Clarifying the Placement of Obsessive-Compulsive Disorder in the Empirical Structure of Psychopathology

Recent work on the empirical structure of psychopathology has aimed to address some limitations that can arise from traditional categorical classification approaches. This research has focused on modeling patterns of co-occurrence among traditional diagnoses, uncovering a variety of well-validated dimensions (or spectra) of psychopathology, spanning common and uncommon mental disorders. A model integrating these empirically derived spectra (the Hierarchical Taxonomy of Psychopathology; HiTOP) has been proposed. However, the placement of obsessive-compulsive disorder (OCD) within this model remains unclear, as studies have variably found OCD to fit best as part of the Fear, Distress or Thought Disorder spectra. One reason for this may be the heterogeneity of symptoms experienced by individuals with OCD, which is lost when analysing categorical diagnoses. For example, different symptom clusters within OCD—such as washing and contamination versus obsessions and checking—may be differentially associated with different spectra in the HiTOP model. The aim of this study was to test this hypothesis. Data were collected in an anonymous online survey from community participants (n?=?609), largely with elevated symptoms of mental illness, and analyzed in a factor analytic framework treating OCD as a unitary construct and as four separate symptom clusters. The results indicated that OCD and its constituent symptom clusters had significant loadings of varying strength on the Fear and Thought Disorder spectra. These findings suggest that OCD may be best characterized as cross-loading on both the Fear and Thought Disorder spectra, and highlight the importance of accounting for diagnostic heterogeneity in future research.

     

Keats's oral imagination: "'Tis not through envy"

This study of four of Keats's greatest poems explores a dynamic pattern in the poet's imagination: a relationship between the oral/fusional imagery and the romantic/oedipal themes. The poet's imagination seems to have been propelled backward from oedipal conflict to earlier narcissistic/oral unrest and pleasure. There is a layering of special psychic capabilities evident in Keats's imagination: an element of oedipal romance which stabilizes the process of sublimation, a sense of magical play and danger in the maternal/oral imagery, and powerful narcissistic longins organized through the desire to communicate and the gift for expression.     

Object relations and multiple personality: an exploration of the literature

Multiple personality is a dissociative hysterical condition in which there are two or more autonomous personalities. Historically multiple personality has been viewed as an oedipal conflict. Case studies, however, indicate the importance of preoedipal dynamic issues as well. Both ego splitting and oedipal repression seem to be the basic defense mechanisms. The depressive position, in which there is integration of good and bad objects, has not been reached. Objects are split on the basis of sex in that the mother is seen as all bad, while the father is seen as all good. Multiple personality can be considered to occupy a position between oedipal and preoedipal development.     

The role of pre‐oedipal and oedipal factors in psychic life1

The Oedipus complex, a basic concept in Freudian theory, is an essential factor in the constitution of the human subject. It plays a key role in the structuring of the personality and in the orientation of desire. It is the oedipal triangular structure that precedes the pre‐oedipal situation (in a logical, not chronological, order), and not vice versa. The oedipal structure exists before the infant's biological birth. It is present in the parents' desires and identifi cations, which inexorably fall upon each subject. That is why the author believes that it is necessary to leave behind a solipsistic reading of the nuclear complex of neuroses‐a reading that is based solely on Oedipus's drive nucleus‐and take a joint and comprehensive view of Laius's and Jocasta's histories and traumatic experiences, which were invested in their son. Among these three vertices, a dynamic set of forces emerges whereby a basic, original unconscious fi eld phantasy is created that bears a unique narrative and an invisible and hermetic web made of passions and beliefs, scandals and secrets. This phantasy gives shape to an unrepeatable oedipal structure in each subject, a structure that articulates with the effects of the narcissistic and fraternal dynamic and may determine the subject's fate. This paper develops the following issues: 1) Oedipus, victimizer or victim? 2) the generational confrontation as dynamic fi eld; and 3) neuroses with a preponderance of dualistic relationships.     

Eye scanpaths during visual imagery reenact those of perception of the same visual scene

Eye movements during mental imagery are not epiphenomenal but assist the process of image generation. Commands to the eyes for each fixation are stored along with the visual representation and are used as spatial index in a motor‐based coordinate system for the proper arrangement of parts of an image. In two experiments, subjects viewed an irregular checkerboard or color pictures of fish and were subsequently asked to form mental images of these stimuli while keeping their eyes open. During the perceptual phase, a group of subjects was requested to maintain fixation onto the screen's center, whereas another group was free to inspect the stimuli. During the imagery phase, all of these subjects were free to move their eyes. A third group of subjects (in Experiment 2) was free to explore the pattern but was requested to maintain central fixation during imagery. For subjects free to explore the pattern, the percentage of time spent fixating a specific location during perception was highly correlated with the time spent on the same (empty) locations during imagery. The order of scanning of these locations during imagery was correlated to the original order during perception. The strength of relatedness of these scanpaths and the vividness of each image predicted performance accuracy. Subjects who fixed their gaze centrally during perception did the same spontaneously during imagery. Subjects free to explore during perception, but maintaining central fixation during imagery, showed decreased ability to recall the pattern. We conclude that the eye scanpaths during visual imagery reenact those of perception of the same visual scene and that they play a functional role.     

