Dream content of schizophrenic, nonschizophrenic mentally ill, and community control adolescents

This study compared the manifest dream content of 20 schizophrenic adolescent inpatients whose medications were stable for at least four weeks, 21 adolescent inpatients with other mental disorders (nonschizophrenic group) matched for age and gender, and 31 matched community controls. All participants were administered the standardized Formal Dream Content Rating Scale (FDCRS), which evaluates dream-related anxiety, cognitive disturbance, implausibility, involvement, primitivity, and recall, as well as two additional scales measuring emotional expression and duration of dream report. The Positive and Negative Symptoms Scale (PANSS) was administered to the two inpatient groups. The community controls demonstrated more involvement and emotional expression than the schizophrenic patients; furthermore, they demonstrated more implausibility and had a greater duration of dream report compared with the nonschizophrenic group. In the schizophrenic patients only, elevated scores on the negative subscale of the PANSS were significantly correlated with lower scores on involvement, emotional expression, and dream recall. No relationship was found between the positive subscale of the PANSS and any of the FDCRS subscales. These results suggest that psychopathology per se, rather than the specific psychiatric disturbance, may be associated with impoverishment of dream content, and that negative, rather than positive, schizophrenic symptomatology may be influential in the dream content of schizophrenic youngsters.     

Transcending the caesura: Reverie,dreaming and counter‐dreaming

The author reflects about our capacity to get in touch with primitive, irrepresentable, seemingly unreachable parts of the Self and with the unrepressed unconscious. It is suggested that when the patient's dreaming comes to a halt, or encounters a caesura, the analyst dreams that which the patient cannot. Getting in touch with such primitive mental states and with the origin of the Self is aspired to, not so much for discovering historical truth or recovering unconscious content, as for generating motion between different parts of the psyche. The movement itself is what expands the mind and facilitates psychic growth. Bion's brave and daring notion of ‘caesura’, suggesting a link between mature emotions and thinking and intra‐uterine life, serves as a model for bridging seemingly unbridgeable states of mind. Bion inspires us to ‘dream’ creatively, to let our minds roam freely, stressing the analyst's speculative imagination and intuition often bordering on hallucination. However, being on the seam between conscious and unconscious, dreaming subverts the psychic equilibrium and poses a threat of catastrophe as a result of the confusion it affords between the psychotic and the non‐psychotic parts of the personality. Hence there is a tendency to try and evade it through a more saturated mode of thinking, often relying on external reality. The analyst's dreaming and intuition, perhaps a remnant of intra‐uterine life, is elaborated as means of penetrating and transcending the caesura, thus facilitating patient and analyst to bear unbearable states of mind and the painful awareness of the unknowability of the emotional experience. This is illustrated clinically.     

Relationship of cognitive strategy use to prospective memory performance in a diverse sample of nondemented older adults with varying degrees of cognitive complaints and impairment

Although older adults typically have better performance on prospective memory (PM) tasks carried out in naturalistic settings, a paucity of research directly assesses older adults’ use of compensatory strategies on such tasks. The current study investigates external memory strategy use during performance of a clinical PM test that features both short-term (in laboratory) and long-term (out of laboratory) subtasks (i.e., the Royal Prince Alfred Prospective Memory Test – RPA-ProMem. Nondemented, community-dwelling older adults (n = 214; mean age = 80.5; 68.2% female; 39.7% non-white) with mild cognitive impairment, subjective cognitive decline, and healthy controls completed the RPA-ProMem while external strategy use was permitted and recorded. Overall, participants utilized external strategies 41% of the time on the RPA-ProMem. Increased utilization of external memory strategies was significantly associated with better PM performance. Additionally, better performance on executive functioning tasks was associated with increased use of external memory strategies. Results are discussed in relation to how memory strategy use can be enhanced to improve everyday memory ability in older adults at risk for dementia.     

Being Right,and Being in the Right

This paper presents a critique of a prevailing conception of the relation between moral reasoning and judgment on the one hand, and moral goodness on the other. I argue that moral reasoning is inescapably vulnerable to moral, as opposed to merely theoretical, failure. This, I argue, means that there is something deeply misleading in the way that Kant's moral theory, and some of its main rivals, have invited us to conceive of their subject matter.