The Treatment of Mental Contamination: A Case Series

The recommended treatment for obsessive-compulsive disorder (OCD) is cognitive behavior therapy (CBT) incorporating exposure and response prevention (ERP), which is effective for approximately 50% of patients. However, there has been little advance in treatment outcomes since the introduction of ERP in 1979. It has been suggested that some progress can be made in treating contamination obsessions and washing compulsions by addressing feelings of dirtiness and contamination that arise without physical contact with a tangible contaminant. To date, the treatment of these “mental contamination” fears in OCD has not been systematically explored. This paper reports on a case series of 12 participants with OCD who received 10 to 20 sessions of a CBT-based treatment for mental contamination. At the end of treatment, 7 participants no longer met the diagnostic criteria for OCD and mental contamination and these gains were maintained at 6-month follow-up. The clinical implications of these findings are discussed.     

Textures shape the attentional focus: Evidence from exogenous and endogenous cueing

The spatial cueing paradigm (Posner Quarterly Journal of Experimental Psychology 32:3–25, 1980) has often been used to investigate the time course of the deployment of visual attention in space. In a series of eight experiments we investigated whether spatial cues would not only enhance processing of stimuli presented at cued locations, but also enhance processing of the entire texture in which the stimuli were presented. Results showed highest accuracy for responses to stimuli presented at cued locations, a replication of the traditional cueing effect (Posner 1980). Additionally, stimuli presented at uncued locations were responded to with higher accuracy when they were presented inside the same texture as the cued location, as compared with stimuli presented outside the texture with the cued location. To investigate this texture advantage for both automatic and voluntary attention deployment, exogenous and endogenous cues were used. The texture advantage was observed for short interstimulus intervals (ISIs) of 50 and 100 ms for exogenous cues and for a longer ISI of 200 ms for endogenous cues. These findings indicate that the arrangement of task-irrelevant visual stimuli also can have a large impact on the cueing effect. This suggests that visual spatial attention spreads texture-wise across the visual field. Control experiments revealed that the homogeneity within texture elements contributes most to the effect but that the texture advantage is a function of both orientation contrast at the texture border and homogeneity within texture elements.     

Some thoughts about thought disturbance in adolescence

One of the principal aims of adolescence is the development of the capacity to think for oneself. The authors explore the difficulties caused by disturbances of thinking in borderline adolescents, pointing out the role that the analyst can take in promoting better functioning of their patients' mental processes. Two cases are explored, one through a supervision and the other through direct clinical experience. Both illustrate the efforts of the analyst to carry out 'management in the area of thinking' with those borderline patients who have not received help from their parents to think, and still need to be shown how mentation takes place. The authors propose some changes in technique in order to implement this improvement, including sharing with the patient the way in which the analyst thinks about him. Thinking itself can be an important integrating factor for these patients.

Une des tâches principales de l'adolescence est de développer la capacité à penser par soi-même. Les auteurs explorent les difficultés occasionnées par des troubles de la pensée chez des adolescents borderline et soulignent le rôle que peut jouer l'analyste pour favoriser un meilleur fonctionnement des processus psychiques chez ces patients. Deux cas sont étudiés dans cet article ; dans l'un, le matériel est extrait de séances de supervision, dans l'autre, il est tiré directement de la situation thérapeutique. Ces cas mettent en évidence les efforts de l'analyste pour aider le patient à mieux fonder ses processus de pensée ; dans les états limites, le patient bien souvent n'a jamais pu bénéficier de l'aide de ses parents dans ce domaine et devra encore apprendre comment mettre en ?uvre l'idéation. Les auteurs proposent quelques modifications techniques afin de faciliter l'activité mentale chez ce type de patient, visant notamment à lui faire part de la manière dont son analyste pense à lui. La pensée en elle-même peut être un facteur important qui favorise l'intégration psychique chez ces patients.

