reacted with panic, but eventually came to “accept” their sons' homosexuality. We discuss the paradox that the fathers' narratives raise: their love and adoration of their (masculine) homosexual sons, and on the other hand their hatred and denunciation of homosexuality. We argue that idealization and splitting in this case operate as regulatory psychic mechanisms in the service of social discourse. This psychic power of discourse reappropriates masculinity (as a fetish) and reinstates the naturalization of heterosexuality and the masculine/feminine binary. The notion of the political unconscious is brought up by concluding that in order to change sexual prejudices we need to understand why we fail to change and how psychic mechanisms work in the service of social and cultural discourse.     

Filipino psychic surgery: Myth,magic, or miracle

This essay considers the current impact and evaluation of Far Eastern psychic healing typified by the psychic surgery of the Philippine Islands. On the basis of a literature survey as well as interviews with persons who had visited the healers and received psychic surgery, an analysis of the spiritual dynamics and physical effects is reported. An attempt is made to balance the positive reports of those who were healed with the more objective and/or skeptical reports of religious and scientific leaders. Cultural, psychological, medical, and magical aspects are considered. An expansion of philosophic outlook coupled with a search for new tools of investigation is suggested.This paper is the result of an exploration of various healing modalities by the authors.     

Murder: A psychotherapeutic investigation

This paper suggests that it is theoretically necessary and clinically useful to make a distinction between two types of psychic encapsulation within the broader literature. The proposed distinction, as it relates to these psychic structural manifestations, is illustrated here as applied to anorexia. The author suggests that psychic encapsulation is commonly encountered in work with anorexics, and that each type seems to imply a somewhat different therapeutic course. The distinction is made between anorexic patients who appear to display evidence of autistic/autistoid encapsulation as opposed to those who seem to manifest non-autistoid/later traumatic encapsulation – termed secondary adjunctive encapsulation in this paper. Defensive encapsulations are associated with pathological organisations of the personality – both within and beyond these structures, they exert an organising power over central mental processes. Psychic encapsulation and pathological organisations are defensive structural developments – the result of psychic trauma. Clinical material from three cases is presented to illustrate the arguments.     

Temporality in Psychosis: Loss of Lived Time in an Alien World

This article presents a model of the temporal structure of psychic life. Time is a rule-guided process. A person's psychic life, too, yields to an examination of necessary and regulated operations. To outline both the regular and the modified perception of time within psychic life, Sigmund Freud's model of the drive interaction is brought to bear on Jacques Marie Émile Lacan's understanding of psychosis. Both Freud's and Lacan's findings are explained with an eye on the temporal dimension of the psyche, temporal modifications manifested in states of psychotic delusion, and the role of time for one's meaningful engagement with the world. Psychic time is nonlinear. The future, the past, and the present must be engaged simultaneously, albeit not in the same way, to yield the sense of temporal fullness. For Freud, the cooperative functioning of the drives accounts for the sustainment of the lucid psychic life, whereas modifications in the drives’ interactions signal psychic disturbances. Lacan (1955/1993) stresses the atemporal character of the nonexistent, negated, or lost reality that pressures an individual to enter a psychotic delusion. This article makes the assumption that the psychological states in which the reckoning with time is lost are the consequences of an unsuccessful incorporation of traumatic stimuli that are caused both by outside phenomena and by the actions of an individual's inner drives. The findings of this article support the view that psychic traumas necessitate modifications to the sense of time. The findings also offer an understanding of the kinds of temporal modifications that occur in an individual's psychic life and the way in which these temporal changes lead to the experience of radical otherness that is present in some cases of psychological disturbances.     

On the metapsychology of schizophrenia.

The author's point of departure is schizophrenic fragmentation, which has been considered here from a drive-economic and structural point of view, starting from Freud's prestructural conceptions and Jacobson's metapsychological formulations. The view is arrived at in the essay that the central psychological mechanism in the schizophrenic disorder is a drive-energetic decathexis of the basic psychic tissue, or the primal representative matrix, which has far-reaching consequences within the entire psychic organization. The basic psychic tissue corresponds to that area of inner reality which, according to Freud, remains beyond the primal repression and is made up of the first representations of the instinctual drive. The entire psychic organization has then been woven out of this representational tissue, binding drive energies in a preliminary way. According to the view put forward here, schizophrenic fragmentation does not primarily represent a disintegration of the psychic macrostructures or a consequence of the ego's resorting to primitive defences but is a consequence of a drive-energetic crisis at the level of the basic psychic tissue. The disorder manifests itself as the disappearance of inner liveliness and as a diffuse dissociation of the entire representional world, which I have characterized as the disappearance of psychic transparence. Its influences naturally also extend to the realm of the more advanced psychic functions and macrostructures and will invalidate in a radical way the person's drive economy. Reference is made in the article to the possibility that the central task of the primal representative matrix may be the creation of lively connexions and a striving for synthesis throughout the entire psychic organization and that the schizophrenic disorder may be intimately related to the decathexis of this function.     

Provocation of panic: three elements of the panic reaction in four anxiety disorders

Subjects with agoraphobia (N = 25), panic disorder (N = 25), social phobia (N = 19) or generalized anxiety disorder (N = 10) and controls with no psychiatric history (N = 16) underwent two provocation tests, voluntary hyperventilation and inhalation of 5% CO2 in air, and three experimental control conditions. They were measured on three elements of the panic reaction: somatic symptoms, psychic anxiety and fears of impending doom, and on a standard YES/NO measure of panic attack. The provocation conditions produced increased somatic symptoms and psychic anxiety across all groups relative to the control conditions. The agoraphobic and panic disorder groups showed a significantly greater increase in fears of impending doom from control to provocation conditions than the social phobic and GAD patients. This difference was not observed on measures of somatic symptoms or psychic anxiety. The present results provide some support for the theory that panic attacks result from the catastrophic misinterpretation of anxious symptoms, in this case produced by the two provocation tests.     

Observation of high and low passive ankle flexibility in stair descent

Able-bodied people from the two extremes of the distribution of passive dorsiflexion exhibit biomechanical differences when descending stairs. Whether physical therapists could judge accurately the amount of ankle flexibility from observation of stair descent was examined with physical therapists (20 neurological 20 cardiothoracic) and 20 students. Subjects were 18 able-bodied men with high or low passive dorsiflexion. Raters viewed videotaped subjects descending stairs at normal playback speed and in slow motion and rated ankle flexibility on a 20-point scale. 'Flexible' or 'inflexible' subjects were classified correctly better than chance, but accuracy of rating flexibility was relatively poor. Both experience and slow motion playback improved accuracy. Physical therapists can detect extremes of normal flexibility in the ankle, based solely on observation of stair descent, and experienced therapists are better at this task than less experienced ones. Using slow motion videotape enhanced observational analysis.