Tinnitus als soziale Infektion?

Background

11 out of 35 male employees of a central alert team with rescue coordination function developed a tinnitus disorder. This clinical case-study highlights the psychodynamic background of this accumulation.

Methods

Employees were investigated by psychometric questionnaires and semistructured psychodynamic biografical interviews. Additionally aspects of group dynamics and organisational structure were assessed.

Results

All staff members reported adverse work conditions. Medical and psychometric examination of the tinnitus patients did not reveal severe pathological findings. The interviews identified psychodynamic conflicts dealing with autonomy and regulation of self-esteem. All tinnitus patients reported a very adverse or punitive father relation and difficulties in performing a stabile male role and self-image. Group dynamics was dominated by paranoid and regressive tendencies complicated by maladaptive coping, crude perception of external facts and a pronounced experience of aggressive impulses.

Conclusion

The remobilisation of infantile powerlessness, ineffectiveness and helplessness triggered by adverse work conditions and the introduction of a new culture of personal responsibility within the work organisation together with an impaired coping of separation conflicts enforced by traumatic aspects of the relation with the father may have promoted the tinnitus symptomatology. Additionally, due to the missing awareness of the importance of such group dynamical processes the employers contributed to an increasing psychosocial distress, which promoted the accumulated manifestation of tinnitus as a conflict expressive symptom.     

Negative self-imagery in social anxiety contaminates social interactions

Patients with social phobia report experiencing negative images of themselves performing poorly when in feared social situations. The present study investigates whether such negative self-imagery (based on memory of past social situations) contaminates social interactions. High socially anxious volunteers participated in two conversations with another volunteer (conversational partner). During one conversation, the socially anxious volunteers held in mind a negative self-image, and during the other they held in mind a less negative (control) self-image. As predicted, when holding the negative image the socially anxious volunteers felt more anxious, reported using more safety behaviours, believed that they performed more poorly, and showed greater overestimation of how poorly they came across (relative to ratings by the conversational partner). Conversational partners rated the socially anxious volunteers' performance as poorer in the negative image condition. Furthermore, the conversation was contaminated since both groups of participants rated its quality as poorer in the negative image condition.     

Shared and separate systems in bilingual language processing: converging evidence from eyetracking and brain imaging

The neurological and cognitive aspects of bilingual language processing were examined in late Russian-English bilinguals using headband-mounted eyetracking and functional neuroimaging. A series of three eyetracking studies suggested that, at early stages of word recognition, bilinguals can activate both languages in parallel, even when direct linguistic input is in one language only. A functional neuroimaging study suggested that, although the same general structures are active for both languages, differences within these general structures are present across languages and across levels of processing. For example, different centers of activation were associated with first versus second language processing within the left Inferior Frontal Gyrus, but not within the Superior Temporal Gyrus. We suggest that parallel activation (as found with eyetracking) and shared cortical structures (as found with fMRI) may be characteristic of early stages of language processing (such as phonetic processing), but the two languages may be using separate structures at later stages of processing (such as lexical processing).     

Desecration,Moral Boundaries,and the Movement of Law: The Case of Westboro Baptist Church

Using participant observation, in-depth interviews, and legislative histories, we examine Westboro Baptist Church, a religious group infamous for homophobic rhetoric and funeral protests. Employing cultural and interactionist perspectives that focus on the semiotics of death, the sacred, and desecration, we outline how Westboro’s activities purposively violate deeply held signifiers of moral order through language, while simultaneously respecting extant laws of behavior. This strategy, in conjunction with the political profitability of opposing the group, explains why the group’s activism triggered extensive legal disputes and modifications at multiple levels of governance. Westboro’s actions and use of symbols—and those of others against the group—lay bare multiple threads in the sacred cultural fabric of American society.     

