Near-Death Experiences in patients with locked-in syndrome: Not always a blissful journey

Memories of Near-Death Experiences (NDEs) most often are recounted as emotionally positive events. At present, no satisfactory explanatory model exists to fully account for the rich phenomenology of NDEs following a severe acute brain injury. The particular population of patients with locked-in syndrome (LIS) provides a unique opportunity to study NDEs following infratentorial brain lesions. We here retrospectively characterized the content of NDEs in 8 patients with LIS caused by an acute brainstem lesion (i.e., “LIS NDEs”) and 23 NDE experiencers after coma with supratentorial lesions (i.e., “classical NDEs”). Compared to “classical NDEs”, “LIS NDEs” less frequently experienced a feeling of peacefulness or well-being. It could be hypothesized that NDEs containing less positive emotions might have a specific neuroanatomical substrate related to impaired pontine/paralimbic connectivity or alternatively might be related to the emotional distress caused by the presence of conscious awareness in a paralyzed body.     

From chaos and insecurity to understanding and coping: experienced benefits of a group-based education programme for people with chronic fatigue syndrome

The aim of this study was to elicit participants' experiences with a multidisciplinary patient education programme and their views regarding the usefulness of the programme. Focus group interviews were conducted with 10 participants immediately and nine months following participation in the programme and analysed using thematic analysis. Initially, the participants experienced confusion and insecurity regarding coping with the illness. Participation in the programme appeared to promote understanding, acceptance and coping through gaining greater knowledge, learning coping strategies and exchanging experiences, as well as receiving understanding and acceptance. Thus, the programme was experienced to be a beneficial intervention. However, the participants expressed a need for more guidance or follow-up to maintain the practice of coping strategies for better coping with their illness.     

Permanently locked-in syndrome in the neurologically impaired neonate: report of a case of Werdnig-Hoffmann disease.

Echenberg, a physician and the chairman of a PEC (perinatal ethics committee) recounts a difficult case of an infant with congenital Werdnig-Hoffman disease, which is characterized by a severe, early-onset form of spinal muscular atrophy, secondary to progressive neurologic degeneration. The two-and-one-half-month-old girl was paralyzed and respirator dependent, but apparently mentally intact and aware. Her parents and other family members tried to avoid serious involvement in the case. The physicians caring for her were resigned to the futility of further treatment, but uncertain how to proceed. The infant's nurses, many of whom had bonded with the child, were strongly divided as to what course of action would be in her best interests, and who should make decisions about continuation or termination of life support. Echenberg summarizes the PEC meeting which was convened about this case, and reviews the issues involved.     

Readiness to change: A longitudinal study of changes in adult identity

It has been suggested in the identity literature that a readiness to change may play a role in identity development beyond adolescence, but an empirical investigation of this relationship had yet to be conducted until now. Therefore, the purpose of the current study was to establish a longitudinal relationship between readiness to change and adult identity development. Participants completed measures of readiness to change and identity at both the beginning and the end of the study. The results revealed a relationship between readiness to change and changes in identity exploration over the study interval, and between readiness to change and changes in identity commitment. The findings are discussed in terms of the currently available literature on identity development in adulthood.     

Aspects of identity: From the inner-outer metaphor to a tetrapartite model of the self

Abstract

We review a program of research on identity orientations – the relative importance or value that individuals place on various identity attributes when constructing their self-definitions. We first provide a brief history of the development of our measure of identity orientations – the Aspects of Identity Questionnaire (AIQ) – after which we present our tetrapartite model of the self that distinguishes among individual, relational, public, and collective aspects of identity. We then review previous research on how the four identity orientations uniquely influence cognition, emotion, and behavior, and close by highlighting what we see as interesting and important directions for future research.     

From landlines to cell phones: negotiating identity positions in new career contexts

This article uses metaphors to explore how changes in technology and the world of work affect the lives and identities of workers today. The author integrates theory from vocational psychology and cultural studies with personal narrative in order to consider positive and negative aspects of the shift from traditional linear careers to postmodern, boundaryless, protean careers. Career is framed as a dialogical construct that is mutually shaped by individual and social practices. Career counselors are invited to consider ways they might adapt their practice to better accommodate clients' lived experiences of evolving career contexts.     

Menstrual-related perceptual changes in women with premenstrual syndrome: Factors to consider in treatment

The state-dependent model of premenstrual syndrome (PMS) suggests that women's perceptions of daily stressors are affected by menstrual cycle phase. Our objective was to further examine the applicability of this model to perceptions of specific kinds of daily stressors and to explore its generalizability to perceptions involving significant others. Thirty-two undergraduate women, 10 PMS and 22 asymptomatic controls, completed the Daily Stress Inventory (DSI) and the Daily Rating Form (DRF) for 35 days. Questionnaires measuring perceived social support and self-esteem were completed premenstrually and postmenstrually. Results indicated that all women perceived a greater number of stressors as being severe premenstrually as compared to postmenstrually. Furthermore, all women perceived a lesser number of signifcant others as being present in their social support network premenstrually. However, only the PMS women were less satisfied with their social support and had more negative self-esteem premenstrually as compared to postmenstrually. Results are discussed within the context of designing treatment intermentions for women with PMS.     

