Eating disorder NOS (EDNOS): an example of the troublesome "not otherwise specified" (NOS) category in DSM-IV

The “Not Otherwise Specified” (NOS) category within DSM-IV is designed for disorders of clinical severity that are not specified within broad diagnostic classes. “NOS” diagnoses are intended to be residual categories and they tend to be neglected by researchers. This can be inappropriate. The problems associated with certain NOS diagnoses are well illustrated by “Eating Disorder NOS” (sometimes termed EDNOS), which is the most common category of eating disorder encountered in routine clinical practice yet it has barely been studied. Indeed, there has been no research on its treatment. Interim and longer-term conceptual and practical solutions to the anomalous status of eating disorder NOS are proposed including the creation of a new diagnosis termed “mixed eating disorder”. Several of these solutions are of relevance to NOS categories in general. All the solutions should fulfil criteria for clinical utility.     

Cognitive processes in panic disorder: an extension of current models

Beck and Clark's 1997 information processing model of panic was presented and evaluated. In general, studies using the Stroop task have shown panic patients have a cognitive bias toward negative and personally relevant information. Several studies have also shown that panic patients tend to have more catastrophic thoughts and are more likely to misinterpret bodily sensations. Further, cognitive-behavioral therapy is more effective than drug therapies. The limitations of the cognitive model and cognitive-behavioral therapy were discussed, and an extension of current models was proposed. The extension of current models combines cognitive-behavioral and psychodynamic concepts and techniques and suggests that exposure in vivo used for agoraphobic situations and interoceptive exposure used for panic should also be applied to the underlying themes of panic disorder.     

Realism in energy transition processes: an example from Bohmian quantum mechanics

In this paper we study in details a system of two weakly coupled harmonic oscillators from the point of view of Bohm’s interpretation of quantum mechanics. This system may be viewed as a simple model for the interaction between a photon and a photodetector. We obtain exact solutions for the general case. We then compute approximate solutions for the case where one oscillator is initially in its first excited state (a single photon) reaching the other oscillator in its ground state (the photodetector). The approximate solutions represent the state of both oscillators after the interaction, which is not an eigenstate of the individual hamiltonians for each oscillator, and therefore the energies for each oscillator do not exist in the Copenhagen interpretation of Quantum Mechanics. We use the approximate solutions that we obtained to compute Bohmian trajectories and to study the energy transfer between the oscillators. We conclude that, even using the Bohmian view, the energy of each individual oscillator is not well defined, as the nonlocal quantum potential is not negligible even after the coupling is turned off.     

Social stress in tree shrews as an animal model of depression: an example of a behavioral model of a CNS disorder

Animal models are invaluable in preclinical research on human psychopathology. Valid animal models to study the pathophysiology of depression and specific biological and behavioral responses to antidepressant drug treatments are of prime interest. In order to improve our knowledge of the causal mechanisms of stress-related disorders such as depression, we need animal models that mirror the situation seen in patients. One promising model is the chronic psychosocial stress paradigm in male tree shrews. Coexistence of two males in visual and olfactory contact leads to a stable dominant/subordinate relationship, with the subordinates showing obvious changes in behavioral, neuroendocrine, and central nervous activity that are similar to the signs and symptoms observed during episodes of depression in patients. To discover whether this model, besides its "face validity" for depression, also has "predictive validity," we treated subordinate animals with the tricyclic antidepressant clomipramine and found a time-dependent recovery of both endocrine function and normal behavior. In contrast, the anxiolytic diazepam was ineffective. Chronic psychosocial stress in male tree shrews significantly decreased hippocampal volume and the proliferation rate of the granule precursor cells in the dentate gyrus. These stress-induced changes can be prevented by treating the animals with clomipramine, tianeptine, or the selective neurokinin receptor antagonist L-760,735. In addition to its apparent face and predictive validity, the tree shrew model also has a "molecular validity" due to the degradation routes of psychotropic compounds and gene sequences of receptors are very similar to those in humans. Although further research is required to validate this model fully, it provides an adequate and interesting non-rodent experimental paradigm for preclinical research on depression.     