Motor imagery vividness and symptom severity in Parkinson's disease

Motor imagery (MI), the mental simulation of movement in the absence of overt motor output, has demonstrated potential as a technique to support rehabilitation of movement in neurological conditions such as Parkinson's disease (PD). Existing evidence suggests that MI is largely preserved in PD, but previous studies have typically examined global measures of MI and have not considered the potential impact of individual differences in symptom presentation on MI. The present study investigated the influence of severity of overall motor symptoms, bradykinesia and tremor on MI vividness scores in 44 individuals with mild to moderate idiopathic PD. Linear mixed effects modelling revealed that imagery modality and the severity of left side bradykinesia significantly influenced MI vividness ratings. Consistent with previous findings, participants rated visual motor imagery (VMI) to be more vivid than kinesthetic motor imagery (KMI). Greater severity of left side bradykinesia (but not right side bradykinesia) predicted increased vividness of KMI, while tremor severity and overall motor symptom severity did not predict vividness of MI. The specificity of the effect of bradykinesia to the left side may reflect greater premorbid vividness for the dominant (right) side or increased attention to more effortful movements on the left side of the body resulting in more vivid motor imagery.     

Symptoms,blood-pressure information and mood effects on symptom recall

Abstract

After completion of an illness symptom checklist (PILL) covering the previous three months, 97 nor-motensives were allocated to either experimental (false pressor feedback, n=42), or information control (accurate pressor feedback, n = 55), groups. The median reported symptom score divided high from low symptom subjects. All were given standard cuff blood pressure (BP) assessment and were normotensive. However, experimental subjects were misinformed that their BP was raised while information control subjects were told their BP was normal. Subsequently, subjects completed the state anxiety form of the State-Trait Personality Inventory, the PILL, and were asked about their belief of the ascribed BP label (normo/hypertensive) and then any perceived causal relationship between their BP and symptoms. Experimental subjects had significantly higher anxiety scores but no change in symptom recall after pressor feedback, whereas control subjects showed lower anxiety scores and decreases in symptom recall.

A post hoc treatment control (no pressor information) group (n = 20) excluded effects of BP labeling on post-BP scores, and a post hoc symptom control group (n = 55) ensured that symptom levels were representative of the normal population. The majority of subjects in both groups rejected any association between BP labels and symptoms. Data are discussed in the light of Leventhal's models of illness representation.     

The form of analog size information in memory

The information used to choose the larger of two objects from memory was investigated in two experiments that compared the effects of a number of variables on the performance of subjects who either were instructed to use imagery in the comparison task or were not so instructed. Subjects instructed to use imagery could perform the task more quickly if they prepared themselves with an image of one of the objects at its normal size, rather than with an image that was abnormally big or small, or no image at all. Such subjects were also subject to substantial selective interference when asked to simultaneously maintain irrelevant images of digits. In contrast, when subjects were not specifically instructed to use imagery to reach their decisions, an initial image at normal size did not produce significantly faster decisions than no image, or a large or small image congruent with the correct decision. The selective interference created by simultaneously imaging digits was reduced for subjects not told to base their size comparisons on imagery. The difficulty of the size discrimination did not interact significantly with any other variable. The results suggest that subjects, unless specifically instructed to use imagery, can compare the size of objects in memory using information more abstract than visual imagery.     

On how task-contingent rewards,individual differences in causality orientations,and imagery abilities are related to intrinsic motivation and performance

This study explored how causality orientations, individual differences in imagery, and reward contingency are related to performance and intrinsic motivation. Cognitive evaluation theory, as applied to both causality orientation and reward contingency, was used to make predictions about the effects of internal or external events perceived as being autonomy supportive or controlling. In the light of the fact that task-contingent rewards must be salient to undermine intrinsic motivation and performance, one can suppose that high imagery may increase the controlling aspects of task-contingent rewards. Moreover, research now indicates that vegetative activation correlates with levels of imagined effort, and that high imagery capabilities enhance performance in motor skills. The main purpose of this study was to contribute some arguments for imagery and reward interaction effects on intrinsic motivation and performance. As predicted, autonomy-oriented subjects reported more interest and intrinsic motivation, and exhibited better performance than did control-oriented individuals. Similar differences were observed in favour of high-imagery individuals. Moreover, the effects of imagery were not only subject to an interaction between imagery and causality orientation, but also between imagery and reward contingency. The links between these variables are discussed in the framework of both Carver and Scheier's (1981) motivational control theory, and Deci and Ryan's (1985a) cognitive evaluation theory. © 1998 John Wiley & Sons, Ltd.     

