Activating Posthypnotic Conflict: Emergent Uncovering Psychopathology Repression,and Psychopathology

An attempt was made to observe the process of repression and symptom formation. Emergent uncovering techniques were used to weaken a spontaneous repression that was produced by the posthypnotic activation of sexual impulses stemming from an implanted oedipal paramnesia. Twelve hypnotic and ten simulating subjects were used in a modified real-simulator design. Although it was not possible to 'lift' the spontaneous repression of derivatives of oedipal strivings in the course of uncovering via visual imagery, a wide variety of spontaneous symptoms were produced in the hypnotically conditioned subjects. The type of symptom was shown to be related to the degree of repression. Simulating subjects produced only a few symptoms. The manifestation of a symptom was concomitant with an increase in the GSR, but not the blatancy of drive representation. These findings were consistent with the phenomena observed using free imagery in emergent uncovering psychotherapy.     

Attention Deficit Disorder: A Neuropsychoanalytic Sketch

A neuropsychoanalytic sketch of attention deficit disorder (ADD) is presented. The syndrome is defined in terms of its core symptoms, and discussed from the perspective of etiology, pathogenesis, diagnosis, differential diagnosis, and treatment. Also unique is the effort to describe the patient's inner experiences and begin to map these onto the external perspective of what is happening psychologically and neurologically, that is, inside the patient's brain (chemically, anatomically, and neurophysiologically). A number of speculations are thus created regarding the role of the executive control network (ECN), particularly, that of the basal ganglia, cerebellum, anterior cingulate, and those parts of the ECN that are responsible for such things as cognitive shifting between low-level routine information processing modes and those used for high-level processing applicable for sensitive or complex analysis. The effects of trauma on the tagging of memories are also considered. In this manner the research of Shevrin et al., Posner and Raichle, Gedo, Levin, and a number of others integrating mind and brain is brought to bear on an illness with known cognitive and personality disordering. This paper complements a companion paper on the subject of learning disability (Orenstein and Levin, in press).     

A Neuropsychoanalytic Viewpoint: Commentary on Paper by Steven H. Knoblauch

In October 2004 it was my pleasure to present at a cutting-edge conference entitled The Interplay of Implicit and Explicit Processes in Psychoanalysis. In addition to offering an address (“The Essential Role of the Right Brain in the Implicit Self: Development, Psychopathogenesis, and Psychotherapy”), I also provided a commentary to Steven Knoblauch's excellent paper, “Body Rhythms and the Unconscious: Toward an Expanding of Clinical Attention.” In the following, I briefly summarize these presentations, with the purpose of showing how current advances in developmental and neuropsychoanalysis are being incorporated into the practice of clinical psychoanalysis. This work is part of an ongoing effort to expand regulation theory, an overarching theoretical model of the development, psychopathogenesis, and treatment of the implicit self.     

Parent vs. Self-Report: Contributions Toward Diagnosis of Adolescent Psychopathology

Assessment of psychopathology in adolescents can be complicated due to uncertainties about who should be considered the primary informant. While a multimethod, multiinformant approach to assessment allows for a thorough assessment, it can also result in contradictory findings. The purpose of this study was to use a sample of 121 adolescents to investigate issues of parent-adolescent agreement on behavior rating scales and a structured diagnostic interview. Additionally, this study evaluated whether adolescent report offers unique information to the assessment beyond the parent's report. The sample included both normal controls and adolescents who met criteria for diagnosis of an Internalizing or Externalizing disorder based on the DSM-IV criteria. Agreement between parents and adolescents on the Diagnostic Interview for Children and Adolescents—Revised (DICA-R) was low for ADHD (39.4%) and Externalizing Disorders (41.1%) and moderate for Internalizing Disorders (56.6%). A significant difference was found between the number of ADHD symptoms reported, with parents reporting more symptoms (M = 9.42) than adolescents (M = 8.34). Regression analysis indicated that the adolescent completed Youth Self-report (YSR) contributed unique information beyond the parent completed measures in predicting both the adolescent and the parent interviews for Internalizing Disorders. This finding emphasizes the need to continue to collect self-report information, especially when assessing Internalizing disorders, which inherently contain symptoms indicating high-risk behaviors such as suicide ideation.     

