Can negative attitudes toward patients with borderline personality disorder be changed? The effect of attending a STEPPS workshop

We sought to determine whether negative attitudes toward patients with borderline personality disorder (BPD) can be modified through education. Mental health clinicians attended a 1-day workshop on the Systems Training for Emotional Predictability and Problem Solving (STEPPS) group treatment program for BPD. A questionnaire to assess attitudes towards BPD was given to 271 clinicians before and after the workshop. Following the workshop, clinicians endorsed having significantly greater empathy toward patients with BPD, and having greater awareness of the distress and low self-esteem associated with the disorder. Significant improvement was seen in the clinicians' attitudes toward patients with BPD and their desire to work with them. Clinicians were significantly less likely to express dislike for BPD patients. They also reported feeling more competent in their ability to treat these patients. The study offers preliminary evidence that negative attitudes toward patients with BPD can be modified through education.     

Positive overgeneralization and Behavioral Approach System (BAS) sensitivity interact to predict prospective increases in hypomanic symptoms: a behavioral high-risk design

Recent work has identified Behavioral Approach System (BAS) sensitivity as a risk factor for the first onset and recurrence of mood episodes in bipolar disorder, but little work has evaluated risk factors for the prospective development of hypomanic symptoms in individuals at risk for, but without a history of, bipolar disorder. The present study used a prospective behavioral high-risk design to evaluate the impact of positive overgeneralization, a cognitive correlate of risk for hypomania, on hypomanic symptoms in individuals with high vs. moderate BAS sensitivity, but without a history of mood elevation. Hierarchical linear regressions indicated that upward positive overgeneralization and BAS sensitivity interacted to predict increased levels of hypomanic symptoms at follow-up, controlling for initial hypomanic symptoms. The pattern of this interaction was such that positive overgeneralization predicted higher levels of hypomanic symptoms among high-BAS, but not moderate-BAS, individuals. Thus, the self-reported tendency to experience grandiose increases in confidence following success may confer additional risk for mood elevation among individuals already at risk for developing bipolar disorder. Potential implications for prevention and treatment are discussed.     

Division I men and women athletes do not differ on perceptions of worth

Historically, especially prior to the increased interest in women's athletics with the passage of Title IX in 1972, there have been negative perceptions of women as athletes. If these social perceptions still hold in part today, as is indirectly suggested by unequal press coverage and less basic support for women athletes, one might predict that collegiate female athletes would rate themselves lower on self-esteem and worth than collegiate male athletes. 176 Division I male (n = 90) and female (n = 86) athletes rated their perceptions of self on the Worth Index which measures basic human worth, personal security, performance, and physical self; these are divided into intrinsic (unconditional worth) measures and behavior or performance (conditional worth) measures. There were no significant sex differences in the ratings of any aspect of perceived worth, in contrast to prior results among non-athletes. In spite of less support given to women athletes, perhaps the long-term high-intensity competition that is required to reach Division I status tends to eliminate sex differences in self-worth.     

Aging, imagery, and the bizarreness effect

ABSTRACT This study examined the bizarre imagery effect in young and older adults, under incidental and intentional conditions. Intentionality was manipulated across experiments, with participants receiving an incidental free recall test in Experiment 1 and an intentional test in Experiment 2. This study also examined the relation between working memory resources and the bizarreness effect. In Experiment 1 young and older adults were presented with common and bizarre sentences; they later received an incidental recall test. There were no age differences in sensitivity to the bizarreness effect in Experiment 1 when ANOVAs were used to analyze the data. However, when the bizarreness effect was examined in terms of effect size, there was evidence that younger adults produced larger bizarreness effect sizes than younger adults. Experiment 2 further explored age differences in sensitivity to the bizarreness effect by presenting young and older adults with bizarre and common sentences under intentional learning conditions. Experiment 2 failed to yield age differences as a function of item type (bizarre vs. common). In addition, Experiment 2 failed to yield significant evidence that the bizarreness effect is modulated by working memory resources. The results of this study are most consistent with the distinctiveness account of the bizarreness effect.     

