Clinical conversations between psychoanalysis and imaginative literature

A literary form created by an imaginative writer captures something of the way the author shapes emotional experience and psychologically engages with it. The manner in which experience is created and contained in an imaginative literary text has much in common with the way experience is generated and worked with in the psychoanalytic situation. The author describes a clinical experience in which there was a collapse of the analytic (imaginative) space. He then discusses how he made use of a "conversation" he created with a short story and his own analytic experience to restore his imaginative capacities and to resume psychological work with the patient.     

Utility of the trauma symptom inventory's atypical response scale in detecting malingered post-traumatic stress disorder

The authors examined the Trauma Symptom Inventory's (TSI) ability to discriminate 88 student post-traumatic stress disorder (PTSD) simulators screened for genuine PTSD from 48 clinical PTSD-diagnosed outpatients. Results demonstrated between-group differences on several TSI clinical scales and the Atypical Response (ATR) validity scale. Discriminant function analysis using ATR revealed 75% correct patient classification but only 48% correct simulator classification, with an overall correct classification rate of 59% (positive predictive power [PPP] = .71; negative predictive power [NPP] = .51). Individual ATR cutoff scores did not yield impressive classification results, with the optimal cutoff (T score = 61) correctly classifying only 61% of simulators and patients (PPP = .66, NPP = .54). Although ATR was not developed as a malingered PTSD screen, instead serving as a general validity screen, caution is recommended in its current clinical use for detecting malingered PTSD.     

Why are hispanics at greater risk for PTSD?

Several studies have found that Hispanic Americans have higher rates of posttraumatic stress disorder (PTSD) than non-Hispanic Caucasian and Black Americans. The authors identified predictors of PTSD symptom severity that distinguished Hispanic police officers (n=189) from their non-Hispanic Caucasian (n=317) and Black (n=162) counterparts and modeled them to explain the elevated Hispanic risk for PTSD. The authors found that greater peritraumatic dissociation, greater wishful thinking and self-blame coping, lower social support, and greater perceived racism were important variables in explaining the elevated PTSD symptoms among Hispanics. Results are discussed in the context of Hispanic culture and may be important for prevention of mental illness in the fastest growing ethnic group in the United States.     

Child Maltreatment and Emergent Personality Organization: Perspectives from the Five-Factor Model

The Five-Factor Model was used to examine personality organization in 211 six-year-old children (135 maltreated and 76 nonmaltreated). Longitudinal assessments were conducted at ages 7, 8, and 9. Six-year-old maltreated children exhibited lower agreeableness, conscientiousness, and openness to experience and higher neuroticism than did nonmaltreated children. Maltreated children also were more frequently represented in less adaptive personality clusters than were their nonmaltreated counterparts. A particularly vulnerable profile occurred predominantly among maltreated children and was related to experiencing both abuse and neglect. Child maltreatment and personality clusters were related to individual differences perceived by peers. Longitudinal stability of the personality dimensions also was assessed. At age nine, evidence was found for maintenance of the organization of the personality clusters obtained at age six and for continuity of maltreated children's personality liabilities.     

A review of research on chaplains and community-based clergy in the Journal of the American Medical Association, Lancet, and the New England Journal of Medicine: 1998-2000

Based on the content analysis of quantitative research appearing in three medical journals, the authors conclude that, despite the shared ideal of providing spiritual care to patients on the part of physicians and chaplains, there is little attention given in these journals demonstrating and promoting this shared perspective. Suggestions for future research that would focus on this common medicine/religion interface and concern are noted.