Traumatic Stress Personality Disorder (TrSPD): Intertheoretical Therapy for the PTSD/PD Dissociogenic Organization

This article discusses a new personality disorder entity, traumatic stress personality disorder, conceptualized as a composite organization with transactional properties that mutually structure post-traumatic stress disorder (PTSD) and personality disorders (PDs). The transactional/synergistic view of PTSD/PD comorbidity derives in part from scientific findings that PTSD's enduring biological effects are discernible in the personality of individuals 30 to 50 years or more after the overwhelming event, and from psychodynamic formulations on the development and structuring of personality defenses. An intertheoretical therapy model is also presented, and consists of multiple therapies actively integrated to meet the patient's complex post-trauma needs. This article argues for the development of theoretical, investigatory, and therapeutic measures to address PTSD/PD configurations in traumatized victims. Basically, the position espoused is that PTSD/PD should be measured as one rather than two entities, with neither component being considered as a confounding but integral factor in measurement. The eight components of traumatic stress personality disorder are discussed, along with a case study to demonstrate the model's clinical applications. The integration of cognitive, behavioral, psychodynamic, and existential treatment approaches is geared to assist the victim to developmental progress to survivor status, and then beyond this level of integration to thriver a person whose adaptational learning in therapy created a vital psychological immune system that consistently protects against dissociative regression in response to the daily stresses of life. Transference, countertransference, therapists' self-care and self-monitoring are seen as integral to the treatment of traumatic stress personality disorders.     

Three Problems for “strong” Modal Fictionalism

Philosophical Studies -     

THE CASE FOR THE PHILOSOPHY OF CHEMISTRY

The philosophy of chemistry has been sadly neglected by most contempory literature in the philosophy of science. This paper argues that this neglect has been unfortunate and that there is much to be learned from paying greater philosophical attention to the set of issues defined by the philosophy of chemistry. The potential contribution of this field to such current topics as reduction, laws, explanation, and supervenience is explored, as are possible applications of insights gained by such study to the philosophy of mind and the philosophy of social science.     

Cognitive rehabilitation of chronic alcohol abusers

The current literature suggests that individuals who chronically abuse alcohol exhibit a wide variety of cognitive deficits resulting from cerebral dysfunction that is either directly or indirectly related to their alcohol consumption history. Cognitive deficits have been hypothesized as having implications for standard alcohol treatment efficacy as they may directly affect cognitively impaired individuals’ abilities to utilize various treatment modalities. Although evidence is accumulating that suggests this is actually the case, the majority of alcohol treatment programs neither directly consider the impact cognitive deficits have on treatment efficacy nor do they employ cognitive rehabilitation treatment strategies to remediate identified cognitive deficits. Few studies exist that investigate the remediability of neurobehavioral deficits or the efficacy of integrating cognitive rehabilitation strategies into more traditional treatment programs. Empirical investigations conducted to date indicate that some cognitive deficiencies secondary to alcoholism are amenable to cognitive rehabilitation and this remediation is generalizable. Rigorous well-controlled treatment outcome investigations are needed in order to determine the efficacy of cognitive rehabilitation techniques in naturalistic settings using ecological outcome measures. Also, emphasis should be placed on integrating cognitive rehabilitation techniques with proven efficacy into traditional alcoholism treatment programs.     

Enhancing Classroom Performance: A Review of Reinforcement Schedules

During the past decade the application of elementary principles of behavior have become a standard in the classroom teacher's repertoire of behavior change strategies. Unfortunately, the application of more advanced principles of behavior derived through basic behavioral research lies as an untapped resource for classroom teachers. Nowhere is this more apparent than in the use of systematic procedures to deliver reinforcers to enhance academic performance. In this paper we provide educators with information on the use of reinforcement schedules in academic settings. Various schedules of reinforcement are presented along with examples of their application in applied settings.     

