Psychosis: A Synthesis of Motivational and Defect Perspectives

Based on the evolution of human intelligence and the tremendous cognitive capacities arising from it, we have an innate tendency for the extreme thought content, thought form, and sensory perceptions of psychosis. During the conscious and awake state, cognitive regulatory control processes block these more extreme variants to facilitate reality congruency necessary for adaptive functioning. While asleep there is no need for reality congruency and the cognitive regulatory control processes are deactivated allowing psychotic equivalents to be expressed in dreams. This paper helps synthesize the two dominant perspectives regarding the etiology of psychosis: the neuroscience defect perspective and the psychoanalytic motivational perspective. Regarding the former, defective cognitive regulation arising from certain conditions, such as the deficit state of schizophrenia, allows extreme cognitive distortions, thought form variants, and sensory perceptual experiences to intrude into the conscious and awake state, thereby producing psychosis. Consistent with the psychoanalytic motivational perspective, defensive processes can motivate extreme cognitive distortions, thought form variants and sensory perceptual experiences, and also facilitate their expression by deactivating the relevant cognitive regulatory control processes.     

Critical Transference in a Case of Severe Epilepsy

In this paper, the author presents a summary of a brief treatment with a young woman, suffering from severe epileptic illness, which describes the mutuality of cross-transferences of deep and intense feelings and the unorthodox way to receive, to take in persons affected with critical phenomena. This treatment was deeply influenced by the traumatic triad, borrowed from Ferenczi: "amnesia, anaesthesia, aboulia," the ways of forgetting (or erasing) the past/the present/the future. The investigation led us to clarify, on the one hand, the incestophilic-or perhaps incestuous-source in the family, and on the other, the burdensome and tragic genealogy and history of each parent. At the end of this short treatment, which took place at a frequency of one session a week (with the patient sitting, standing, lying on the floor; with sometimes severe fits, deliria, threats; bringing of letters, texts, drawings; and a few phone calls), there was an alleviation of the critical phenomena and revival.     

An integrated approach to delivering exposure-based treatment for symptoms of PTSD and depression in OIF/OEF veterans: preliminary findings

Combat-exposed military personnel from the wars in Iraq and Afghanistan report high rates of PTSD and associated psychiatric problems. A formidable body of research supports exposure therapy as a front-line intervention for PTSD; however, relative to studies of civilians, fewer investigations have evaluated the effectiveness of exposure therapy using military samples. Specifically, barriers to care (e.g., stigma associated with receiving mental health services ) may compromise utilization of evidence-based psychotherapy. As such, researchers have argued that veterans with PTSD may require an integrated and innovative approach to the delivery of exposure techniques. This paper presents the rationale for and preliminary data from an ongoing clinical trial that compares the home-based telehealth (HBT) application of a brief, behavioral treatment (Behavioral Activation and Therapeutic Exposure; BA-TE) for veterans with PTSD to the standard, in-person application of the same treatment. Forty OIF/OEF veterans with PTSD and MDD were consented, enrolled, and randomized to condition (BA-TE in-person, or BA-TE HBT) and symptoms of anxiety and depression were assessed at pre- and posttreatment. Participants in both conditions experienced reductions in depression, anxiety, and PTSD symptoms between pre- and posttreatment, suggesting that HBT application of an integrated PTSD treatment may be feasible and effective.     

Effects of experienced disgust on habituation during repeated exposure to threat-relevant stimuli in blood-injection-injury phobia

Despite growing evidence implicating disgust in the etiology of blood-injection-injury (BII) phobia, the relevance of disgust for exposure-based treatment of BII phobia remains largely unknown. Individuals with BII phobia were randomly assigned to a disgust (view vomit videos) or neutral activation (view waterfall videos) condition. They were then exposed to 14 videotaped blood draws, during which fear and disgust levels were repeatedly assessed. Participants then engaged in a behavioral avoidance test (BAT) consisting of exposure to threat-relevant stimuli. Examination of outcome comparing the identical first and last blood-draw clips revealed that fear and disgust toward blood draws was significantly reduced in both groups. Disgust levels were also found to be more intense for the video stimuli relative to fear levels whereas the opposite was true for BAT stimuli. Contrary to predictions, the disgust induction did not enhance reductions in negative responses to the target video or reduce behavioral avoidance. Growth curve analyses did show that individuals with BII phobia exposed to the disgust induction showed greater initial fear levels during repeated exposure than those in the neutral condition. However, this effect was not consistently observed across different analytic approaches. Changes in fear during exposure were also found to be independent of changes in disgust but not vice versa, and greater initial fear levels during repeated exposure to threat was associated with fear and disgust levels during the BAT. The implications of these findings for conceptualizing the role of disgust in etiology and treatment of BII phobia are discussed.     

