Paranoid-Schizoid Anxiety,Triangulation, and Oedipal Trauma

The interaction of strong aggressive and libidinal drives, various primitive intrapsychic fantasies linking somatic sensations, body parts, ego, object, and the effects of early environmental stress and trauma all produce a potential crisis in the paranoid-schizoid period of development. Certain innate methods of understanding somatic experiences as well as the interaction between internal and external reality lead to an unconscious triangulation of part objects. A frustrating, stimulating, or punitive "third" that blocks, nullifies, or overgratifies certain wishes then emerges as a pivotal object in the internal landscape. During the paranoid-schizoid, triadic process, there is a fluctuation between separation/individuation and de-differentiation/fusion. If the early triangulation process has been either exceedingly frustrating or overly stimulating in regards to "reaching the third" or "warding off the third," the infantile ego is fixed by aggressive and libidinal forces to de-differentiation experiences rather than to more separate and individuated ways of relating. Therefore, the later oedipal stage will be colored by excessive oral and anal conflicts and will be weighted on the side of primitive maneuvering based on splitting, projection, and introjection. When the child (and later the adult) becomes involved in oedipal situations marked by stimulation or frustration of triadic drives, there can be a regression to the earlier paranoid-schizoid triadic period. A case study was presented in which a patient struggled with a partial working through of these conditions in dreams and in the transference. This pulled her more in the direction of a differentiated Oedipal conflict and whole object functioning.     

Emotional states and physical health

Positive emotional states may promote healthy perceptions, beliefs, and physical well-being itself. To explore potential mechanisms linking pleasant feelings and good health, the authors consider several lines of research, including (a) direct effects of positive affect on physiology, especially the immune system, (b) the information value of emotional experiences, (c) the psychological resources engendered by positive feeling states, (d) the ways in which mood can motivate health-relevant behaviors, and (e) the elicitation of social support. As anticipated by the Greek physician Hippocrates, positive emotions and healthy outcomes may be linked through multiple pathways.     

Health anxiety moderates the effects of distraction versus attention to pain

Little is known about the relationship between health anxiety and chronic pain. The present study explored whether individual differences in health anxiety would influence the response of chronic pain patients to physical therapy. Furthermore, the interaction of health anxiety with coping strategy usage (distraction versus attention) was studied. Participants were 81 chronic pain patients who were interviewed and completed measures of pain, anxiety and cognition following an active physiotherapy session in which they either: (1) attended to physical sensations; (2) distracted from physical sensations or (3) completed the session as usual. Health anxious, compared to non-health anxious, individuals worried more about their health and injury during the session and attended to and catastrophically misinterpreted sensations more frequently. A complex interaction between health anxiety and coping strategy emerged. Among health anxious patients, attention to sensations resulted in lower anxiety and pain than did distraction. It appears as though attention had a short-term anxiety reducing effect for health anxious patients. Among non-health anxious patients, attention resulted in greater worry about health than distraction. Clinical and theoretical implications are discussed.     

Cognitive processes in social anxiety: the effects of self-focus, rumination and anticipatory processing

We examined three cognitive processes hypothesized to contribute to biases in judgments about and memory for social events: self-focused attention, post-event rumination, and anticipatory processing. Socially anxious (N = 58) and nonanxious (N = 58) subjects participated in a social interaction and then completed measures of self-focused attention and anxiety-related physiological sensations and behavior. The next day, subjects completed measures that assessed frequency of post-event processing and recall of the interaction. The results indicated that selective attention to negative self-related information led to biases in social judgments and recollections and that post-event processing contributed to the recall of negative self-related information. No evidence was found for selective retrieval of negative self-related information prior to a second social interaction. The results reconcile inconsistent previous findings related to memory bias in social anxiety.     

Fantasy proneness, dissociation, and DSM-IV axis II symptomatology

Scores on the Inventory of Childhood Memories and Imaginings (S. C. Wilson & T. X. Barber, 1981) identified fantasizers and controls who were administered the Structured Interview for DSM-IV Personality (SIDP-IV; B. Pfohl, N. Blum, & M. Zimmerman, 1994) and the Dissociative Experiences Scale (DES; E. M. Bernstein & F. W. Putnam, 1986). Fantasizers had increased rates of Cluster A and B personality disorders but were equivalent to controls in Cluster C diagnoses. For both Clusters A and B, 55% of the fantasizers received clinical diagnoses. Fantasizers had significantly higher DES, DES-T (N. G. Waller, F. W. Putnam, & E. B. Carlson, 1996), and Normal Dissociative Index scores. Although nearly one half of the fantasizers' DES-T patterns were classified within the pathological dissociative taxon (N. G. Waller & C. A. Ross, 1997), none of the controls and only 10.03% of the original screening sample received this classification. Both Axis II pathology and pathological dissociation were associated with fantasy proneness.     

Effortful control in early childhood: continuity and change, antecedents, and implications for social development

The course, antecedents, and implications for social development of effortful control were examined in this comprehensive longitudinal study. Behavioral multitask batteries and parental ratings assessed effortful control at 22 and 33 months (N = 106). Effortful control functions encompassed delaying, slowing down motor activity, suppressing/initiating activity to signal, effortful attention, and lowering voice. Between 22 and 33 months, effortful control improved considerably, its coherence increased, it was stable, and it was higher for girls. Behavioral and parent-rated measures converged. Children's focused attention at 9 months, mothers' responsiveness at 22 months, and mothers' self-reported socialization level all predicted children's greater effortful control. Effortful control had implications for concurrent social development. Greater effortful control at 22 months was linked to more regulated anger, and at 33 months, to more regulated anger and joy and to stronger restraint.