Uno degli scopi principali dell'adolescenza e' lo sviluppo della capacita' di pensare per se stessi. Le autrici esplorano le difficolta' causate dai disturbi del pensiero in adolescenti borderline, sottolineando il ruolo che l'analista puo' avere nel promuovere un miglior funzionamento dei processi mentali dei loro pazienti. Vengono riportati due casi, uno attraverso l'esperienza di supervisione e l'altro attraverso l'esperienza diretta del lavoro clinico. In entrambi i casi viene illustrato lo sforzo dell'analista di portare avanti il 'management nell'area del pensare' con quei pazienti bordeline che non sono stati aiutati dai loro genitori a pensare, e che ancora hanno bisogno di capire come prende luogo il processo del pensare. Le autrici propongono dei cambiamenti nella tecnica per poter implementare tale miglioramento, compreso il condividere con il paziente il modo in cui l'analista pensa a lui. Il pensare puo' essere di per se' un importante fattore di integrazione per questi pazienti.

Eines der Hauptziele der Adoleszenz ist die Entwicklung der Fähigkeit, für sich selber zu denken. Die Autorinnen betrachten die Schwierigkeiten, die durch Denkstörungen bei Borderline- Jugendlichen verursacht werden, und stellen die Rolle heraus, die Analytiker einnehmen können, um ein besseres Funktionieren der mentalen Prozesse ihrer Patienten zu fördern. Es werden zwei Fälle betrachtet, einer durch Supervision und der andere durch direkte klinische Erfahrung. Beide illustrieren die Bemühungen der Analytikerin, 'Management im Bereich des Denkens' auszuführen mit diesen Borderline-Patienten, die von ihren Eltern keine Unterstützung zu denken erlangt hatten, und denen noch gezeigt werden muss, wie Denkprozesse stattfinden. Die Autorinnen schlagen einige Veränderungen in der Technik vor, um diese Verbesserung zu implementieren, einschliesslich dem, dass man dem Patienten mitteilt, wie die Analytikerin über ihn denkt. Denken selbst kann ein wichtiger integrierender Faktor für diese Patienten sein.     

Reading and Spelling Disabilities in Children with and Without a History of Early Language Delay: A Neuropsychological and Linguistic Study

Language delay is a frequent antecedent of literacy problems, and both may be linked to phonological impairment. Studies on developmental dyslexia have led to contradictory results due to the heterogeneity of the pathological samples. The present study investigated whether Italian children with dyslexia showed selective phonological processing deficits or more widespread linguistic impairment and whether these deficits were associated with previous language delay. We chose 46 children with specific reading deficits and divided them into two groups based on whether they had language delay (LD) or not (NoLD). LD and NoLD children showed similar, severe deficits in reading and spelling decoding, but only LD children showed a moderate impairment in reading comprehension. LD children were more impaired in phonological working memory and phonological fluency, as well as in semantic fluency, grammatical comprehension, and verbal IQ. These findings indicate the presence of a moderate but widespread linguistic deficit (not limited to phonological processing) in a subset of dyslexic children with previous language delay that does not generalize to all children with reading difficulties.     

The two sides of competition: Competition‐induced effort and affect during intergroup versus interindividual competition

Competition strongly affects individual effort and performance for both individuals and groups. Especially in work settings, these effort gains might come at the cost of individual well‐being. The present study tested whether competition increases both effort (as indicated by task performance) and stress (in terms of cardiovascular reactivity and affective response), and whether this effect is further qualified by the type of competition (interindividual vs. intergroup), using a cognitive computer‐based task and a 2 (Group: Yes, No) × 2 (Competition: Yes, No) × 2 (Gender) factorial design (N= 147). All participants either worked as a representative of a group or as an individual, and were offered performance‐related incentives distributed in a lottery. In the competition conditions, participants were informed that they competed with someone else, and that only the winning person/team would take part in the lottery. Consistent with expectations, competition increased both individual effort and cardiovascular reactivity compared to non‐competitive work. Moreover, for female participants, intergroup competition triggered increased effort and more positive affect than interindividual competition. Aside from documenting costly side‐effects of competition in terms of stress, this study provides evidence for a stress‐related explanation of effort gains during intergroup competition as compared to interindividual competition.     

