Mentalizing in psychotherapy: patients’ and therapists’ reflective functioning during the psychotherapeutic process / Mentalizando en psicoterapia: funcionamiento reflexivo de pacientes y terapeutas durante el proceso psicoterapéutico

Abstract

There has been a growing interest in mentalization in clinical research given its relationship with normal and psychopathological functioning and its explanatory potential as a mechanism of psychotherapeutic change. This study uses the Reflective Functioning Scale (RFS) to identify and characterize mentalization manifestations in psychotherapeutic interaction. Method: the RFS was applied to a sample of relevant episodes — 44 sessions from five different psychotherapy processes carried out with adult patients who had different diagnoses. Results: we observed a higher probability of reflective functioning (RF) passages in relevant events than in neutral segments. There were no differences in the RF passages according to episode or actor type, but there were in RF Failures, which is more likely in patients and during rupture episodes. Discussion: although certain modifications are necessary, the RFS can be applied to clinical material, and it is a promising strategy for the study of mentalization within psychotherapy.     

Are Automatic Imitation and Spatial Compatibility Mediated by Different Processes?

Automatic imitation or “imitative compatibility” is thought to be mediated by the mirror neuron system and to be a laboratory model of the motor mimicry that occurs spontaneously in naturalistic social interaction. Imitative compatibility and spatial compatibility effects are known to depend on different stimulus dimensions—body movement topography and relative spatial position. However, it is not yet clear whether these two types of stimulus–response compatibility effect are mediated by the same or different cognitive processes. We present an interactive activation model of imitative and spatial compatibility, based on a dual‐route architecture, which substantiates the view they are mediated by processes of the same kind. The model, which is in many ways a standard application of the interactive activation approach, simulates all key results of a recent study by Catmur and Heyes (2011) . Specifically, it captures the difference in the relative size of imitative and spatial compatibility effects; the lack of interaction when the imperative and irrelevant stimuli are presented simultaneously; the relative speed of responses in a quintile analysis when the imperative and irrelevant stimuli are presented simultaneously; and the different time courses of the compatibility effects when the imperative and irrelevant stimuli are presented asynchronously.     

Neuropsychological Deficits in Relation to Symptoms of ADHD: Independent Contributions and Interactions

Twelve children with and without Down syndrome (DS) performed eight subtests of an apraxia battery to determine under what conditions children with DS had difficulty performing representational and nonrepresentational gestures. Participants with DS also completed a dichotic listening test. Participants with DS performed just as well as control participants on all aspects of the apraxia battery except a subtest in which they were required to pantomime tool use from verbal instruction. This suggests that children with DS have difficulty generating an action from memory following verbal instruction. Given the sufficient context or visual demonstration, children with DS performed similar to the other participants. As well, there was a great deal of within-group variability for dichotic listening ear advantage. Participants with a greater left ear advantage on the dichotic listening test committed more errors on an imitation test that also included a verbal component than participants with a greater right ear advantage.     

Social attitudes modulate automatic imitation

In naturalistic interpersonal settings, mimicry or “automatic imitation” generates liking, affiliation, cooperation and other positive social attitudes. The purpose of this study was to find out whether the relationship between social attitudes and mimicry is bidirectional: Do social attitudes have a direct and specific effect on mimicry? Participants were primed with pro-social, neutral or anti-social words in a scrambled sentence task. They were then tested for mimicry using a stimulus-response compatibility procedure. In this procedure, participants were required to perform a pre-specified movement (e.g. opening their hand) on presentation of a compatible (open) or incompatible (close) hand movement. Reaction time data were collected using electromyography (EMG) and the magnitude of the mimicry/automatic imitation effect was calculated by subtracting reaction times on compatible trials from those on incompatible trials. Pro-social priming produced a larger automatic imitation effect than anti-social priming, indicating that the relationship between mimicry and social attitudes is bidirectional, and that social attitudes have a direct and specific effect on the tendency to imitate behavior without intention or conscious awareness.     

Psychometric evaluation of the adolescent and parent versions of the Gaming Addiction Identification Test (GAIT)

The objective of the study is to evaluate the psychometric properties of the Gaming Addiction Identification Test (GAIT) and its parent version (GAIT‐P), in a representative community sample of adolescents and parents in Västmanland, Sweden. Self‐rated and parent‐rated gaming addictive symptoms identified by GAIT and GAIT‐P were analyzed for frequency of endorsement, internal consistency, concordance, factor structure, prevalence of Internet gaming disorder (IGD), concurrence with the Gaming Addiction Scale for Adolescents, 7‐item version (GAS) and the parent version of GAS (GAS‐P), and for sex differences. The 12‐month prevalence of IGD was found to be 1.3% with GAIT and 2.4% with GAIT‐P. Results also indicate promising psychometric results within this population, with high internal consistency, and high concurrent validity with GAS and GAS‐P. Concordance between adolescents and parents ratings was high, although moderate in girls. Although exploratory factor analysis indicated poor model fit, it also indicated unidimensionality and high factor loadings in all analyses. GAIT and GAIT‐P are suitable for continued use in measuring gaming addiction in adolescents, and, with the additional two items, they now cover all nine IGD criteria.     

Automatic imitation of intransitive actions

Previous research has indicated a potential discontinuity between monkey and human ventral premotor-parietal mirror systems, namely that monkey mirror systems process only transitive (object-directed) actions, whereas human mirror systems may also process intransitive (non-object-directed) actions. The present study investigated this discontinuity by seeking evidence of automatic imitation of intransitive actions--hand opening and closing--in humans using a simple reaction time (RT), stimulus-response compatibility paradigm. Left-right and up-down spatial compatibility were controlled by ensuring that stimuli were presented and responses executed in orthogonal planes, and automatic imitation was isolated from simple and complex orthogonal spatial compatibility by varying the anatomical identity of the stimulus hand and response hemispace, respectively. In all conditions, action compatible responding was faster than action incompatible responding, and no effects of spatial compatibility were observed. This experiment therefore provides evidence of automatic imitation of intransitive actions, and support for the hypothesis that human and monkey mirror systems differ with respect to the processing of intransitive actions.     

Mortality of geriatric and younger patients with schizophrenia in the community

Little is known about the differences in mortality among non-institutionalized geriatric and younger patients with schizophrenia. In this study long-term mortality and suicidal behavior of all the geriatric (age > or = 65 years), middle-age (age 41-64 years), and young (age 15-40 years) subjects with schizophrenia living in a Chinese rural community were compared. A 10 year follow-up investigation among a 1994 cohort (n = 510) of patients with schizophrenia was conducted in Xinjin County, Chengdu, China. Compared with young subjects, geriatric subjects with schizophrenia were more likely to be female, have more previous physical illness, never accepted treatment, and practice religious (p < or = 0.01). There were no significant differences of suicide attempts among the three groups. Young subjects had a higher rate of suicide (1,033.8 per 100,000 person-years), and geriatric subjects had a higher rate of deaths due to other causes (accident and natural causes) (4,314.2 per 100,000 person-years). Standardized mortality ratios for both suicide and deaths due to other causes were highest in young subjects and the lowest in geriatric subjects. Patients with schizophrenia in all age groups had a marked increase in mortality and suicide. Specific intervention strategies for decreasing mortality and suicide should be developed for patients with schizophrenia in different age groups.