Inventar zur therapeutischen Beziehung (ITB)

A successful psychotherapy requires a good therapeutic relationship. An adequate operationalization by German diagnostic instruments has to be improved. A new instrument for measuring the therapeutic relationship from the patient’s perspective is presented. It is suitable for various therapeutic orientations, integrates current empirical findings in a broad theoretical framework and corrects methodological deficits of the existing German questionnaires. The therapeutic relationship questionnaire (ITB) was developed with a sample of 44 therapists and 519 inpatient, outpatient and day clinic patients. The ITB findings confirm a very good reliability (internal consistency and retesting reliability). There is initial evidence for convergent, divergent and differential validity and for associations with therapy effects. The ITB is an economic instrument that in contrast to other questionnaires measures a general factor which could be replicated in several confirmatory and exploratory factor analyses.     

The effects of modifying interpretation bias on worry in generalized anxiety disorder

This study investigated whether facilitating a benign interpretive bias decreases negative thought intrusions in generalized anxiety disorder (GAD). Clients were randomly allocated to an interpretation modification condition in which they repeatedly accessed benign meanings of emotionally ambiguous homographs and scenarios, or to a control condition in which they accessed threat and benign meanings with equal frequency. Worry frequency was assessed using a breathing focus task that involved categorising the valence of thought intrusions before and after an instructed worry period. Interpretation bias was assessed during the modification tasks, and on a different measure of interpretation bias (sentence completion) following a period of worry. The experimental procedure modified interpretations made during training, and in the later sentence completion task. Furthermore, compared to the control group, the benign group showed fewer negative thought intrusions during breathing focus (as rated by both participants and an assessor). These findings show that it is possible to induce a more benign interpretive bias in GAD clients and that this reduces negative thought intrusions.     

The effect of attention modification with explicit vs. minimal instructions on worry

In this experiment we investigated the effect of different instructions on the modification of attentional biases, and subsequently on worry persistence. Participants without excessive worry completed a modified dot-probe task, designed to train attention either to threat or neutral words. Half of each group was given explicit instructions regarding the relationship between word valence and target location, and half were given the more usual minimal instructions. Impact on worry persistence was assessed by categorizing the valence of thought intrusions before and after a period of instructed worry. Response latencies to test items on the dot-probe task showed that attention had been successfully manipulated in the expected direction, and explicit instructions led to more effective attention modification. Moreover, participants in the attend-threat group who received explicit instructions reported significantly more negative thought intrusions following instructed worry, as rated by an assessor, whereas participants in the attend-neutral group did not. These findings suggest that an attentional bias towards threatening information plays a role in worry persistence, and that explicit instructions may be helpful in modifying this bias.     

Online Gatekeepers of History: Yahoo! Answers Community Discussing Holocaust Denial

Scholarly attention has been directed to the spread and scope of online Q&A services, including the level of activity, types and messages and the social roles the members of these sites occupy. A content analysis was conducted of the answers supplied in response to questions aimed at identifying the reasons for Holocaust denial in Yahoo! Answers. The replies denoted the existence of two main opposing online socio-cultural roles adopted by these participants: online gatekeepers of history and online gatekeepers of pseudo-history. The activity levels of those filling these roles and the community’s approval of their answers were also assessed. Future avenues of research regarding these two roles are suggested.     

The Flawed Person of the Analyst: Commentary on Paper by Lauren Levine

The way that the current conception of mutual enactment is understood, any analysis, in order to be ultimately successful must first go badly for some period of time. Any analysis that goes too smoothly is subject to the suspicion that some very difficult interactional material is being mutually unaddressed. In this context I see that Dr. Lauren Levine enacted the role of her abandoned patient (concordant countertransference) and as well, for a time, indeed, figuratively abandoned her patient (complementary countertransference). The author's central contribution in this paper is an illustration of how drawing on difficult and painful dimensions in one's own personal analysis, the analyst has the advantage of being able to withstand highly toxic material in both the transference and the countertransference. Dr. Levine is fortunate in having had a personal analysis that helped her integrate highly shameful aspects of her self, though it must be recognized that this is not always the case in all training analyses.