Lateralized Changes in Regional Cerebral Blood Flow during Performance of Verbal and Facial Recognition Tasks: Correlations with Performance and “Effort”

Functional neuroimaging has been used to investigate neural substrates of mnemonic processes, and cerebral blood flow (CBF) measures have been sensitive to activation with memory tasks. Studies of memory with two-dimensional¹³³Xenon clearance techniques found that word and face recognition tasks produced contralateral CBF changes in mid-temporal cortical regions. This study replicated the activation paradigm, expanding to the three-dimensional resolution of positron emission tomography (PET). Word and face recognition, and a control baseline task were administered to 19 healthy right-handed volunteers (11 men, 8 women) during successive 10 min PET¹⁵O-water measures of CBF. Quantitative CBF rates were calculated with the arterial input function and the equilibrium model. Redistributions of blood flow were compared across tasks using both absolute and relative (region/whole brain) CBF.Replicating the¹³³Xenon clearance findings, CBF was “appropriately” lateralized during task performance (left–right for words > left–right for faces) in the mid-temporal region. Contrary to predictions, the recognition tasks did not activate expected mesolimbic or prefrontal areas. The task-induced CBF changes also correlated with performance. Bilateral CBF in mid-temporal and parahippocampal gyrus regions of interest correlated with the ability to correctly identify word targets (sensitivity). Left-lateralized CBF in the amygdala and hippocampus correlated with better word sensitivity as well as specificity (ability to correctly reject foils). Complementally, right-lateralized CBF in the parahippocampal gyrus correlated with better face specificity performance. In addition, left-lateralized CBF in the amygdala and right-lateralized CBF in the parahippocampal gyrus and hippocampus correlated with “mental effort” indices (task performance relative to basal ability) for word and face memory tasks, respectively. Thus, whereas this recognition task showed the expected lateralized increase in the mid-temporal region and not in frontal and limbic areas, lateralized activation in some of these areas was associated with better performance. Exploratory analyses on other regions showed lateralized changes in one additional temporal region, the occipital-temporal, and several limbic regions.     

Freud, Oedipus and the Hebrew Bible

The current paper examines the question of why Freud employed Greek rather than Hebrew foundation legends, specifically the story of Oedipus, as a basis for psychoanalysis, Freud's choice of Oedipus emanates from his deterministic view of the universe, paralleling the Greek rather that the Biblical story of creation. In the Biblical account God precedes and creates nature with no sign of an Oedipal conflict. In the Greek account, nature precedes the gods and the Oedipal conflict is inherent. Freud's choice has implications for his view of human psychology.     

WHEN THE ANTIDOTE IS THE POISON:

Abstract— The theory of ironic processes of mental control holds that both the most and the least desired effects of attempts to control one's own mental states accrue from two processes an intentional operating process (a conscious, effortful search for mental contents that mil produce a desired slate of mind) and an ironic monitoring process (an unconscious, automatic search for mental contents that signal a failure lo produce the desired Mate of mind) Although the monitoring process usually functions just to activate the operating process, during stress distraction, time urgency, or other mental load, the monitor's effects on mind can supersede those of the operator, producing the very state of mind that is least desired An individual's attempts lo gain mental control may thus precipitate the unwanted mental states.     

THE SIMILARITY OF BRAIN ACTIVITY ASSOCIATED WITH TRUE AND FALSE RECOGNITION MEMORY DEPENDS ON TEST FORMAT

Abstract— Event-related potentials (ERPs) were compared for correct recognitions of previously presented words and false recognitions of associatively related, nonpresented words (lures). When the test items were presented blocked by test type (old, new, lure), waveforms for old and lure items were different, especially at frontal and left parietal electrode sites, consistent with previous positron emission tomography (PET) data (Schacter, Reiman, et. al., 1996). When the test format randomly intermixed the types of items, waveforms for old and lure items were more similar. We suggest that test format affects the type of processing subjects engage in, consistent with expectations from the source-monitoring framework (Johnson, Hashtroudi, & Lindsay, 1993). These results also indicate that brain activity as assessed by neuroimaging designs requiring blocked presentation of trials (e g, PET) do not necessarily reflect the brain activity that occurs in cognitive-behavioral paradigms, in which types of test trials are typically intermixed.