Sequential combinations of drug and cognitive behavioral therapy for chronic insomnia: an exploratory study

This study explores the efficacy of sequential treatments involving medication and cognitive behavioral treatment (CBT) for primary insomnia. Seventeen participants took part in a multiple baseline design and were assigned to: (a) medication for 5 weeks, followed by combined medication plus CBT for 5 weeks; (b) combined treatment for 5 weeks, followed by CBT alone; or (c) CBT alone. Each treatment sequence produced significant sleep improvements, but at different points in time. For the first sequence, most of the sleep improvement was obtained after the introduction of CBT, while for the other sequence and CBT alone, improvement appeared during the first weeks. These results suggest that sleep improvement seems affected by the way treatments are combined. Also, a sequence beginning with a combined treatment followed by CBT alone seems to produce the best outcome. Additional research should be conducted with larger samples to determine the most effective sequence.     

Attachment state of mind, learning dispositions, and academic performance during the college transition

The purpose of this study was to examine the relation among attachment state of mind, students' learning dispositions, and academic performance during the college transition. Sixty-two students were involved in a short-term longitudinal study and were interviewed with the Adult Attachment Interview. Students' learning dispositions were assessed at the end of high school (Time 1) and halfway through their 1st semester in college (Time 2). Academic records were collected at Time 1 as well as at the end of the 1st, 2nd, and 3rd college semesters. Autonomous students showed better learning dispositions throughout the transition and were less likely than dismissing and preoccupied students to experience a decrease in these dispositions between Time 1 and Time 2. In addition, dismissing students obtained the lowest average of grades in college, and this association was mediated by changes in quality of attention during the transition.     

The self-organizing consciousness

We propose that the isomorphism generally observed between the representations composing our momentary phenomenal experience and the structure of the world is the end-product of a progressive organization that emerges thanks to elementary associative processes that take our conscious representations themselves as the stuff on which they operate, a thesis that we summarize in the concept of Self-Organizing Consciousness (SOC).     

Factor analyses of the DIB-R in adolescents

The goal of this study was to examine the factor structure of the Revised Diagnostic Interview for Borderlines (DIB-R; Zanarini, Gunderson, Franckenburg, & Chauncey, 1989) in a nonpatient sample of 118 adolescents. A principal components factor analysis with a Varimax rotation extracted three factors. A confirmatory factor analysis showed that this three-factor model provided an adequate fit. The first factor, which included depression, anxiety, helplessness/hopelessness, loneliness/emptiness, and also encompassed odd thinking/unusual perceptive experiences and quasi-psychotic experiences, appeared to be centered on painful feelings and dissociative defense. The second factor, labeled "impulsivity," consisted of impulse action patterns, counterdependency, and stormy relationships. This factor seemed to be centered on defensive acting-out. The third factor, called "aggressiveness," consisted of anger, hypomania, devaluation/manipulation/sadism, and demand/entitlement, and might express manic/narcissistic defenses. These analyses suggest that there may be homogeneous components of borderline symptomatology in adolescents that may reflect affective disturbances and defensive mechanisms.     

Psychological,endocrine, and neural correlates of attentional bias in subclinical depression

Background: Our knowledge with respect to psychological, endocrine, and neural correlates of attentional bias in individuals with high vulnerability to developing depression – the subclinically depressed, still remains limited. Design: The study used a 2?×?2 mixed design. Methods: Attentional bias toward happy and sad faces in healthy (N?=?26) and subclinically depressed individuals (N?=?22) was assessed via a neuroimaging dot-probe attention task. Participants also completed trait and state psychological measures and provided saliva samples for cortisol analysis. Results: The subclinical group showed attentional bias toward happy faces; past use of problem-focused coping strategies when dealing with a personally relevant stressor as well as state levels of anxiety, together, contributed to this bias. In the control group, the happy attentional bias was positively correlated with activity in the right caudate. In the subclinical group, the bias was negatively associated with the left fusiform gyrus and positively with the left inferior parietal lobule and bilateral putamen. We observed group differences in association between cortisol levels during the task and neural activity during happy attentional bias processing within the key regions involved in attention. Conclusions: The attentional bias toward happy faces may reflect an active coping attempt by the subclinical participants.     

Preview benefit in speaking occurs regardless of preview timing

Speakers access information from objects they will name but have not looked at yet, indexed by preview benefit—faster processing of the target when a preview object previously occupying its location was related rather than unrelated to the target. This suggests that speakers distribute attention over multiple objects, but it does not reveal the time course of the processing of a current and a to-be-named object. Is the preview benefit a consequence of attention shifting to the next-to-be-named object shortly before the eyes move to that location, or does the benefit reflect a more unconstrained deployment of attention to upcoming objects? Using the multiple-object naming paradigm with a gaze-contingent display change manipulation, we addressed this issue by manipulating the latency of the onset of the preview (SOA) and whether the preview represented the same concept as (but a different visual token of) the target or an unrelated concept. The results revealed that the preview benefit was robust, regardless of the latency of the preview onset or the latency of the saccade to the target (the lag between preview offset and fixation on the target). Together, these data suggest that preview benefit is not restricted to the time during an attention shift preceding an eye movement, and that speakers are able to take advantage of information from nonfoveal objects whenever such objects are visually available.     

Digging beneath the surface: Results from stage one of a qualitative analysis of factors influencing the well-being of trans youth in Quebec

ABSTRACT

Background: The literature on trans youth has been dominated by etiological studies interested in trans experience as a medical phenomenon. An emerging body of literature has begun to document that trans youth are a diverse, vulnerable, yet resilient population, and to investigate the role of various sites of support such as the family, peer groups, institutions, and community spaces in contributing to or impeding trans youth's well-being.

Method: This article presents the results of Stage One of interviews (n = 24) conducted for a Community-Based Participatory Action Research (CBPAR) qualitative research project based in Quebec. It studies the factors that enhance trans youth's well-being as well as the factors of oppression that negatively affect it. This paper offers a brief overview of the anti-oppressive methodology used for this project, emphasizing how CBPAR was combined with Grounded Theory (GT) methods to encourage the direct involvement of communities and the translation of knowledge into action.

Results: We present preliminary categories emerging through the ongoing axial coding process. These categories address trans youth's experiences in and perceptions of various “sites”: 1) healthcare services both for gender-related and general care, 2) other institutional spaces, 3) the family and other social circles, and 4) community spaces.

Conclusion: While much of this study's results support existing evidence on trans youth's experiences, they also provide a more nuanced portrayal of the complex ways in which recognition, as well as non-, mis-, or mal-recognition, influence trans youth's well-being at different sites. We also argue that recognition itself must be considered through the lens of intersectionality.     

People are not cabbages: reflections on patient and analyst change

The author describes how her own internal change was a vital part of transformation between herself and two patients. She draws on Loewald's work as she discusses how change in her own internal relationship with her father was part of a lifelong emotional reorganization of Oedipal relations. She describes a process of mutual change whereby her and her patients' unconscious growth each stimulated the other. She suggests that the analyst's own emotional growth is a vital, not an incidental, part of psychoanalysis, as it brings new life to the work for patients as well as analysts themselves.