Review of Awakening the Dreamer: Clinical Journeys by Philip M. Bromberg

The current paradigm shift in psychoanalysis and related sciences is generating more powerful models of psychopathogenesis and treatment. Toward that end, in Awakening the Dreamer Philip Bromberg masterfully integrates psychoanalytic, developmental, trauma, and neurobiological data to explore the bottom-line defense of dissociation. In this review I offer a neuropsychoanalytic perspective of the origin of pathological dissociation, focusing on the enduring impact of this early defense against attachment trauma and its growth inhibiting impact on the development of the biological substrate of the human unconscious, the right brain. Patients with a history of abuse or neglect frequently access pathological dissociation in response to relational stressors to block the emotional pain that accompanies overwhelming affective states. And yet there is a cost. The characterological use of this affect regulating strategy induces a failure of integration of the higher right hemisphere with the lower right brain, thereby inducing an instant collapse of both subjectivity and intersubjectivity in the short term and a blockade of emotional development in the long term. Bromberg's creative book is an excellent example of how effective clinical work with such patients incorporates the current paradigm shift from not only cognition to affect but also repression to dissociation.     

Self-Esteem and Its Relationship to Mental Health and Quality of Life in Adults with Cystic Fibrosis

Research from the general population indicates an important role for self-esteem in mental health, but limited research in this area exists in the cystic fibrosis (CF) literature. This study aimed to explore the predictive value of self-esteem and health-related quality of life (HRQoL) in mental health symptoms in adults with CF. Seventy-four participants, recruited online, completed the Clinical Outcomes in Routine Evaluation-Outcome Measure 34 (CORE-OM), Rosenberg Self-esteem Scale and Cystic Fibrosis Questionnaire-Revised (CFQ-R). Comparably high levels of self-esteem were found, but HRQoL was lower than previous research. Thirty percent of participants scored within the clinical range for mental health difficulty. Hierarchical regression, controlling for gender, explored the value of four CFQ-R subscales (physical, social, emotional and role functioning) and self-esteem in predicting CORE-OM total score. Gender accounted for 8.2 % of the variance in mental health scores while the five independent variables accounted for a further 73.0 % of variance. Of the five variables, CFQ-R emotional functioning and self-esteem were significant predictors of mental health symptoms. Results are discussed in relation to clinical implications and potential uses for internet technologies to promote socialisation.     

Psychological functioning and well-being among Ghanaian women: A brief report

This study examined correlates of psychological well-being and distress among women in Accra, Ghana. A total of 200 women between 18 and 65 years completed measures of psychological well-being and distress. Independent t-test and One-way ANOVA F-test analysis of the data suggested differences among the women in their psychological well-being and distress levels by their religiosity, education, and monthly income. Christian women reported higher psychological well-being compared to non-Christians. Religiosity, higher education, and income appear to be protective resources against psychological distress among Ghanaian women.     

Failure to alter psychophysiological reactivity in type a men with physical exercise or stress management programs

Abstract

Psychophysiological reactivity has been associated with heightened risk of coronary heart disease. Since behavioral processes may contribute to disease etiology, the possibility arises that they might also contribute to disease prevention. The capability of behavioral interventions to modify exaggerated reactivity in Type A men. was therefore, brought under experimental scrutiny. Subjects were 107 male managers. who met the following criteria: (1) no history or current signs of heart disease. (2) presence of Type A behavior pattern, and (3) exaggerated psychophysiological reactivity to mental stress. After matching for age and physical fitness level. participants were randomly assigned to one of three 10-week intervention programs: aerohic training, weight training and cognitive-behavioral stress management. Heart rate and blood pressure were monitored while challenging mental tasks were performed in pre-training and post-training laboratory sessions before and after the intervention programs. Although participants in the two physical activity programs showed the expected physical adaptations, no changes in psychophysiological reactivity were seen in the three groups. This negative result may indicate either that reactivity was not altered owing to the conditions of the present experiment, or that these behavioral interventions are truly without effect.     

