Understanding suicidal behaviour in young people referred to specialist CAMHS: a qualitative psychoanalytic clinical research project

A qualitative psychoanalytic clinical research project using a post-Kleinian contemporary approach was undertaken by a team of seven qualified and experienced child psychotherapists working in community Tier 3 Child and Adolescent Mental Health Services (CAMHS). A number of referred young people who deliberately harmed themselves or attempted suicide, who fulfilled the inclusion criteria and consented to participate, were offered an extended individual and family assessment. Grounded Theory analysis of the qualitative data led to the formulation of the Truth Danger Theory. Typical situations in which suicidal behaviour occurred were identified, including intergenerational confusion, neglect, physical and/or sexual abuse within the family, Oedipal conflict, maternal depression and families in which there was a chronically ill sibling. We found that there was a marked disparity between the young person's experience of relationships in the family and the family's own account of their situation, a fractured reality. This can be reflected in an incongruence in the young person's presentation, which may be misleading when assessing risk. The young person feels him/herself to be in a dead end from which there seems to be no escape. Self-harm, for some, contains this impossible dilemma (albeit pathologically) but when it does not, suicide may seem the only option. The Truth Danger Theory provides explanations and predictions for suicidal behaviour and has implications for clinical practice.     

Book reviews

BERNARD RIMLAND:Infantile Autism: The Syndrome and Its Implications for a Neural Theory of Behaviour. Methuen. London. 1965. 36/-     

Working memory differences in illusory recollection of critical lures

In the present experiments, we explored the relationship between individual differences in working memory (WM) capacity and susceptibility to false recognitions and their accompanying subjective experiences. Deese/Roediger–McDermott (DRM) associative lists were used to elicit false memories, and remember/know judgments were used to measure the recollective experiences accompanying recognition decisions. We found that WM capacity was related to false recognitions of nonpresented critical lures and to the proportion of remember responses given to critical lures, such that higher WM capacity was associated with lower false-recognition rates and with lower proportions of remember responses. Importantly, these WM differences were only found when participants were forewarned about the nature of the DRM task prior to encoding (Exp. 1). When the forewarning was absent, WM capacity was not related to false recognitions or to the proportion of remember responses given to critical lures (Exp. 2). These results support the controlled-attention view of WM and suggest that subjective experiences of falsely recognized lures fluctuate as a function of WM capacity.     

Thoughts on autism with special reference to a paper by melanie klein

The article begins with a brief exploration of the various aspects of adolescent's psychic qualities as these are described in Greek mythology. It is argued that myths are an integral part of the way that adolescence is perceived and myths play an important role in adolescents' psychic and external world, as well as in their mythological thinking. Connections are made with the attraction towards the creation of myths about adolescence in ancient and contemporary societies. Three clinical vignettes from adolescents' psychoanalytic psychotherapy are presented in an effort to support the idea of the value and importance of mythology in adolescence in the clinical practice. Through the clinical material, we try to explore how psychic and developmental disturbances, which might lead to psychopathology, are reflected in family and personal myths and also in the mythological thinking of adolescents.     

Council-Based Approaches to Intimate Partner Violence: Evidence for Distal Change in the System Response

Communities across the United States are collaborating to create a coordinated response to intimate partner violence (IPV); ideally, this involves promoting best practices in the justice and human service systems and engaging a broad array of community sectors (e.g., human service; criminal justice; faith; business; education) to promote victim safety and batterer accountability (Pence, 1999). The current study examined the extent to which Family Violence Coordinating Councils resulted in change in the systems’ response to IPV. Specifically, we examined judicial order of protection data from 1990 to 2005 to establish whether the formation and development of councils across the state of Illinois promoted the issuance of plenary orders of protection following the initial granting of emergency orders of protection. Such a pattern would indicate implementation of a best practice in the system response to IPV. Utilizing a multilevel logistic modeling approach, we found that the introduction and development of councils was indeed related to the accessibility of plenary orders of protection. The specific ways in which councils may have influenced such an outcome and the implications of this approach for research on council effectiveness are discussed.     

Pure reason and contemporary philosophy of religion: the rational striving in and for truth

This essay urges contemporary philosophers of religion to rethink the role that Kant’s critical philosophy has played both in establishing the analytic nature of modern philosophy and in developing a critique of reason’s drive for the unconditioned. In particular, the essay demonstrates the contribution that Kant and other modern rationalists such as Spinoza can still make today to our rational striving in and for truth. This demonstration focuses on a recent group of analytic philosophers of religion who have labelled their own work ‘analytic theology’ and have generated new debates, including new arguments about Kant bridging philosophy and theology. Cultivation of a reflective critical openness is encouraged here; this is a practice for checking reason’s overly ambitious claims about God.     

Evaluation of stimulus control over a communication response as an intervention for stereotypical responding

Stereotypical behavior maintained by automatic reinforcement often does not result in harm but may be undesirable in some situations. In the current investigation, participants were 2 individuals who engaged in nonharmful stereotypical responses shown in an analogue functional analysis to be insensitive to social contingencies. After bringing these responses under stimulus control using differential punishment, both participants learned a mand to terminate punishment for stereotypy. We also assessed whether the mand could be brought under stimulus control.     

Tell me more: The effects of expressed interest on receptiveness during dialog

Two studies investigated the effect of expressed interest on individuals’ openness to opposing viewpoints and perceptions of debate counterparts. Participants in Study 1 engaged in an online conversation with a purported debate counterpart who did or did not express interest in the participants’ viewpoint by asking an elaboration question—that is, a question geared at soliciting additional information. Compared to control participants, participants who received a question rated their debate counterpart more favorably, were more willing to engage in future interaction with their counterpart, and acted in a more receptive manner. Study 2 tested the effects of instructions to prepare elaboration questions on listeners’ responses to a speaker offering counter-attitudinal arguments. Preparing questions caused participants to be more open to the idea of having a conversation with the speaker, to make more positive attributions about typical proponents of the speaker’s viewpoint, and to judge the conclusions of the speech as more valid. Theoretical and practical implications of this research are discussed.     

Common Grief,Complex Grieving

In this article, the author reflects on the changes during the last 25 years in our understanding of grief and on the emerging new issues in the field of loss and grief studies. He identifies several significant issues, including the implications of violent death for public and private grief, the increased attention upon the family as a mourner, and new ritual patterns emerging out of changes in funeral practices in recent years. The essay concludes by briefly considering a number of issues shaping grief and our care for those who mourn.     

Overcoming default categorical bias in spatial memory

In the present study, we investigated whether a strong default categorical bias can be overcome in spatial memory by using alternative membership information. In three experiments, we tested location memory in a circular space while providing participants with an alternative categorization. We found that visual presentation of the boundaries of the alternative categories (Experiment 1) did not induce the use of the alternative categories in estimation. In contrast, visual cuing of the alternative category membership of a target (Experiment 2) and unique target feature information associated with each alternative category (Experiment 3) successfully led to the use of the alternative categories in estimation. Taken together, the results indicate that default categorical bias in spatial memory can be overcome when appropriate cues are provided. We discuss how these findings expand the category adjustment model (Huttenlocher, Hedges, & Duncan, 1991) in spatial memory by proposing a retrieval-based category adjustment (RCA) model.