Comparing a narcissistic and an autistic retreat: 'looking through or at the window'

In this paper I discuss two different forms of psychic retreats that I encountered in the treatment of a patient who suffered from two traumatic experiences: the loss of his mother when he was 2 years old and his 'near-death' experience when he was five. In the parasitic narcissistic retreat, using intensive projective identification enabled him to create an impasse in the form of a 'high tide - low tide' scenario in which alternating hope and disappointment kept the process going, yet paralyzed development. The autistic retreat, for its part, led to the collapse of projective identification mechanisms, dismantling and disrupting the transference/countertransference negotiations. The emerging state of non-communication and 'near death' seemed to act as a protection against the unbearable pain of abandonment and desolation.     

The Challenges and Opportunities of Faith Community (Parish) Nursing in an Ageing Society

SUMMARY

Faith Community Nursing is one form of health ministry that provides an opportunity to meet the challenges of an ageing society. This nursing is based on principles of communion, stewardship, service and transformation to promote the health of the community. Faith Community Nurses (FCNs) provide education, advocacy, counselling and assistance with care management to the faith community and beyond. Their work is complimented and supplemented by health ministry volunteers, using their knowledge and skills to build the social capital of the community.     

Assessment procedures for narcissistic personality disorder: a comparison of the personality diagnostic questionnaire-4 and best-estimate clinical judgments

This study examined the degree of correspondence between two assessments for narcissistic personality disorder (NPD) in a mixed clinical and community sample--one using a self-report measure (Personality Diagnostic Questionnaire-4) and the other using clinical judgments derived from an assessment based on the longitudinal, expert, all data (LEAD) methodology. NPD scores demonstrated moderate convergence for the total scores but weak convergence for the individual criteria. The authors also examined the correlates created by each set of NPD scores using Cloninger's Temperament and Character Inventory (TCI). The NPD scores demonstrated areas of convergence (e.g., Cooperativeness, Self-directedness) and divergence (i.e., Harm Avoidance, Novelty Seeking) with these personality scores. These divergences may be due to the wording of certain items on the Personality Diagnostic Questionnaire-4 NPD scale, which may require rewriting if it is to provide an assessment that is more highly convergent with the Diagnostic and Statistical Manual of Mental Disorders NPD construct.     

Holistic and analytic processes in the comparison of letters

College students made “same-different” judgments about successively presented pairs of letters whose degree of difference, in terms of the number of line segments out of register, was systematically varied. Reaction time was found to decrease with increases in the degree of difference in “different” responses, as well as to depend on the number of line segments present in the second (probe) letter. “Same” responses were much faster than different responses and were unaffected by the number of segments in the probe letter. This pattern of results suggests analytic (component-by-component) processing of “different” letters and holistic processing of “same” letters. The results have important implications for studies of multi-letter comparisons, in which it is commonly assumed that letter comparisons are holistic in nature.     

APP23 mice as a model of Alzheimer's disease: an example of a transgenic approach to modeling a CNS disorder

Animal models are considered essential in research ensuing elucidation of human disease processes and subsequently, testing of potential therapeutic strategies. This is especially true for neurodegenerative disorders, in which the first steps in pathogenesis are often not accessible in human patients. Alzheimer's disease is vastly becoming a major medical and socioeconomic problem in our aging society. Valid animal models for this uniquely human condition should exhibit histopathological, biochemical, cognitive, and behavioral alterations observed in Alzheimer's disease patients. Major progress has been made since the understanding of the genetic basis of Alzheimer's disease and the development and improvement of transgenic mouse models. All present Alzheimer's disease models developed are partial but nevertheless essential in further unraveling the nature and spatial and temporal development of the complex molecular pathology underlying this condition. One of the more recent transgenic attempts to model Alzheimer's disease is the APP23 transgenic mouse. This article describes the development and assessment of this human amyloid precursor protein overexpression model. We summarize histopathological and biochemical, cognitive and behavioral observations made in heterozygous APP23 mice, thereby emphasizing the model's contribution to clarification of neurodegenerative disease mechanisms. In addition, the first therapeutic interventions in the APP23 model are included.     

