Expressions of vernacular psychoanalysis

The present paper examines the clinical integration of theory and experience from the perspective of clinicians’ subjective shaping of inquiry. The author suggests that the historical, conceptual development of clinical psychoanalysis parallels the progressive articulations of consensual understanding within the clinical hour. He suggests that the clinician's utilization of vernacular elements, derivative of direct experience as well as of reference to the wider range of psychoanalytic thinking, addresses gaps and disconnections within the abstract understanding of the clinical psychoanalytic process. Providing examples from psychoanalytic history, he concludes with a contemporary example of psychoanalytic papers, reflecting vernacular elements that are of use to practicing clinicians.     

Hemodynamic responses to active and passive coping tasks and the prediction of future blood pressure in Thai participants: A preliminary prospective cohort study

Cardiovascular responses to mental stress tests have been related to future blood pressure (BP) levels. However, most studies have been completed in North America and Europe; only one study has been conducted in Asia. Therefore, the study explored whether cardiovascular responses to mental stress predict future resting BP in Thailand. Hemodynamic measures were obtained from 101 healthy adults before, during and after mental arithmetic, a speech task, and a cold pressor task. A follow‐up assessment of resting BP was undertaken 1 year later. Results showed that Thais responded to standardized mental stress tasks with large and significant cardiovascular reactivity. Regression analyses indicated that, after adjustment for baseline BP and traditional risk factors, heightened systolic blood pressure (SBP) responses to mental arithmetic were associated with increased future SBP (ΔR² = .045). These findings suggest that BP reactivity predicts future BP and may play a role in the development of hypertension. In addition, Thais displayed large cardiovascular responses to standardized mental stress tasks, of a similar magnitude to previous studies of North Americans and Europeans.     

The adrenergic receptor α-2A gene (ADRA2A) and neuropsychological executive functions as putative endophenotypes for childhood ADHD

There is resurgent interest in the psychiatric literature in endophenotypes, variables thought to more strongly reflect the effects of candidate genes than do manifest disorders. In a sample of 176 children with attention deficit hyperactivity disorder (ADHD) and 52 of their siblings, we examined the validity of several putative endophenotypes for ADHD that represent commonly used clinical measures of multiple cognitive/neuropsychological domains of executive functions (EFs). We review their distributional normality, their relations to ADHD symptoms in probands and unaffected siblings relative to nonADHD controls, and their correlation in siblings. We also tested the EF measures’ associations with the ADRA2A gene and whether they mediated or moderated the associations between ADHD and ADRA2A. Several EF measures showed association with ADRA2A, as well as moderation, but not mediation, of its association with ADHD. Implications of the results for evaluating the validity and utility of putative endophenotype measures and for finding candidate gene effects on ADHD are discussed.     

Attentional fixation in panic disorder

According to Beck's (1988) clinical observations, patients with panic disorder describe a fixation on their distressing physical and psychological symptoms and an inability to access corrective information during panic attacks. The present study sought to evaluate empirically the notion that attentional fixation is characteristic of these patients. A subset of panic patients participating in 3 cognitive therapy clinical trials completed the Attentional Fixation Questionnaire (AFQ) at intake, during treatment and at termination. The AFQ had adequate internal consistency at all time intervals, and it correlated positively with measures of depression, anxiety and distorted cognitive content. At termination, the AFQ total score and nearly all single items decreased significantly, and patients who continued to meet diagnostic criteria for panic disorder scored higher on most items than patients who no longer met diagnostic criteria for panic disorder. These preliminary data suggest that attentional fixation is an important dimension of cognition relevant to panic disorder.     

Belief in supernatural agents in the face of death

Four studies examined whether awareness of mortality intensifies belief in supernatural agents among North Americans. In Studies 1 and 2, mortality salience led to more religiosity, stronger belief in God, and in divine intervention. In Studies 3 and 4, mortality salience increased supernatural agent beliefs even when supernatural agency was presented in a culturally alien context (divine Buddha in Study 3, Shamanic spirits in Study 4). The latter effects occurred primarily among the religiously affiliated, who were predominantly Christian. Implications for the role of supernatural agent beliefs in assuaging mortality concerns are discussed.     

Psychiatric hospitalization after deliberate self-poisoning

The decision for psychiatric hospitalization after deliberate self-poisoning (DSP) is not well understood. This study, a longitudinal cohort study of 3,148 consecutive DSP patients found 920 (29.2%) subjects were referred for psychiatric hospitalization, 576 (18.3%) on involuntary basis. A logistic regression analysis showed increased risk for: age 25 or older, homelessness, unemployment, previous self-harm, psychiatric inpatient treatment within 12 months, earlier psychiatric inpatient treatment, suicidal ideation or plan, mood or psychotic disorders, and lower clinician experience; and lower risk for being married/defacto, and after hours presentation. Recommendation for psychiatric hospitalization was based on complex decision making. These findings have implications for clinical practice guidelines, service costs, and service organization.     

Is belief reasoning automatic?

Understanding the operating characteristics of theory of mind is essential for understanding how beliefs, desires, and other mental states are inferred, and for understanding the role such inferences could play in other cognitive processes. We present the first investigation of the automaticity of belief reasoning. In an incidental false-belief task, adult subjects responded more slowly to unexpected questions concerning another person's belief about an object's location than to questions concerning the object's real location. Results in other conditions showed that responses to belief questions were not necessarily slower than responses to reality questions, as subjects showed no difference in response times to belief and reality questions when they were instructed to track the person's beliefs about the object's location. The results suggest that adults do not ascribe beliefs to agents automatically.