The clinical evaluation of common sexual concerns

Whose job is it to discover and manage patients' sexual concerns? If you believe that you have a role to play, just what is that role and how will you perform it? Sexual disorders are common, yet infrequently diagnosed. A willingness to inquire about sexual function is the most critical diagnostic step for clinicians. Once a problem is discovered, a systematic diagnostic process can uncover etiologic organic and psychogenic factors using customary diagnostic tools, including taking a psychosexual and medical history, comprehensive and focused physical examinations, psychological assessment instruments, laboratory tests, and special procedures.     

Ocular signatures of proactive versus reactive cognitive control in young adults

During the execution of a cognitive task, the brain maintains contextual information to guide behavior and achieve desired goals. The AX-Continuous Performance Task is used to study proactive versus reactive cognitive control. Young adults tend to behave proactively in standard testing conditions. However, it remains unclear how interindividual variability (e.g., in cognitive and motivational factors) may drive people into more reactive or proactive control under the same task demands. We investigated the use of control strategies in a large population of healthy young adults. We computed the proactive behavioral index and consequently divided participants into proactive, reactive, and intermediate groups. We found that reactive participants were generally slower, presented lower context sensitivity, and larger response variability. Pupillary changes and blink rate index cognitive effort allocation. We measured, concomitantly to the task, the pupil size and frequency of blinks associated with the cue maintenance and response intervals. During the cue period, nonfrequent, nontarget cues led to increased pupil dilation and number of blinks in all participants. During the response interval, we found more errors and increased pupil dilation to the probe when all participants had to overcome a response bias generated by the frequent cue. Only reactive participants showed larger response-related pupil when they had to overcome a response bias related to the frequent probe. Contrary to expectations, groups did not differ in ocular measures in the cue period. In conclusion, interindividual differences in cognitive control between healthy adults can be mapped onto different patterns of effort allocation indexed by the pupil.     

Negative affectivity,coping, immune status,and disease progression in hiv iwected individuals

Abstract

The primary goal of the study was to assess the relationship between personality dispositions, coping styles, immune markers, clinical status, and subjective somatic symptoms in a mixed sample of HIV positive individuals. Specifically, the prognostic value of psychological and immunological measures in HIV progression was emphasized. Subjects (n = 104) were recruited from a cohort of 422 HIV positive individuals enrolled in the Oslo HIV Cohort Study. The partkipants were given self-administered questionnaires assessing behavioral, psychological, and psychdal variables. Clinical assessment and immunological tests were performed at regular follow-up visits. Clinical status was assessed according to the Centers for Disurse Control criteria. The immune markers used were CD4 T cell counts, beta2-microglobulin concentration, sewn levels of HIV-1 p24 core protein, and levels of antibodies to core protein. In addition, subjective somatic symptoms were assessed.

The results showed that measure-s of negative affectivity (NA; e.g. anxiety, distress, tension) were consistently related to subjective somatic symptoms and passivedefensive coping style. However, no amistent association between NA measures and immune markers was found. Individuals who developed AIDS in the study period had significantly lower initial CD4 cell counts as well as lower scores on measures of active-pmblem related wping (e.g. Positive reappraisal, Seeking social support) and passivedefensive coping (i.e. Escape-Avoidance, Self-control).

The results suggest (1) that coping styles may merit a specific focus in future research of psychological factors and medical outcomes in HIV infection, and (2) because of associations of NA measures with symptom reports studies of the relationship between e.g. stress, depression and HIV outcome should consider these variables as confounders.     

‘Adolescent fantasies and the horror-film genre‘: The freud museum 1995 spring conference

Abstract

As I walked towards home across Waterloo Bridge, having left this conference in its apt setting of the National Film Theatre, I realized I had attended the day from two points of interest: firstly, from my professional position of working in a university counselling service where I encounter adolescents and their ‘phantasies’ regularly. Only the other day a young student I had been seeing started the session by telling me she had seen the film Interview with the Vampire the night before, had been sick at the end, and then casually ‘threw up’ to me that she did not think she would need to go on seeing me.     

A Meta‐Analytic Structural Model of Dispositonal Affectivity and Emotional Labor

The exponential growth of the service economy has increased the attention that organizational researchers have paid to the concept of emotional labor. Although much progress has been made in the field, few studies have provided an integrated picture of how individual dispositions, perceived display rules, and emotional labor behaviors shape employee outcomes. To clarify and compare results across this growing body of literature, a quantitative review was developed, along with a theoretically derived path diagram of key emotional labor constructs. Evidence from our structural meta‐analytic model based on 116 primary studies demonstrates that examining affective dispositions and emotional labor constructs and the pattern of positive and negative results helps to clarify and add specificity to the literature. Results were consistent with the perspective that surface acting emotion regulation strategies have a pattern of negative relationships with work outcomes of job satisfaction and stress/exhaustion (but not with job performance), whereas deep acting emotion regulation strategies have a pattern of positive relationships with all of these work outcomes.     

Validation of the SASB Introject Surface in a Norwegian Clinical and Nonclinical Sample

Aronow, Reznikoff, and Moreland (this issue) have written a thoughtful contribution to the debate on the status of nomothetic and idiographic approaches to the Rorschach test. One of the interesting and attractive features of the current Rorschach er a is—as the Rorschach has experienced a resurgence of interest—the continuing interest in the foundations of the test and the historic antecedents to contemporary thought about the Rorschach (cf. Handler, 1994). One cannot consider Rorschach's seminal insights or those of the first and second generation and not deepen one's contemporary understanding and practice. In other words, the more you know about the test, the better "Rorschacher" you will be. This is witness to the test's utility and profundity. For this we may be grateful for the thought-provoking contribution of Aronow and his colleagues.     

Validation of the SASB Introject Surface in a Norwegian clinical and nonclinical sample

In this study, we examined the reliability and construct validity of the Structural Analysis of Social Behavior Introject Surface, Intrex long form A (SASB-IS; Benjamin, 1995) in 2 Norwegian samples. The fit of the 8 SASB-IS scales to the structural requirements of a circumplex model with relaxed equal spacing constraints was reasonably good in an outpatient sample, but poor in a normal reference sample. The deviations from the equal spacing based on an ideal circumplex model, however, seem to have minimal implications for the utility of the instrument in clinical assessment. The reliability of the SASB-IS was acceptable on most scales, but two scales had unacceptable low reliability. Correspondence with external criteria supported the validity of the SASB-IS in both samples. Profile patterns related to different segments of the introject circumplex model were systematically related to severity of psychopathology: Hostile and accepting patterns of self-relatedness formed polar opposites; control patterns and intermediate patterns gave intermediate pathology scores.