Surviving and Thriving in a Secularized Culture: The Phenomenon of Religious (Church/Faith) Schools in England

While the mainstream churches are being increasingly ignored as religious institutions in rapidly secularizing England, their schools survive and, in many instances, thrive. These schools, financed by public funds, are an increasingly important part of the English state schooling system. It would appear that their survival and expansion has been driven by increased societal emphasis on academic success, which, in the main, these schools provide. What are the implications of this in terms of social divisiveness and what is the response of the churches themselves in terms of their role in the communities they serve? While the arguments for and against are entered into by a small number of commentators, it is perhaps significant that the once politically sensitive area of church/faith schools is still left alone by politicians.     

It can be done: an example of a behavioral Individualized Education Program (IEP) for a child with autism

With state agencies and scientists recommending Early Intensive Behavioral Intervention (EIBI) for children with autism, the demand for qualified behavior consultants exceeds the supply. Consequently, children with autism are either receiving alternative, ineffective, and unsubstantiated treatments or are receiving EIBI programming from unqualified personnel. Additionally, when school districts are approached to provide services, the resulting Individualized Education Programs (IEPs) are typically not behavioral and lack the detailed and specific objectives required for children with autism. This article was written to provide parents and educators with an objective and quantifiable IEP, which has been used as a guideline for treatment for a 4‐year‐old boy with autism. Copyright © 2000 John Wiley & Sons, Ltd.     

Heuristic and analytic processes in mental models for conditionals: An integrative developmental theory

This article presents a developmental dual-process theory of the understanding of conditionals that integrates Evans’ heuristic–analytic theory within the revised mental model theory of conditional proposed by Barrouillet, Gauffroy, and Lecas (2008). According to this theory, the interpretation of a conditional sentence is driven by unconscious and implicit heuristic processes that provide individuals with an initial representation that captures its meaning by representing the cases that make it true. This initial model can be enriched with additional models (a process named fleshing out within the mental model theory) through the intervention of conscious and demanding analytic processes. Being optional, these processes construct representations of cases that are only compatible with the conditional, leaving its truth-value indeterminate when they occur. Because heuristic processes are relatively immune to developmental changes, while analytic processes strongly develop with age, the initial model remains stable through development whereas the number of additional models that can be constructed increases steadily. Thus, the dual-process mental model theory predicts in which cases conditionals will be deemed true, indeterminate, or false and how these cases evolve with age. These predictions were verified in children, adolescents and adults who were asked to evaluate the truth value and the probability of several types of conditionals. The results reveal a variety of developmental trajectories in the way different conditionals are interpreted, which can all be accounted for by our revised mental model theory.     

Critical reflection and critical reflexivity as core processes for critical WOP: Precarious employment as an example

This work suggests that researchers in work and organizational psychology (WOP) and WOP as a discipline would benefit from a critical perspective on their own research and practice. We highlight the value of critical reflection and critical reflexivity on contexts of research and practice in order to increase the practical impact of WOP for everyone. First, we outline how WOP currently fails to address pressing global issues, such as precarious employment, by focusing on work-related phenomena in affluent societies and neglecting issues relevant to the majority of the world's working population. Second, we present a heuristic framework of four fundamental contextual components that are important to consider when engaging in a continuous process of critical reflection and critical reflexivity: history; economy and politics; society and culture; and personal background. Third, we illustrate why these contexts are important for WOP with the example of precarious employment. Considering context more explicitly is important for future WOP research because context not only co-determines the experiences of the working people under investigation but also the subjectivity of researchers themselves. We hope to encourage WOP researchers to engage in critical reflection and critical reflexivity to promote a more critical WOP.     