Ego development and the ethics of care and justice: the relations among them revisited

This study examined the links among ego development and the ethics of care and justice in 144 Norwegian men and women, 15 to 48 years old, taking into consideration age, sex, education, and verbal intelligence. As expected, the relationship between Loevinger's model of ego development and care-based moral reasoning as measured with Skoe's Ethic of Care Interview (ECI) was significantly stronger than the one between ego development and justice as measured with Rest's Defining Issues Test (DIT). Both ethics correlated significantly with verbal ability. Analyses showed that beyond its overlap with verbal intelligence, the variance shared between the ECI and ego development was substantial. By contrast, when verbal intelligence was controlled, the DIT was not significantly related to ego development or to the care ethic.     

Marital interaction of agoraphobic women: a controlled,behavioral observation study

Married couples with a female agoraphobic spouse (n = 22) were compared with demographically similar community control couples (n = 21) on self-report and observational measures of marital interaction. Consistent with hypotheses, husbands of agoraphobic women were more critical of their wives than were control husbands, and clinical couples were less likely to engage in positive problem solution than control couples. Contrary to hypothesis, clinical husbands were not less supportive than control husbands. Where general measures of marital distress were concerned, clinical couples, relative to control couples, evinced more distress by self-report, by their higher rate of negative nonverbal behavior, and by their longer sequences of negative exchanges.     

When rejection stings: how self-esteem constrains relationship-enhancement processes

Three experiments examined how needs for acceptance might constrain low versus high self-esteem people's capacity to protect their relationships in the face of difficulties. The authors led participants to believe that their partner perceived a problem in their relationship. They then measured perceptions of the partner's acceptance, partner enhancement, and closeness. Low but not high self-esteem participants read too much into problems, seeing them as a sign that their partner's affections and commitment might be waning. They then derogated their partner and reduced closeness. Being less sensitive to rejection, however, high self-esteem participants affirmed their partner in the face of threat. Ironically, chronic needs for acceptance may result in low self-esteem people seeing signs of rejection where none exist, needlessly weakening attachments.     

Relationship between the rorschach and the MMPI-2 in a Swedish population: a replication study of the effects of first-factor related test-interaction styles

A sizeable amount of research literature has failed to demonstrate a stable relationship between self-report and the Rorschach (Exner, 1993). However, principal component first-factor related test-interaction style has been shown to moderate convergence. In this study 78 psychiatric patients completed the Rorschach and the Minnesota Multiphasic Personality Inventory-2 (MMPI-2; Hathaway & McKinley, 1989). Practically no correlation was evident between the MMPI-2 and the Rorschach, measuring similar constructs, in all patients. Patients with similar test-interaction styles demonstrated positive intermethod correlations between both conceptually related and conceptually not directly related test indexes. The same scales were negatively correlated in patients with discordant test-interaction styles, and this difference between test-interaction style groups was significant. It is suggested that first-factor related test-interaction style moderates convergence. It is further suggested that test-interaction style moderates convergence between both conceptually related and conceptually not directly related measures of distress or psychopathology.     

Sleep-dependent hippocampal slow activity correlates with waking memory performance in humans

The positive effect of postlearning sleep on memory consolidation as well as the relationship between sleep-related memory processes and the hippocampal formation are increasingly clarified topics in neurobiology. However, the possibility of a stable relationship between waking mnemonic performance and sleep-dependent hippocampal electric activity is unexplored. Here we report a correlative analysis between sleep-dependent parahippocampal-hippocampal (pHip-Hip) electric activity recorded by foramen ovale (FO) electrodes and different types of memory performances in epileptic patients. Psychological testing was performed days or weeks before electrophysiological recordings. The relative spectral power of the slow activity (below 1.25 Hz) during deep non-REM (NREM) sleep at the right pHip-Hip region correlated positively with the visual memory performance according to Rey-Osterrieth Complex Figure Test (ROCFT). Along the posterior-anterior direction of the hippocampal formation a linear increasing of correlations was observed. The relative power of the activity below 1.25 Hz at the left pHip-Hip during phasic REM sleep correlated positively with verbal learning performance and mnemonic retention values according to ROCFT. It is concluded that the pHip-Hip structures' capacity of producing high amplitude and synchronized slow (< 1 Hz) oscillation during deep NREM sleep is related to the functional power of these structures. We hypothesize that the asymmetric (side-specific) propagation of ponto-geniculo-occipital (PGO) activity to the pHip-Hip region is related to the memory correlates of phasic REM sleep.