Differential attrition in health behaviour change trials: A systematic review and meta-analysis

Objective: Attrition is a common problem in health behaviour change (HBC) trials. When the degree of attrition differs between treatment conditions, then this is called differential attrition and is regarded as a major threat to internal validity. The primary research question of this study was: how often and to what degree does differential attrition occur in HBC trials?

Design: A systematic review and meta-analysis of a random selection of HBC trials (k = 60). We meta-analysed the relative attrition rates using a random-effects model and examined the relationship between the relative attrition rates and the potential moderators: the amount of human contact in delivery and the intensity of the intervention/control condition, the type of control condition, and the follow-up intensity and duration.

Main outcome measures: Relative attrition rates.

Results: The average attrition rate was 18% (SD = .15; M = .15) in the intervention and 17% (SD = .13; M = .13) in the control conditions. The estimated average relative attrition rate was 1.10 (95% CI: 1.01–1.20, p = .02), suggesting an overall higher attrition rate of 10% in the intervention conditions. This relative attrition rate was not related to any of the potential moderators.

Conclusion: There is indication of a slightly higher amount of attrition on average in the intervention conditions of HBC trials.     

Colour, face, and visuospatial imagery abilities in low-vision individuals with visual field deficits

This study investigates to what extent visual perception integrity is necessary for visual mental imagery. Sixteen low-vision participants with severe peripheral visual field loss, 16 with severe central field loss, 6 left brain-damaged patients with right homonymous hemianopia, 6 right brain-damaged patients with left homonymous hemianopia, and 16 normally sighted controls performed perceptual and imagery tasks using colours, faces, and spatial relationships. Results showed that (a) the perceptual and mental image>ry disorders vary according to the type of visual field loss, (b) hemianopics had no more difficulties imagining spatial stimuli in their contralesional hemispace than in their ipsilesional one, and (c) the only hemianopic participant to have perceptual and mental imagery impairments suffered from attentional deficits. Results suggest that (a) visual memory is not definitively established, but rather needs perceptual practice to be maintained, and (b) that visual mental imagery may involve some of the attentional-exploratory mechanisms that are employed in visual behaviour.     

Hannah Arendt,evil and the eradication of thought

Evil deeds may be committed intentionally or out of madness, but it is those who follow orders that present us with the most complex moral, philosophical and psychological questions. In writing about the banality of evil, Hannah Arendt argues that “in granting pardon, it is the person and not the crime that is forgiven; in rootless evil there is no person left whom one could ever forgive.” Arendt postulates that “being a person” necessarily entails the acts of memory and thought. This paper explores Arendt’s ideas on memory and thought and how these processes can become subverted in the service of a higher order. Clinical material illustrates Whitmer’s idea of dissociation as an “impairment of subjectivity” as distinct from Freud’s view of dissociation as a form of repression. This shift in theoretical perspective sheds new light on our understanding of the totalitarian state of mind, i.e. of the mind of a “nobody”, and the conditions within which evil is committed.     

Book Reviews

K ast , V erena . The Creative Leap: Psychological Transformation through Crisis
K ast , V erena . Die Dynamik der Symbole: Grundlagen der Jungschen Psychotherapie
B ion , W. R. A Memoir of the Future
Z iegler , A lfred J. Bilder einer Schattenmedizin     

Book Reviews

N agy , M. Philosophical Issues in the Psychology of
N agy , M. Philosophical Issues in the Psychology of C. G. Jung.
E dinger , E. F. Transformation of the God-Image: An Elucidation of Jung's 'Answer to Job'.
M oon , B., (ed.). An Encyclopaedia of Archetypal Symbolism: The Archive for Research in Archetypal Symbolism.
T ustin , F. The Protective Shell in Children and Adults.     

Reviews

H enderson , J oseph , L. Shadow and Self: Selected Papers in Analytical Psychology .
J ung , C. G. Analytical Psychology: Notes of the Seminar given in 1925 .
H opcke , R obert H. Jung, Jungians, and Homosexuality .
J acoby , M ario . Individuation & Narcissism: The Psychology of Self in Jung & Kohut .
E dinger , E dward , F. The Living Psyche: A Jungian Analysis in Pictures .
B isagni , F rancisco (Ed.) Analysis: An International Review of Clinical Psychotherapy     

Purposive aspects of the erotic transference

This paper illustrates the erotic transference of a male patient towards his female analyst and the pressures and resistances within the transference and counter-transference to act out sexually. The patient's desire to act out sexually is seen both as a form of repetition compulsion within the transference and, in its purposive aspect, as an expression of the patient's need to find a loving breast and an empathic father. The patient's confused sexual identity is seen as a narcissistic defence against the experience of unbearable frustration in the pre-Oedipal stage. Through internalizing a new primal scene, the patient is able to separate from his past and to work through the Oedipus complex within the transference.