Single session treatment of a borderline personality disorder

Debbie, a patient in ongoing therapy, volunteered to assist in a workshop by participating in an interview. The goals of the session were to identify some small, discrete problem that could be worked on in the limited time available, and to demonstrate how a short-term treatment can be used.The issues considered revolved around Debbie's schema. Her early abuse set several schemas that have directed Debbie's life. The goals of the therapy would be to help modify those rules. The single session was a microcosm of a longer-term therapy. Overall, from the reports of the patient and her therapist, on follow-up, she was able to do the homework with the the therapist's assistance and found that it was helpful in countering the negative thoughts. This led to a lifting of the concomitant depression and a diminution in the self-injurious behavior.Many sessions would be needed to reinforce and strengthen the exercise strated in this session. Overall, I would see this session as both a successful treatment session and a demonstration of how identifying discrete, proximal goals can benefit patients with long-standing Axis II problems. The hypotheses and questions led to data gathering and hypothesis testing. Throughout the session, it was essential to be aware of the likely schemas so that some could be used in the session, while others were clearly avoided. By developing a conceptualization or model of the problem(s), a set of interventions could be mobilized within the session and as homework between sessions. By working toward a coping model of treatment rather than attempting to cure long-standing problems, brief cognitive behavioral interventions can be successful.     

Metabolic mapping of the rat cerebellum during delay and trace eyeblink conditioning

The essential neural circuitry for delay eyeblink conditioning has been largely identified, whereas much of the neural circuitry for trace conditioning has not been identified. The major difference between delay and trace conditioning is a time gap between the presentation of the conditioned stimulus (CS) and the unconditioned stimulus (US) during trace conditioning. It is this time gap or trace interval which accounts for an additional memory component in trace conditioning. Additional neural structures are also necessary for trace conditioning, including hippocampus and prefrontal cortex. This addition of forebrain structures necessary for trace but not delay conditioning suggests other brain areas become involved when a memory gap is added to the conditioning parameters. A metabolic marker of energy use, radioactively labeled glucose analog, was used to compare differences in glucose analog uptake between delay, trace, and unpaired experimental groups in order to identify new areas of involvement within the cerebellum. Known structures such as the interpositus nucleus and lobule HVI showed increased activation for both delay and trace conditioning compared to unpaired conditioning. However, there was a differential amount of activation between anterior and posterior portions of the interpositus nucleus between delay and trace, respectively. Cerebellar cortical areas including lobules IV and V of anterior lobe, Crus I, Crus II, and paramedian lobule also showed increases in activity for delay conditioning but not for trace conditioning. Delay and trace eyeblink conditioning both resulted in increased metabolic activity within the cerebellum but delay conditioning resulted in more widespread cerebellar cortical activation.     

Inferior colliculus lesions impair eyeblink conditioning in rats

The neural plasticity necessary for acquisition and retention of eyeblink conditioning has been localized to the cerebellum. However, the sources of sensory input to the cerebellum that are necessary for establishing learning-related plasticity have not been identified completely. The inferior colliculus may be a source of sensory input to the cerebellum through its projection to the medial auditory thalamus. The medial auditory thalamus is necessary for eyeblink conditioning in rats and projects to the lateral pontine nuclei, which then project to the cerebellar nuclei and cortex. The current experiment examined the role of the inferior colliculus in auditory eyeblink conditioning. Rats were given bilateral or unilateral (contralateral to the conditioned eye) lesions of the inferior colliculus prior to 10 d of delay eyeblink conditioning with a tone CS. Rats with bilateral or unilateral lesions showed equivalently impaired acquisition. The extent of damage to the contralateral inferior colliculus correlated with several measures of conditioning. The findings indicate that the contralateral inferior colliculus provides auditory input to the cerebellum that is necessary for eyeblink conditioning.     

Masculinity and femininity in middle childhood: Developmental and factor analyses

Developmental differences in children's self-perceptions of masculinity and femininity during the middle childhood period were investigated in English-speaking children from Grades 2–7 (N=517). The majority of participants were Caucasian and from middle socioeconomic families. The multidimensionality of masculinity and femininity was also examined. The Children's Personal Attributes Questionnaire (CPAQ), a standardized self-report instrument, was used to assess masculinity (instrumentality) and femininity (socioemotional expressiveness). Developmental differences were found within a cross-sectional design, with a decrease in feminine responding and an increase in masculine responding. At the item level, however, both boys and girls were relatively selective and limited in the items that had a grade effect. Interestingly, greater symmetry was observed between boys' masculine and feminine scores than between girls' scores. Furthermore, fewer boys had predominantly masculine responding than girls had predominantly feminine responding. Factor analysis provided initial support for the presence of three factors—interpersonal orientation, leadership, and emotionality—which appear to have greater specificity and reflect more distinct subtraits than the original scales of the CPAQ. The results of the present study suggest that meaningful developmental changes occur during the middle childhood period, and that a single summary score for masculinity or femininity ignores variations in gender-typed subtraits and thus raises both scoring and interpretation concerns.     