Orthographic and phonological facilitation in speech production: new evidence from picture naming in Chinese

Picture naming is facilitated when a target picture (e.g. of a cat) is accompanied by a form-related context word (e.g. CAP) relative to an unrelated word (e.g. PEN). Because in alphabetic languages phonological and orthographic similarity are confounded, Chinese, a logographic language, has been employed to study these two effects in isolation. The results obtained suggest that the orthographic facilitation effect is localized at an earlier processing level than the phonological facilitation effect. In the present study we examine this issue again, using an experimental design in which the context words in the related and unrelated conditions are optimally matched. In contrast to the earlier studies Experiments 1 and 2 fail to show differences in the time course of the two context effects. Moreover, Experiment 3 provides direct evidence against an early, conceptual locus of orthographic facilitation. Our findings indicate that in Chinese language production both orthographically and phonologically related context words have their effect at the rather late level of word-form encoding.     

Personalized and not general suggestion produces false autobiographical memories and suggestion-consistent behavior

Suggesting false childhood events produces false autobiographical beliefs, memories and suggestion-consistent behavior. The mechanisms by which suggestion affects behavior are not understood, and whether false beliefs and memories are necessary for suggestions to impact behavior remains unexplored. We examined the relative effects of providing a personalized suggestion (suggesting that an event occurred to the person in the past), and/or a general suggestion (suggesting that an event happened to others in the past). Participants (N=122) received a personalized suggestion, a general suggestion, both or neither, about childhood illness due to spoiled peach yogurt. The personalized suggestion resulted in false beliefs, false memories, and suggestion-consistent behavioral intentions immediately after the suggestion. One week or one month later participants completed a taste test that involved eating varieties of crackers and yogurts. The personalized suggestion led to reduced consumption of only peach yogurt, and those who reported a false memory showed the most eating suppression. This effect on behavior was equally strong after one week and one month, showing a long lived influence of the personalized suggestion. The general suggestion showed no effects. Suggestions that convey personal information about a past event produce false autobiographical memories, which in turn impact behavior.     

Offline improvement occurs for temporal stability but not accuracy following practice of integer and non-integer rhythms

Procedural learning benefits from memory processes occurring outside practice resulting in offline learning. Offline gains have been demonstrated almost exclusively for the ordinal structure of sequential motor tasks. Many skills also demand that the correct serial order of events be appropriately timed. Evidence indicates that the temporal aspect of a procedural skill can be encoded independent of serial order knowledge and governed by at least two distinct neural circuits. The present experiment determined if (a) offline gains emerge for temporal learning, and (b) if such gains occur for timing supervised by distinct timing systems. Participants experienced 216 practice trials of a 7-key press sequence that involved integer- or non-integer timing rhythms. Twenty-four hours after training 30 test trials were administered. Results revealed robust offline enhancement for timing performance of the non-integer based temporal sequences. This improvement was localized to stabilization of the required relative but not absolute time profiles. The neural circuitry central to supporting the performance of non-integer timing sequences is also a principal constituent of what is described as the "cognitive" timing system. Timing governed by this system appears most susceptible to offline gains via consolidation.     

Nonsymbolic numerical magnitude comparison: reliability and validity of different task variants and outcome measures, and their relationship to arithmetic achievement in adults

The numerical ratio effect (NRE) and the Weber fraction (w) are common metrics of the precision of the approximate numbers sense (ANS), a cognitive mechanism suggested to play a role in the development of numerical and arithmetic skills. The task most commonly used to measure the precision of the ANS is the numerical comparison task. Multiple variants of this task have been employed yet it is currently unclear how these affect metrics of ANS acuity, and how these relate to arithmetic achievement. The present study investigates the reliability, validity and relationship to standardized measures of arithmetic fluency of the NRE and w elicited by three variants of the nonsymbolic number comparison task. Results reveal that the strengths of the NRE and w differ between task variants. Moreover, the reliability and validity of the reaction time NRE and the w were generally significant across task variants, although reliability was stronger for w. None of the task variants revealed a correlation between ANS metrics and arithmetic fluency in adults. These results reveal important consistencies across nonsymbolic number comparison tasks, indicating a shared cognitive foundation. However, the relationship between ANS acuity and arithmetic performance remains unclear.     

Empathy Deficit in Antisocial Personality Disorder: A Psychodynamic Formulation

Empathic difficulty is a highly consequential characteristic of antisocial personality structure. The origin, maintenance, and possible resolution of this profound deficit are not very clear. While reconstructing empathic ability is of primary importance in the treatment of antisocial personality, not many proven procedures are in evidence. In this article, the author offers a psychodynamic formulation of the origin, character, and maintenance of the empathic deficiency in antisocial personality. The author discusses some of the treatment implications from this dynamic formulation.