Correction to: A Family Socialization Model of Transdiagnostic Risk for Psychopathology in Preschool Children

Research on Child and Adolescent Psychopathology - A correction to this paper has been published: https://doi.org/10.1007/s10802-021-00812-1     

Psychoanalysis and the Model of Homosexuality as Psychopathology: A Historical Overview

The American Journal of Psychoanalysis -     

A Family Socialization Model of Transdiagnostic Risk for Psychopathology in Preschool Children

Research on Child and Adolescent Psychopathology - This longitudinal study examined the presence of general (P) and specific internalizing (INT) and externalizing (EXT) psychopathology factors in a...     

Repression, Dissociation, and the Recovered Memory Debate: Constructing Scientific Evidence and Expertise

We examine arguments about the scientific status of repression and dissociation in the written discourse of academic social scientists and clinicians on the controversial issue of recovered memories of child sexual abuse. The rhetorical deployment of theories, methods, and evidence by representatives of both camps regarding the authenticity of recovered memories, repression, and dissociation is compared. The ways in which supporters and sceptics bolster claims for their own expertise while undermining that of opponents are also explored. Supporters of recovered memory emphasise the pragmatic relevance of theories and clinical evidence, while sceptics draw rhetorically on positivist standards of scientific rigour and reliability to undermine claims of recovered memory. The themes of relevance and reliability are then related to discussions of recent legal changes in the United States on the admissibility of expert opinion evidence in recovered memory cases.     

The Voice in Dissociation: A Group Model for Helping Victims Integrate Trauma Representational Memory

The current article focuses on the subjective elements of voice in trauma and dissociation, and the manifestation of voice in four phases of group treatment for victims of extreme, catastrophic events. The voice discussed here is no ordinary voice: it captures an attribute of dissociated representational experience that, though not easily defined, is nonetheless replete with trauma messages from the depth of somatopsychic processes, expressed in the patient's nonverbal talking in gestures, tone of voice, posture, silences, facial expressions, and in rhythm, timbre, movement, and syntax. Dissociation, trauma representational memory, and the phases of a proposed group model are discussed in detail with their respective phase-specific voice.     

Personality and Psychopathology: An Application of the Five-Factor Model

Our review is concerned with the relationship of the five-factor model of personality to psychopathology, focusing in particular on Axis II personality disorders and depression. The five factors provide a particularly compelling model for interpreting the Axis II personality disorders as maladaptive variants of normal personality traits. However, we also discuss methodological and conceptual limitations of this application. There has been little research on the relationship of Openness, Agreeableness, and Conscientiousness to Axis I mental disorders, but considerable attention has been given to Neuroticism and Extraversion. We focus in particular on the difficulty in distinguishing between the various ways in which personality can relate to depression, either as a predisposition to, a complication of, a pathoplastic effect upon, or a spectrum variant of the mental disorder. We conclude with recommendations for future research.     

A Tower Unto Heaven: Toward an Expanded Framework for Psychopathology

I respond to commentaries on my target article “An Evolutionary Life History Framework for Psychopathology.” I start by addressing criticism of my basic assumptions about life history strategies and their implications for individual differences in human behavior. Next, I examine the theoretical structure of the proposed framework and respond to the commentators’ challenges to its generality and flexibility. I show how the framework can be expanded to include multiple levels of analysis and to integrate behavioral control with neurological functionality; I also reinterpret the recent finding of a general factor of psychopathology in the context of the expanded framework. In the last section I discuss specific psychopathological conditions, namely attention deficit/hyperactivity disorder, borderline personality disorder, substance abuse, autism spectrum disorders, schizophrenia spectrum disorders, obsessive-compulsive disorder, eating disorders, and depression. For each condition, I reply to the commentators’ criticism of my life history analysis, integrate their suggestions and insights, highlight the present weaknesses of the theory, and indicate promising directions for future research.     

