Projective identification and the psychoanalytic dialogue

A survey of several psychoanalytic conceptions of projective identification is followed by a discussion, with case illustrations, of its communicative and defensive function. In this context, special attention is paid to the use of language as an instrument for the destruction of the object--in this case, the analyst--who is simultaneously yearned for and experienced as a threat.     

Dreidimensionales Körperbild in der Psychodiagnostik

The body sculpture technique is a procedure in which patients create a three-dimensional model of their own body with modelling clay. This existing technique has been further developed into the modular body sculpture technique and offers a diagnostic approach to the body image. After an introduction in the conceptual foundations of body self-representation the technique is described. Using a case study, advantages for clinical applications are illustrated. Contributions of this technique to a deeper understanding of the structure of body memory are discussed in the context of current cognitive theories.     

Do patients suffering from chronic diseases retrospectively overestimate how healthy they were before they fell ill?

Background/Objective: To examine the impact of a disease on a person's subjective health state, patients are often asked to assess their current health state and to retrospectively assess how healthy they were before they fell ill. The objective of this study was to test whether patients generally overestimated the quality of their pre-disease health. Method: Six samples of patients with chronic diseases (cancer patients, cardiovascular patients, and patients diagnosed with sarcoidosis, N between 197 and 1,197) were analyzed. The patients assessed their current health states and their health states at the time before diagnosis. The retrospective scores were compared with matched data from general population studies. Results: In three of the six studies, the retrospective health ratings of the patients were significantly higher than the general population norms (effect sizes between 0.24 and 0.46), two studies yielded nonsignificant effects, and in one study there was an opposite trend. The general overestimation of pre-disease health was more pronounced in older patients as compared with younger ones, and it was more pronounced when global health/quality of life was to be assessed. Conclusions: Retrospective assessments of pre-disease health states are not appropriate for assessing disease-related changes in a person's health state.     

The Core Self-Evaluation Scale: Psychometric Properties of the German Version in a Representative Sample

The Core Self-Evaluation Scale (CSES) is an economical self-reporting instrument that assesses fundamental evaluations of self-worthiness and capabilities. The broad aims of this study were to test the CSES's psychometric properties. The study is based on a representative survey of the German general population. Confirmatory factor analyses were conducted for different models with 1, 2, and 4 latent factors. The CSES was found to be reliable and valid, as it correlated as expected with measures of depression, anxiety, quality of life, self-report health status, and pain. A 2-factor model with 2 related factors (r = –.62) showed the best model fit. Furthermore, the CSES was measurement invariant across gender and age. In general, males had higher values of positive self-evaluations and lower negative self-evaluations than females. It is concluded that the CSES is a useful tool for assessing resource-oriented personality constructs.     

Evaluation of the Latin American version of the Life Orientation Test-Revised

The Life Orientation Test (LOT-R) is the most intensively used instrument for the assessment of optimism, but empirical evidence of its psychometric quality in Latin America is lacking. The aim of this study was to test psychometric properties of this questionnaire based on a representative sample of the general population of Colombia (N = 1,500). Confirmatory factor analyses confirmed the bi-dimensionality of the questionnaire with two factors, namely Optimism and Pessimism. The sum scores of the optimism and pessimism subscale correlated with r = ?.12. Convergent validity aspects were studied by correlating LOT-R values with anxiety, depression, quality of life, fatigue, mental health, hopelessness, and self-efficacy. Optimism was more strongly correlated with these variables than pessimism. Normative data and mean values for both genders and different age groups are given. Generally, there were only small age and gender effects. Compared to the German norm data, the Colombian participants scored on average one scale point higher in the dimension of optimism. In summary, the LOT-R in its Spanish version is an appropriate and practical tool for screening purposes in individual diagnostics and epidemiological research in Latin American samples.     

Quality of life in breast cancer patients: Associations with optimism and social supportCalidad de vida en pacientes con cáncer de mama: asociación con optimismo y apoyo social

Background/Objective: The purpose of this study was to examine quality of life (QoL) in breast cancer patients from Colombia and to explore the relationship between QoL, habitual optimism, and social support. Method: A sample of 95 breast cancer patients treated in a hospital in Bogotá were administered the QoL instrument EORTC QLQ-C30 and the Life Orientation Test LOT-R. Additionally, they were asked to indicate from whom (physicians, friends, nurses, etc.) they wished and received social support. Reference data for the EORTC QLQ-C30 and the LOT-R were taken from a representative sample of the general Colombian population. Results: The breast cancer patients showed detriments to their QoL on most functioning scales and symptom scales of the EORTC QLQ-C30, while their general assessments of health and QoL were not worse than those of the controls. Optimism was positively correlated with QoL. Most patients wanted and received social support from their physicians and friends/family. Conclusions: The results suggest that optimism helps patients better cope with disease. A general assessment of global QoL cannot replace the more specific assessments of the functioning domains and symptoms.