Reducing Youth Access to Alcohol: Findings from a Community-Based Randomized Trial

Underage drinking continues to be an important public health problem and a challenge to the substance abuse prevention field. Community-based interventions designed to more rigorously control underage access to alcohol through retailer education and greater enforcement of underage drinking laws have been advocated as potentially effective strategies to help address this problem, but studies designed to evaluate such interventions are sparse. To address this issue we conducted a randomized trial involving 36 communities to test the combined effectiveness of five interrelated intervention components designed to reduce underage access to alcohol. The intervention was found to be effective in reducing the likelihood that retail clerks would sell alcohol to underage-looking buyers, but did not reduce underage drinking or the perceived availability of alcohol among high school students. Post hoc analyses, however, revealed significant associations between the level of underage drinking law enforcement in the intervention communities and reductions in both 30-day use of alcohol and binge drinking. The findings highlight the difficulty in reducing youth drinking even when efforts to curtail retail access are successful. Study findings also suggest that high intensity implementation of underage drinking law enforcement can reduce underage drinking. Any such effects of enhanced enforcement on underage drinking appear to be more directly attributable to an increase in perceived likelihood of enforcement and the resultant perceived inconveniences and/or sanctions to potential drinkers, than to a reduction in access to alcohol per se.     

Making Music Together: Discussion of Gianni Nebbiosi’s “The Smell of Paper”

Finding life in our patients is a common goal for analysts. Historically this project had been defined as one of freeing unacceptable impulses from their imprisoning defenses with the analyst, via interpretation, then contrasting the patient’s internal fantasied reality with “actual” reality. Untangling fantasy from reality could free the impulses to provide energy for more realistic projects. This imagery stands in stark contrast to the fluidity of a contemporary relational conceptualization of human experience where our inner experience is now understood to be the lens through which we construct our vision of external reality, always a subjective perception. Clinical change—finding life—now depends more on the activation of a generative intersubjective process between patient and analyst, which contributes to the expansion of the patient’s subjective experience. Gianni Nebbiosi’s use of music and of mime to help him feel his way into his patient’s and ultimately into his own similarly defended experience demonstrates the creativity and idiosyncratic clinical approaches that emerge from a contemporary relational orientation. This orientation recognizes the analyst’s subjectivity as a fundamental tool of clinical change—a vehicle through which any theoretical approach will necessarily be shaped. Differing approaches to a clinical situation do not always simply reflect theoretical disagreements; they may also reflect the expression of the particular subjectivity of the analyst.     

Long-term effect of prefrontal lobotomy on verbal fluency in patients with schizophrenia

OBJECTIVE: This study investigated the long-term effects of bilateral prefrontal leukotomy on lexical abilities in schizophrenia subjects. METHOD: we compared performances of leukotomized (LSP), non-leukotomized schizophrenia patients (NLSP) and normal controls, using a test of verbal fluency. Multiple case and triple comparison design were implemented. i.e., the performance of each LSP was compared to that of NLSP and that of a normal control. The sample consisted of four LSP, four NLSP, and four normal subjects. Subjects were matched in sex, age, handedness, and schooling. In Addition, schizophrenia groups were matched in diagnosis and years of hospitalization. Quantitative and qualitative analyses of generated words and errors produced by subjects were carried out. RESULTS: A deficiency in both groups of schizophrenia was observed, although a better performance in LSP patients was detected. CONCLUSION: Intact Lexical ability in LSP indicates its poor relation to the frontal lobe.     

The “soap opera” effect in story recall

When people learn a series of actions of a character, their memory is strongly influenced, we suggest, by beliefs about that character’s motives. Motives serve as schema for deciding the meaning of the actions, their importance, and their interconnections. In two experiments, subjects read and later remembered some dull activities of a character. Experimental subjects knew what this character was worrying about (e.g., an unwanted pregnancy); control subjects did not. Recall and recognition showed that motive subjects distorted many of the colorless events to be motive relevant. Although the motive schema helped connect the disparate actions, it interfered with accurate recording and recall of the details.