A Developmental Psychopathology and Neurobiological Model of Borderline Personality Disorder in Adolescence

The antecedents and risk factors and for developing borderline personality disorder (BPD) are now well documented, but there is a paucity of developmental models to understand the key processes through which they impact on the development of BPD in adolescents. In this article, we present a developmental psychopathology model of BPD in adolescence and link the difficulties adolescents with BPD have with impulsivity and self regulation, with risk factors such as genetic vulnerability, parenting and trauma. We propose a number of psychological processes through which these risk factors undermine personal and interpersonal functioning, and makes it particularly difficult to engage with the challenges of adolescence. These key psychological processes undermine the integration of the self, with extreme unintegrated affects and extreme representations of self and others, undermining the capacity to mentalize. We then make links to possible neurobiological underpinnings of the disturbances in affect, Theory of Mind and interpersonal difficulties in adolescents with BPD.     

A Dimensional Model of Psychopathology Among Homeless Adolescents: Suicidality,Internalizing, and Externalizing Disorders

The present study examined associations among dimensions of suicidality and psychopathology in a sample of 428 homeless adolescents (56.3% female). Confirmatory factor analysis results provided support for a three-factor model in which suicidality (measured with lifetime suicidal ideation and suicide attempts), internalizing disorders (assessed with lifetime diagnoses of major depressive episode and post-traumatic stress disorder), and externalizing disorders (indicated by lifetime diagnoses of conduct disorder, alcohol abuse, and drug abuse) were positively intercorrelated. The findings illustrate the utility of a dimensional approach that integrates suicidality and psychopathology into one model. Kevin A. Yoder and Susan L. Longley made equal contributions to this paper.     

Discrimination and Eating Disorder Psychopathology: A Meta-Analysis

Eating disorders occur in diverse populations, and discrimination may be a specific factor that is related to higher eating disorder psychopathology among marginalized individuals. To evaluate the current evidence on this topic, a meta-analysis was used to quantitatively synthesize the literature on discrimination and eating disorder psychopathology across a heterogeneous range of studies. Searches were conducted in peer-reviewed journals and accessible unpublished dissertations of all years through January 2020. Studies were coded by two authors using a tailored coding form, and zero-order bivariate correlations were used as effect size measures. There were 55 cross-sectional studies extracted for inclusion in the meta-analysis. Results showed a small-to-medium association between discrimination and eating disorder psychopathology that was consistent across domains. Effect sizes were typically higher for weight discrimination. For binge eating and general eating disorder pathology, effects were smaller in studies that had larger proportions of women, and for binge eating only, effects were higher in college samples. These findings could suggest that discrimination represents a contributory factor related to eating disorder psychopathology across types of discrimination and eating disorder psychopathology. Implications are discussed for future research on discrimination and psychopathology including possible mechanisms.     

The Relationship Between Parental Alcoholism and Adolescent Psychopathology: A Systematic Examination of Parental Comorbid Psychopathology

The relationship between parental alcohol dependence (with and without comorbid psychopathology) and adolescent psychopathology was examined in a sample of 665 13-17 year-old adolescents and their parents. Results indicated that adolescents who had parents diagnosed with alcohol dependence only did not significantly differ from adolescents who had parents with no psychopathology in regard to any of the measures of psychological symptomatology (substance use, conduct disorder, and depression) or clinical diagnoses (alcohol dependence, marijuana dependence, conduct disorder, or depression) assessed. In contrast, adolescents who had parents diagnosed with alcohol dependence and either comorbid drug dependence or depression were more likely to exhibit higher levels of psychological symptomatology. In addition, adolescents who had parents diagnosed with alcohol dependence, depression, and drug dependence were most likely to exhibit psychological problems. These findings underscore the importance of considering parental comorbid psychopathology when examining the relationship between parental alcoholism and offspring adjustment.