The impact of psychological therapies on violent behaviour in clinical and forensic settings: A systematic review

Violent behaviour is a serious problem in terms of the impact on victims, quality of life for perpetrators, and the financial burden on the prison service, the health sector, and society generally. However, to date there is not a general consensus as to how this can be managed other than removing the perpetrators from communities. Incarceration can be on an indeterminate basis or for a short period of time before reintegration into society, depending on the gravity of the offence. This systematic review critically examines the existing research literature on psychotherapeutic interventions for violent behaviour in forensic and clinical populations. Five databases were searched, selected journals were hand searched, and authors of identified papers were contacted in efforts to obtain relevant unpublished work. The first author and a colleague independently evaluated the eligibility of all studies identified, abstracted data, and assessed study quality. The overall findings provide tentative support for the utility of psychotherapeutic interventions in reducing aggressive behaviour in forensic and psychiatric patients with a history of violent behaviour.     

Separating perception time from response time: the slope transition paradigm

This paper describes the slope transition paradigm (STP), a variant of rapid serial visual presentation (RSVP) that separates early (perceptual) processing time from total response time. The paradigm is based on a very simple idea: provide varying amounts of time for perceptual processing and find the moment when the subject begins to waste time waiting for more data. That moment is a measure of how much time was actually needed. The method was used in two experiments. Results are discussed in relation to set-size effects, perceptual capacity limits, attentional dwell times, and some related neurophysiological findings. The method appears to tap aspects of information processing that differ from those tapped in studies of the psychological refractory period, the attentional blink, and repetition blindness.     

The effects of interactive staff training on staff programing and patient aggression in a psychiatric inpatient ward

Interactive staff training (IST) uses principles of organizational psychology to help line-level staff members design and implement social learning programs for severely mentally ill inpatients. IST is a training package that includes assessment of staff perceptions regarding programatic needs, selection of appropriate social learning strategies to meet these needs, appointment of a program committee from within the ward to champion development of the social learning strategy, and participative decision making about aspects of the social learning strategy. Staff on an extended care ward at a state hospital participated in IST for 15 months as part of a pilot study of its effects. Ongoing examination of ward programing showed that IST significantly increased staff and patient participation in rehabilitation programing and decreased the rate of physical restraints and aggression-related. Changes in staff attitudes about rehabilitation programing were noted on a subsample of IST participants. Implications for more controlled research into IST are discussed.     

Attribution of behavioral intentions to obese and normal-weight stimulus persons

This study examines the relationship between the attribution of traits and the attribution of short-term, situation-specific intentions and probable behaviors, with particular reference to the perception of obese persons. College students performed one of four tasks: (1) Rating photographs of obese and normal-weight female faces for likeability and attractiveness; (2) attributing short-term intentions and probable behaviors to these stimulus persons within the context of briefly described social interactions; (3) judging the situationally determined demand characteristics of the intentions and probable behaviors; or (4) judging the ‘meaning’ of the intentions or behaviors in terms of trait scales. The results demonstrate that although the obese faces were consistently rated significantly less likeable and less attractive than the normal-weight faces, these judgments were paralleled by only a few differences in the situation-specific intentions or behaviors attributed to the two groups of stimulus faces. It is suggested that impression-formation measured in terms of global, dispositional characteristics such as traits cannot be assumed to directly predict many differences in behavioral expectations in specific interpersonal settings. On the basis of the few attributions of intention which did discriminate, an ‘obese personality’ stereotype emerged, consisting either of socially undesirable traits or traits of ambiguous social desirability. The implications of the relationships among traits, intentions and situational demand characteristics for an interactive model of situational vs. personality determinants of expected behavior are discussed.     

Factor dimensions of the child Nowicki-Strickland internal-external scale

Previous factor analyses of the Nowicki Internal-External Scales have not yielded consistent results. The present study, factoring the Child Nowicki-Strickland Internal-External Scale (CNS-IE), and employing 871 male adolescents, discovered 4 clear factor dimensions that were labelled ‘Autonomy-Restriction’, ‘Reinforcement Endowed-Reinforcement Deprived‘, ‘Internal Determinism-External Determinism’ and ‘Social Competence-Social Impotence’. An alternative scoring procedure is suggested for item No. 38 and a 20-item short version of the CNS-IE Scale is also proposed.