Narrative identity in female patients with remitted bipolar disorder: a negative past and a foreshortened future

The present study examined narrative identity and subjective well-being in outpatients with remitted bipolar disorder (BD) and a healthy control group. Fifteen female outpatients with remitted BD and 15 healthy control participants identified past and future chapters in their life stories, gave their age for the beginning and end of each chapter, rated emotional tone as well as positive and negative self-event connections associated with the chapters, and for future chapters rated the probability of the chapter. The BD patients reported less positive emotional tone and self-event connections for past chapters, but not for future chapters. However, the patients did describe fewer future chapters with shorter temporal projection into the future, and reported lower probability of future chapters. These characteristics of chapters were related to lower subjective well-being. The study suggests that a more negative narrative identity with a foreshortened future perspective may contribute to lower subjective well-being in patients with BD.     

Coniunctio—in bodily and psychic modes: dissociation, devitalization and integration in a case of chronic fatigue syndrome

Three years of analytical psychotherapy with a professional woman in mid-life, suffering from chronic fatigue syndrome (CFS), is described. Gradual recovery merged into mid-life changes; marriage, along with a new balance of maternal and paternal imagos, enabled her to trust enough to become pregnant— coniunctio in the most primal bodily and psychic modes.
Her life-long, schizoid type pattern, 'the pendulum of closeness and isolation', with its extreme of psycho-physical collapse and devitalization, was replayed in therapy. The analyst's symbolic attitude is emphasized, containing the patient's initial affective explosion and validating the physicality of her condition. Mirroring and steady rhythmic attunement became a new, pre-verbal, source of trust—vitalization; differentiation and separation replaced defensive splitting and dissociation. Then the overwhelmingly powerful bodily/maternal could be counterbalanced by the masculine, and a transitional space emerged for symbolic work.
Both the regressive and the dynamic aspects of CFS are located in the earliest undifferentiated, archetypal, bodily/psychic modes, when the frustration of primary needs evokes the defences of the self. It is argued that our psychodynamic understanding can contribute to the stalemate in seeing chronic fatigue syndrome as either an organic illness or depression, and that a new linking of the somatic and psychic calls for a new professional collaboration.     

From symptom to process: how the PDM alters goals and strategies in psychological assessment

In many respects the Psychodynamic Diagnostic Manual (PDM) P and M Axes represent psychoanalytic versions of Diagnostic and Statistical Manual of Mental Disorders (DSM) Axes II and V: Whereas the DSM axes focus on surface behaviors and their associated mental states (e.g., thought patterns, affective responses), the PDM axes emphasize underlying psychodynamic processes (e.g., implicit motives, conflicts, defenses), with more modest attention to expressed behavior. The paradigmatic shift envisioned by the PDM creates tremendous opportunities for clinicians and researchers, and significant assessment challenges as well. This article discusses those opportunities and challenges. After briefly contrasting the DSM and PDM conceptualizations of personality pathology and global psychological functioning, I discuss the implications of these contrasting perspectives for diagnosis and psychological assessment, outline strategies for documenting the construct validity of DSM and PDM symptom criteria using symptom-focused and process-focused methods, and offer suggestions for how DSM symptom-focused data can be integrated with PDM process-focused data to facilitate case conceptualization and treatment planning.     

Born in the USA: how immigrant generation shapes meritocracy and its relation to ethnic identity and collective action

Endorsing meritocracy can make low-status group members more accepting of inequality. This study examined whether rejecting meritocracy is related to increased ethnic identification among Latino immigrants, and whether identity in turn is related to increased support for collective action. We hypothesize that these relationships depend upon immigrant generation. A survey was conducted with 184 first- and second-generation Latino immigrants in New York City. Second-generation Latinos endorsed meritocracy less than those in the first generation, at least in part because they perceived that other Americans viewed their group in a less positive light (i.e., lower public regard). Further, meritocracy was negatively linked to ethnic identity and, through it, support for collective action among the second generation. Among the first generation, meritocracy was not related to ethnic identity and was positively related to support for collective action. We discuss the implications of growing up near the bottom of the U.S. social hierarchy for ethnic identity and collective action.     

Different groups, different motives: identity motives underlying changes in identification with novel groups

Social identification is known to have wide-reaching implications, but theorists disagree about the underlying motives. Integrating motivated identity construction theory with recent social identity research, the authors predicted which motives underlie identification with two types of groups: interpersonal networks and social categories. In a five-wave longitudinal study of social identity processes among 268 new university residents, multilevel analyses showed that motives involved in identity enactment processes--self-esteem, belonging, and efficacy--significantly predicted within-person changes in identification with flatmates (an interpersonal network group), whereas motives involved in identity definition processes--meaning, self-esteem, and distinctiveness--significantly predicted within-person changes in identification with halls of residence (an abstract social category). This article discusses implications for research into identity motives and social identity.     