Together in pain: attachment-related dyadic processes and posttraumatic stress disorder

We used actor-partner interdependence modeling to explore associations among attachment-related dyadic processes, posttraumatic stress disorder (PTSD) in war veterans, and secondary traumatic stress (STS) in their wives. A sample of 157 Israeli couples (85 former prisoners of war and their wives and a comparison group of 72 veterans not held captive and their wives) completed self-report scales assessing attachment insecurities (anxiety, avoidance) and PTSD symptoms. For both groups of veterans and their wives, attachment anxiety was associated with the severity of their own and their spouses' PTSD and STS. Avoidant attachment was associated with PTSD and STS only in couples that included a former prisoner of war. A complex pattern of associations involving avoidant attachment was observed in the actor-partner analyses of these couples. The study demonstrates that attachment-related dyadic processes play a role in the development and maintenance of PTSD in traumatized veterans and STS in their wives.     

Passive-aggressive (negativistic) personality disorder: a population-based twin study

The objective of this study was to investigate the familial aggregation of passive aggressive personality disorder (PAPD), and explore issues regarding PAPD raised by the DSM-IV Personality Disorder Work Group. Two thousand seven hundred and ninety-four Norwegian twins from the population-based Norwegian Institute of Public Health Twin Panel were interviewed with the Structured Interview for DSM-IV Personality (SIDP-IV). Because of the rarity of the twins meeting full diagnostic criteria for PAPD a dimensional representation of the disorder was used for the analyses. Overlap with other axis II disorders was assessed by polychoric correlations, while familial aggregation was explored by structural equation twin models. Overlap was highest with paranoid (r = 0.52) and borderline personality disorder (r = 0.53), and lowest with schizoid (r = 0.26). Significant familial aggregation was found for PAPD. The twin correlations and parameter estimates in the full model indicated genetic and shared environmental effects for females, and only shared environmental effects for males, but the prevalence of endorsed PAPD criteria in this community sample was too low to permit us to conclude with confidence regarding the relative influence of genetic and shared environmental factors on the familial aggregation of PAPD.     

Within or without: negotiating psychic space with an adolescent at risk of developing a narcissistic personality structure

This paper examines a 22-month once weekly psychotherapy with an adolescent young man. My patient was one of a group of adolescents who, due in part to excessive aggression, envy, anxiety or confusion, has chronically evaded the intimate and dependent psychic contact with others that is necessary for psychological development. In my view, this comes about through a combination of external factors and internal predisposition, with the quality of care received during infancy playing a crucial role. These adolescents appear to be developing narcissistic modes of being in the world which if allowed to persist into adulthood would be seen as deeply entrenched clinical psychopathology. Managing separation and loss is one of the central aspects of adolescence, but these young people tend to intrude or merge with others with such aggressive force that recognising difference between self and other becomes difficult. In psychotherapy, this often takes the form of the patient’s inability to tolerate experiencing the therapist as a separate person, and when knowledge of the therapist as separate impinges on their view, they frequently react in a variety of primitively destructive ways. This paper seeks to explore these central ideas through a detailed examination of psychotherapy with a young man in whom such struggles predominate.     

Discriminating malingered from genuine civilian posttraumatic stress disorder: a validation of three MMPI-2 Infrequency scales (F, Fp, and Fptsd)

The Infrequency-Posttraumatic Stress Disorder scale (Fptsd), recently created for the Minnesota Multiphasic Personality Inventory-2 (MMPI-2), has demonstrated incremental validity over other MMPI-2 scales in malingered posttraumatic stress disorder (PTSD) detection. Fptsd was developed with combat-exposed PTSD patients, potentially limiting its use with PTSD patients in general. The current study evaluated the MMPI-2's F, Infrequency-Psychopathology scale (Fp), and Fptsd scales in discriminating genuine civilian PTSD among 41 adult victims of child sexual abuse from a group of 39 students instructed to simulate PTSD. Analyses demonstrated Fptsd's incremental validity over F but not over Fp. Based on the two studies examining Fptsd, Fptsd may be more appropriate for combat trauma victims, and Fp may be more appropriate for civilian trauma victims.     

Consuming Religion: Faith in the Future and the Future of Faith

Books reviewed in this article:
John Drane, The McDonaldization of the Church: Spirituality, Creativity, and the Future of the Church
George Ritzer, Enchanting A Disenchanted World: Revolutionizing the Means of Consumption