Enactment as understanding and as misunderstanding

The author considers the concept of enactment as a ubiquitous event that is best seen as part of a sequence in the process of understanding a patient. As such, enactments are not unusual or special save as they are often subject to disavowal or to being singled out by the analyst as especially subject to scrutiny. Once recognized, enactments need to be interpreted: not so much in terms of their unconscious origins, but more with regard to the need to include them in the analytic dialogue.     

The Moderating Role of Anxiety in the Associations of Callous-Unemotional Traits with Self-Report and Laboratory Measures of Affective and Cognitive Empathy

In a sample of detained male adolescents (n = 107; Mean age = 15.50; SD = 1.30), we tested whether anxiety moderated the association of CU traits with self-report and computerized measures of affective (emotional reactivity) and cognitive (affective facial recognition and Theory of Mind [ToM]) empathy. Hierarchical regression analyses revealed that CU traits were negatively associated with self-reports of affective empathy and this association was not moderated by level of anxiety. Significant interactions revealed that CU traits were negatively associated with cognitive empathy (self-report) only at high levels of anxiety, whereas CU traits were positively associated with cognitive empathy on the ToM task only at low levels of anxiety. CU traits were also associated with greater fear recognition accuracy at low levels of anxiety. Implications for understanding and treating different variants of CU traits (i.e., primary and secondary) are discussed.     

Pharmacogenetics: ethical issues and policy options

Pharmacogenetics offers the prospect of an era of safer and more effective drugs, as well as more individualized use of drug therapies. Before the benefits of pharmacogenetics can be realized, the ethical issues that arise in research and clinical application of pharmacogenetic technologies must be addressed. The ethical issues raised by pharmacogenetics can be addressed under six headings: (1) regulatory oversight, (2) confidentiality and privacy, (3) informed consent, (4) availability of drugs, (5) access, and (6) clinicians' changing responsibilities in the era of pharmacogenetic medicine. We analyze each of these categories of ethical issues and provide policy approaches for addressing them.     

Emotion and cognition: feeling and character identification in dreaming

This study investigated the relationship between dream emotion and dream character identification. Thirty-five subjects provided 320 dream reports and answers to questions on characters that appeared in their dreams. We found that emotions are almost always evoked by our dream characters and that they are often used as a basis for identifying them. We found that affection and joy were commonly associated with known characters and were used to identify them even when these emotional attributes were inconsistent with those of the waking state. These findings are consistent with the finding that the dorsolateral prefrontal cortex, associated with short-term memory, is less active in the dreaming compared to the wake brain, while the paleocortical and subcortical limbic areas are more active. The findings are also consistent with the suggestion that these limbic areas have minimal input from the dorsolateral prefrontal cortex in the dreaming brain.