The effects of mental imagery on skin temperature and skin temperature sensation

In a series of six experimental sessions five subjects were instructed to imagine their hand in a hot and cold water stream. During the imagery period the subjects estimated with a psychophysical scale their subjective temperature sensations caused by the imagery. Skin temperature was measured from the thumb of the subjects' dominant hand. After each session the subjects were asked whether they had succeeded in producing an imagery. The skin temperature changes deviated significantly from the control level in the successful imagery experiments. Differences in the skin temperature changes between the successful and unsuccessful imagery experiments were significant. The skin temperature changes measured and the subjects' temperature sensations, produced by the imagery, were similar in the successful imagery experiments. The possible relationships between mental imagery and changes in skin temperature and skin temperature sensation are discussed.     

The Network Structure of Childhood Psychopathology in International Adoptees

International adoptees are at an increased risk of emotional and behavioral problems, especially those who are adopted at an older age. We took a new approach in our study of the network structure and predictability of emotional and behavioral problems in internationally adopted children in Finland. Our sample was from the on-going adoption study and comprised 778 internationally adopted children (387 boys and 391 girls, mean age 10.5 (SD 3.4) years). Networks were estimated using Gaussian graphical models and lasso regularization for all the children, and separately for those who were adopted at different ages. The results showed that anxiety/depressive symptoms, social problems, and aggressiveness were the most central symptom domains. Somatic symptoms were the least central and had the weakest effect on the other domains. Similarly, aggressiveness, social problems, and attention problems were high in terms of predictability (73–65%), whereas internalizing problems were relatively low (28–56%). There were clear but local age-group differences in network structure, symptom centrality, and predictability. According to our findings, network models provide important additional information about the centrality and predictability of specific symptom domains, and thus may facilitate targeted interventions among international adoptees.     

Father and daughter: Identification with difference—a contribution to gender heterodoxy

This paper reinterprets the historical problem of penis envy, that is, the girl's wish to be masculine, in terms of a developmental need to identify with father. Many of the problems posed by earlier analyses of femininity can be clarified by recognizing that before the girl “turns”; to the oedipal father as love object, she looks to the rapprochement father for identification. Identification is not merely an internal structure, it is a relationship in which the subject recognizes herself or himself in the other. In rapprochement, love of the father, who symbolically represents the outside world, takes the place of the practicing toddler's “love affair with the world.”; This identificatory love of the father, initially noticed in boys by Freud and later authors, is often frustrated by the father's absence or inability to recognize the daughter. This frustrated longing takes the penis as its symbol of likeness. The pre‐oedipal over‐inclusive phase of identification with the other sex parent is not superceded by the oedipal constellation, but is integrated with it. Thus identification becomes an important basis of the love of the other: it is not so much the opposite of object love as an important precursor and ongoing constituent of it. Case material illustrates the multiple possibilities of identificatory love and use of phallic symbolism to represent them.     

A variation on Freud's theme in "A child is being beaten"--mother's role: some implications for superego development in women.

Clinical material is presented leading to a discussion of beating fantasies which varies from Freud's model. Analysis shows that the fantasied role girls assign to mother as the punisher in the oedipal drama is equivalent to the fantasied role boys ascribe to father as castrator. For both sexes, castration anxiety spurs the internalization of parental prohibitions, the repression of oedipal wishes, and the subsequent structuralization of the superego. Mother establishes the "oedipal law" for the girl analogously to father's doing the same for the boy. The role that such fantasies play in the formation of the female superego is examined.     