From "in the air" to "under the skin": cortisol responses to social identity threat

The authors examined women's neuroendocrine stress responses associated with sexism. They predicted that, when being evaluated by a man, women who chronically perceive more sexism would experience more stress unless the situation contained overt cues that sexism would not occur. The authors measured stress as the end product of the primary stress system linked to social evaluative threat-the hypothalamic-pituitary-adrenal cortical axis. In Study 1, female participants were rejected by a male confederate in favor of another male for sexist reasons or in favor of another female for merit-based reasons. In Study 2, female participants interacted with a male confederate who they learned held sexist attitudes or whose attitudes were unknown. Participants with higher chronic perceptions of sexism had higher cortisol, unless the situation contained cues that sexism was not possible. These results illustrate the powerful interactive effects of chronic perceptions of sexism and situational cues on women's stress reactivity.     

A social identity model of riot diffusion: From injustice to empowerment in the 2011 London riots

Previous research has shown that riots spread across multiple locations, but has not explained underlying psychological processes. We examined rioting in three locations during the August 2011 disorders in England to test a social identity model of riot diffusion. We triangulated multiple sources to construct a narrative of events; and we analysed interviews with 68 participants to examine experiences. In line with the model, we found evidence for two pathways of influence: “cognitive” and “strategic”. For some participants, previous rioting was highly self-relevant, and shared identity was the basis of their subsequent involvement. For others, previous rioting was empowering because it demonstrated the vulnerability of a common enemy (the police). In each location, interaction dynamics mediated the link between initial perceptions and collective action. The utility of this social identity approach is that it is able to account for both the boundaries and the sequence of urban riot diffusion.     

From a state to a trait: Trajectories of state mindfulness in meditation during intervention predict changes in trait mindfulness

Theory suggests that heightening state mindfulness in meditation practice over time increases trait mindfulness, which benefits psychological health. We prospectively examined individual trajectories of state mindfulness in meditation during a mindfulness-based intervention in relation to changes in trait mindfulness and psychological distress. Each week during the eight-week intervention, participants reported their state mindfulness in meditation after a brief mindfulness meditation. Participants also completed pre- and post-intervention measures of trait mindfulness and psychological symptoms. Tests of combined latent growth and path models suggested that individuals varied significantly in their rates of change in state mindfulness in meditation during the intervention, and that these individual trajectories predicted pre-post intervention changes in trait mindfulness and distress. These findings support that increasing state mindfulness over repeated meditation sessions may contribute to a more mindful and less distressed disposition. However, individuals’ trajectories of change may vary and warrant further investigation.     

From adolescence to adulthood: age-related changes in beliefs about cigarette smoking in a midwestern community sample.

The current study used a cohort-sequential design to examine age-related changes in health-relevant beliefs from the middle school years through age 37 in a large, midwestern, community sample (N=8,556). Results suggest systematic age-related changes such that beliefs in the personalized risks of smoking declined in middle school and then increased, beliefs in generalized health risks increased beginning in the middle school years, and values placed on health as an outcome decreased in the high school years and then increased. These findings suggest that intervention programs must counter declining personalized risk perceptions among middle school students and declining values placed on health among high school age students.     

From religious association to ethnic community: a research project on identity formation among the Syrian orthodox under muslim rule

At the Universityof Leiden, a research group is investigating the formation of a communal identity among West Syrian (or Syrian Orthodox) Christians after the Council of Chalcedon in 451 CE. Of the anti-Chalcedonians, the Syrian Orthodox were probably least likely to form a national or ethnic community. Yet a group emerged with its own distinctive literature and art, its own network and historical consciousness. In a process of adoption and rejection, the West Syrians selected elements from the cultures to which they were heirs and from those with which they came into contact, thus defining a position of their own. In order to study this phenomenon, scholars from various disciplines and affiliated to two different faculties are working together. This paper discusses their research programme and its basic hypothesis.     

From fault line to group fission: understanding membership changes in small groups

Group fissions occur when two or more members leave a parent group to either form a new group or join an existing group. This article investigates the interplay between two factors: the presence of an intragroup conflict and subgroup boundaries on the group fission process. It is hypothesized that subgroup divisions act as potential fault lines along which groups split after they experience conflict. The results of three experiments, one scenario study and two laboratory studies involving small task groups, support the group fault line hypothesis. The authors discuss the implications of these findings for theory and research on membership changes in small groups.     

Neuropsychological performance in patients with fibromyalgia syndrome: relation to pain and anxiety

Previous studies have revealed the presence of cognitive impairment in patients with fibromyalgia syndrome (FMS). However, they have not determined the possible influence of the diverse clinical variables in these disturbances. The first aim of the current study is to compare the cognitive function of 81 patients with FMS and 35 healthy controls by means of a neuropsychological battery. The second aim is to determine the influence of anxiety and pain in the cognitive impairment of patients with FMS. The results of our study show that patients with FMS display a significantly lower cognitive performance and a significantly higher anxiety level than the healthy controls in all the parameters assessed. The neuropsychological performance in patients with FMS is associated with pain, and this relation was independent of the anxiety level. The relationship between cognitive performance and anxiety level was also significant. Therefore, we conclude that cognitive performance is primarily affected by pain. The level of anxiety explains part of the variability in neuropsychological tests that is not explained by pain.