Dimensions of impulsivity and aggression associated with suicide attempts among bipolar patients: a preliminary study

Impulsivity and hostility are often thought to be interrelated among depressed patients with suicidal behavior, but few studies have examined this relationship empirically. In this study, we assessed trait impulsivity and hostility among 52 DSM-IV bipolar subjects with and without histories of suicide attempts. Impulsivity and hostility were correlated among attempters (r = .41, p = .03) but not non-attempters (r = .22, p = .28). As compared to non-attempters, attempters had significantly higher levels of overall hostility, more extensive subcomponents of hostility, and a trend toward higher overall impulsivity. Associations between lifetime suicide attempts and overall hostility were significant while controlling for current depression severity and lifetime illness duration. Aggression and impulsivity appear linked among bipolar patients with lifetime suicide attempts but may be independent constructs among non-attempters. The presence of both factors may elevate risk for suicidal behavior.     

Beyond binary judgments: Prime validity modulates masked repetition priming in the naming task

Bodner and Masson (2001) reported that masked repetition priming of lexical decisions is often greater when the repetition primes appear on a high, rather than a low, proportion of trials. They suggested that processing episodes are constructed for masked primes and that recruitment of those episodes is affected by the probability that the prime will be useful for processing the target. If context-sensitive recruitment of primes is a general mechanism, a similar effect should also occur in a nonbinary response task. In accord with this hypothesis, using the naming task and a 45-msec prime duration, we show that masked repetition priming effects for uppercase words, case-alternated words, and pseudohomophones were greater when .8 rather than .2 of the trials involved repetition (vs. unrelated) primes. Prime validity effects are consistent with a memory recruitment view of priming but may be difficult to explain using activation-based mechanisms.     

Pathways of Economic Influence on Adolescent Adjustment

An important part of a science aimed at the prevention of human dysfunction involves the development of empirically based models that identify processes of risk for or protection from emotional distress or behavioral problems over time. The present study developed and evaluated such a model that proposed two pathways through which family economic pressure was expected to influence change in adolescent internalizing symptoms (depression and anxiety) during the period from the eighth to the tenth grades. A total of 377 rural families in a midwestern state provided data for the analyses. The results were generally consistent with the conceptual model in that family economic pressure increased adolescent perceptions of family economic hardship, which, in turn, reduced the adolescent's sense of control or mastery over time. Lowered mastery was associated with increases in emotional distress. Also consistent with the model, prior levels of mastery appeared to reduce the magnitude of economic stress experienced by the adolescent, whereas prior emotional distress intensified the economic stress process. Although gender differences were found in these processes, the overall pattern of results suggests that girls and boys are both at risk for internalizing problems when families experience economic pressure. Implicatios of the findings for the dvelopment of effective preventive interventions with financially stressed families in rural areas are discussed.     

The tasks of self-managing hepatitis C: the significance of disclosure

The narratives of those with hepatitis C were viewed through the lens of Corbin and Strauss' [Corbin, J., & Strauss, A. (1988). Unending work and care: Managing chronic illness at home. The Jossey-Bass health series and The Jossey-Bass social and behavioral science series. San Francisco, CA: Jossey-Bass.] self-management model for chronic illness, using qualitative methodology. Fifteen Australian hepatitis C positive interviewees described the challenges and turning points in adjusting to their diagnosis. The data were analysed using open- and closed-coding methods. Support was found for a self-management model encompassing medical, emotional and life role facets for those adjusting to life with hepatitis C. Unique challenges emerged beyond those described by Corbin and Strauss (1988), namely that disclosure impacted both positively and negatively on the tasks of self-management. It was concluded that self-management may be compromised by disclosure, particularly distress derived from hepatitis C-related stigma. The self-management tasks described contribute to broadening clinicians' understanding of the challenges faced by those living with hepatitis C.     

Test context affects recollection and familiarity ratings: implications for measuring recognition experiences

The binary remember/know task requires participants to dichotomize their subjective recognition experiences into those with recollection and those only with familiarity. Many variables have produced dissociative effects on remember/know judgments. In contrast, having participants make independent recollection/familiarity ratings has consistently produced parallel effects, suggesting the dissociations may be artifacts of using binary judgments. Bodner and Lindsay (2003) reported a test-list context effect with binary judgments: Increased remembering but decreased knowing for a set of critical items tested with a set of less-memorable (vs. more-memorable) items. Here we report a parallel effect of test-list context on recollection and familiarity ratings, induced by a shift in response bias. We argue that independent ratings are preferable to binary judgments because they allow participants to directly report the co-occurrence of recollection and familiarity for each item. Implications for the measurement of self-reported recognition experiences, and for accounts of recognition memory, are discussed.     

Addressing Challenges in Individual Psychotherapy with Delusional Patients: A Case Study

Although cognitive-behavioral treatments for schizophrenia and other psychotic disorders demonstrate strong results in clinical trials, not all patients respond to these treatments. Common challenges in psychotherapy with delusional patients include a mismatch between the therapist’s and the patient’s expectations about the purpose of therapy, the patient’s lack of motivation to reduce delusional beliefs in service of other goals, and the patient’s dependence on the delusions in order to preserve an intact sense of self. This case highlights the value of integrating a psychodynamic perspective with cognitive-behavioral interventions to address challenges in psychotherapy with chronically delusional patients.     

Transformations of mathematical and stimulus functions

Following a pretest, 8 participants who were unfamiliar with algebraic and trigonometric functions received a brief presentation on the rectangular coordinate system. Next, they participated in a computer-interactive matching-to-sample procedure that trained formula-to-formula and formula-to-graph relations. Then, they were exposed to 40 novel formula-to-graph tests and 10 novel graph-to-formula tests. Seven of the 8 participants showed substantial improvement in identifying formula-to-graph relations; however, in the test of novel graph-to-formula relations, participants tended to select equations in their factored form. Next, we manipulated contextual cues in the form of rules regarding mathematical preferences. First, we informed participants that standard forms of equations were preferred over factored forms. In a subsequent test of 10 additional novel graph-to-formula relations, participants shifted their selections to favor equations in their standard form. This preference reversed during 10 more tests when financial reward was made contingent on correct identification of formulas in factored form. Formula preferences and transformation of novel mathematical and stimulus functions are discussed.     

Joseph Sandler's Contributions to The Concept of Countertransference

A few months before Joe Sandler's death, he participated in an American Psychoanalytic Association panel that focused on the Controversial Discussions that occurred in the British Psychoanalytic Society from 1941 to 1945. Our plan was to revisit the controversies in the context of British psychoanalysis some 50 years later. As we designed the panel, I suggested that we have one Kleinian panelist, one contemporary Freudian panelist, and a third panelist representing the Independents.