Continuous dynamics in the real-time perception of race

Although the outcomes of race categorization have been studied in detail, the temporal dynamics of real-time processing of race remain elusive. We measured participants’ hand movements en route to one of two race-category alternatives by recording the streaming x, y coordinates of the computer mouse. Study 1 showed that, when categorizing White and Black computer-generated faces that featurally overlapped with the opposite race, mouse trajectories showed a continuous spatial attraction toward the opposite category. Moreover, these race-atypical White and Black targets induced spatial attraction effects that had different temporal signatures. Study 2 showed that, when categorizing real faces that varied along a continuum of racial ambiguity, graded increases in ambiguity led to corresponding increases in trajectories’ attraction to the opposite category and trajectories’ movement complexity. These studies provide evidence for temporally dynamic competition across perceptions of race, where simultaneously and partially-active race categories continuously evolve into single categorical outcomes over time. Moreover, the findings show how different social category cues may exert different dynamic patterns of influence over the real-time processing that culminates in categorizations of others.     

Private events: Do they belong in a science of human behavior?

The role of thinking, feeling, and other private events has received a great deal of attention in mainstream psychology but has been virtually ignored in behavior analysis until recently. This paper introduces a series of papers from a symposium that explored the roles of private events in a science of human behavior. We briefly explore the role private events are assigned in several behavioral orientations. Next, we discuss several positions on how private events might be conceptualized within a behavior-analytic framework. We conclude by noting that the dearth of research and conceptualizations about private events unnecessarily limits the theoretical or conceptual understanding on which applied behavior analysts base their work. With this paper and the papers that follow, we hope to spark research, discussion, and yes, thinking, about the roles of thinking and feeling.     

Newborn Screening for Cystic Fibrosis: Parents’ Preferences Regarding Counseling At the Time of Infants’ Sweat Test

Newborn screening (NBS) protocols for cystic fibrosis (CF) are the first regional population-based programs to incorporate DNA analysis into their procedures. Research about these programs can inform policy and practice regarding how best to counsel families with abnormal NBS results. The grounded theory method guided interviews with 33 families whose infants had abnormal CF NBS results. A dimensional analysis of these interviews provided a theoretical framework describing parents’ preferences regarding counseling during their infant's sweat test appointment. This framework describes the contexts and characteristics of the two main dimensions of parents’ preferences: factual information and emotional support. Factual information included learning about the probability of a CF diagnosis, CF disease facts, sweat test procedure, and CF genetics. Social support consisted of offering parents a choice about the timing and amount of CF information, showing empathy for their distress, instilling hope, personalizing counseling, and providing hospitality. This framework also explains the consequences of counseling that matched versus mismatched parental preferences in these domains. Counseling that matched parents preferences reduced parents’ distress while mismatched counseling tended to increase parents’ worry about their infant.     

The struggle to maintain neutrality in the treatment of patient with pedophilia

This article explores the ethical concept of neutrality through use of a psychiatric clinical vignette. In this case a psychiatry resident is faced with the treatment of a patient who was found by the FBI to be in possession of child pornography. Although not accused of any other crimes, the patient was a fugitive from the law and requesting treatment for pedophilia. Faced with the pressures of limited resources and anxiety about the patient's dangerousness to others, the resident and his supervisor tried to strike a balance between the ethical principles of neutrality and beneficence. Through this vignette, the importance of neutrality, as well as how it can be compromised by other pressures such as expediency and anxiety, is explored.     

Configuration-specific attentional modulation of flanker- -target lateral interactions

Elements of a contour are often easier to detect when they possess collinearity, with their local orientations matching the global orientation of the contour. We recently reported attentional modulation of such lateral interactions between a central near-threshold target Gabor patch and flanking high-contrast patches (Freeman et al, 2001 Nature Neuroscience 4 1032-1036). Here, we examined whether such attentional effects reflect specific modulation of mechanisms sensitive to collinear configurations, or instead more general modulation of sensitivity to either the global or local orientation-components of the stimulus. Thresholds for detecting a central Gabor target were measured, while observers also judged the Vernier alignment between one pair of flankers and ignored a second flanker pair (when present). Target contrast-thresholds were facilitated only when attending collinear flankers. There was no facilitation when attending flankers that shared only local orientation with the target, or flankers that fell on a global axis aligned with target orientation but having orthogonal local orientation. Ignored collinear flankers had no effect on target thresholds. These results demonstrate strong and specific attentional modulation of contour-integration mechanisms in early vision sensitive to collinear configurations.     

Using the Short Form-36 with multiple sclerosis patients in five countries: a cross-cultural comparison

Questionnaires measuring health-related quality of life are increasingly used in international studies of medical effectiveness. It is important to know if data from these instruments are comparable across countries. We initiated a collaboration among five research groups--from the USA, The Netherlands, Belgium, France, and the UK--in the field of health-related quality of life in multiple sclerosis. All groups used the 36-item Short Form Health Survey. The goal of our study was to make a cross-cultural comparison. In the five countries under study the sample size varied from 50 to 134 patients with multiple sclerosis. The survey was completed by a total of 457 patients, who were heterogeneous in relation to age, duration of illness, severity and type of multiple sclerosis. There appeared to be major differences among the samples in scores on each of the eight scales. These findings may be influenced by differences in method of recruitment, demographic and disease-related characteristics, administration, and cultural factors. After having performed a number of analyses, it appeared that the differences were mainly attributable to sampling effects; however, cultural influences could not be excluded.