The use of subliminal psychodynamic activation in the study of repression

Female undergraduates (N = 33) selected for the presence of high sexual guilt were divided into two groups. One group evidenced a high degree of personality development from which it was inferred that they were prone toward (a) the use of repression rather than more primitive defenses and (b) oedipal rather than preoedipal conflict. The second group evidenced a lesser degree of personality development, and hence the above inferences did not apply. The subliminal psychodynamic activation method was used with both groups to investigate the effects on repression of intensifying and diminishing unconscious conflict over sexual wishes. Subjects were exposed to the verbal stimuli "LOVING DADDY IS WRONG" (conflict intensifying), "LOVING DADDY IS OK" (conflict reducing), and "PEOPLE ARE WALKING" (neutral control), each accompanied by a congruent picture both before (in one condition) and after (in another) a recall test of both neutral and sexual material. The conflict-reduction condition did not affect memory of the passages, but the conflict-intensification condition did for the group with the greater degree of personality development, when this condition was presented before the material to be remembered, and for the recall of neutral passages. The special conditions necessary for demonstration of repression are viewed as shedding light on why it has previously been difficult to show evidence of repression in laboratory experiments.     

Retrospective Revaluation and Inhibitory Associations: Does Perceptual Learning Modulate our Perception of the Contingencies Between Events?

The reported experiments seek to reconcile the conflict between proposed explanations of retrospective revaluation of contingency judgements in experiments with humans (e.g. Dickinson & Burke, 1996) and those of a perceptual learning phenomenon discovered in rats (Espinet, Iraola, Bennett, &Mackintosh, 1995). The experiments employ a medical diagnosis scenario, in which subjects are asked to judge whether particular symptoms signal the presence or absence of a fictitious disease. In Experiment 1, following alternating exposure to pairs of symptoms, AX and BX, subjects were informed that symptom A was predictive of illness. As a result of this training, subjects rated symptom B as predictive of the absence of the illness. In Experiment 2, a possible mechanism behind this effect was considered. In particular, it was established that pre-exposure in which the AX pair reliably preceded the BX pair produced the same pattern of results as those shown in Experiment 1. In contrast, when the order of pairs was reversed, so that BX reliably preceded AX, the reduction in ratings for symptom B was not obtained. Several extant associative theories are discussed, but none are found to account adequately for this pattern of results. To overcome these inadequacies, a parsimonious theory is suggested that explains all the effects observed in these experiments.     

Vividness of positive mental imagery predicts positive emotional response to visually presented Project Soothe pictures

Lang's bioinformational theory of mental imagery proposes that mental imagery and external stimuli engage emotional information-processing systems in similar ways. However, the positive and negative systems are thought to be distinct, so this similarity is likely to show a valence-specific effect. Therefore, we hypothesized that an individual's ability to construct vivid positive, but not negative, mental imagery would predict positive emotional responding to positive visual stimuli, independently of depressive symptoms. Our stimuli were pictures collected through Project Soothe for possible use in psychotherapy ( www.projectsoothe.com ); as these pictures were intended to induce soothing emotion, we hypothesized that theoretically linked variables Self-compassion and Self-criticism would also predict positive responding to the stimuli. A total of 214 participants completed an online study including validated questionnaire measures, mental imagery tasks, and a picture-rating exercise. Only Positive Imagery Vividness and Self-compassion were significant predictors of positive responding to the soothing pictures, even controlling for depressive symptoms, and Negative and General Imagery Vividness. These findings support Lang's theory and provide evidence for individual differences in a positive processing tendency shared across mental imagery-based and perceptual representations. As this relationship is distinct from depressive symptoms, future imagery-based psychotherapies might aim to influence this positive processing tendency.     

Memory for Movement Sequences in Gymnastics: Effects of Age and Skill Level

The authors studied the performances of 8- to 13-year-old skilled (n = 30) and less skilled (n = 30) gymnasts on a gymnastics routine recall task by examining the role of memorization strategies and imagery ability. Subjects had to reproduce 3 movement sequences presented on videotape. The number of trials needed to achieve correct recall, the strategies employed, and the subjects' imagery ability were analyzed. Recall performance improved with age and skill level. Movement labeling was the most prevalent strategy used; its frequency increased with age, although it did not lead to better recall performance. Performance was higher, however, among subjects with better imagery skills. The role of strategy development in the age-related improvement in memory performance was not clearly demonstrated. The effect of skill level is interpreted in terms of knowledge bases and kinesthetic movement encoding.     

Psychopathology subtypes and symptom correlates among former prisoners of war

Psychopathology and symptom patterns were studied in 60 former prisoners-of-war (POWs) by administering standardized tests including the Minnesota Multiphasic Personality Inventory (MMPI), an adjustment problem checklist, and a structured clinical interview. Most POWs showed marked psychological impairment, but modal profile analysis identified two prototypic MMPI patterns, which differed in pervasiveness and type of psychopathology. Profile subtypes were defined by unique clusters of clinical symptoms and differed in confinement stress severity. The typology of symptoms argues against a homogeneous conceptualization of stress-induced disorders and suggests the need for definition of the severity and subtype of stress phenomena and individual difference factors in responding to trauma.