Designs for studying the effectiveness of long-term psychoanalytic treatments: balancing level of evidence and acceptability to patients

Long-Term Psychoanalytic Treatments (LTPT) include both long-term psychoanalytic psychotherapy (LTPP) and psychoanalysis (PsAn). Current opinion seems to be that there is some evidence for the effectiveness of LTPP, but none for that of PsAn. This may be due in part to researchers not balancing the level of evidence of randomized controlled studies (RCTs), cohort studies, and pre-post studies with patients' acceptance of these various research designs used in studying the effectiveness of LTPT. After a review of the merits of eight possible control conditions for LTPT in RCTs and cohort studies, and a consideration of the limitations and merits of pre-post studies, it was found that RCTs pair high levels of evidence with limited degrees of patient acceptance, especially where PsAn is concerned. Cohort studies appear to provide at most a moderate level of evidence. Their acceptability is hardly better than that of RCTs, as it depends on the acceptability of control conditions similar to those of RCTs. The acceptability of pre-post studies is much better, but they can provide, at most, a moderate level of evidence. Apart from randomization, they can meet all methodological criteria for high-quality research (often they do not, but there are ways to correct this). In summary, in the long-term treatment of complex mental disorders with LTPT, RCTs often pair a high level of evidence with limited patient acceptance of the method. Compared to RCTs, cohort studies show a lower level of evidence without much gain in acceptability. Pre-post studies pair the highest level of acceptability with the lowest level of evidence of the three designs. Limited acceptability is not to be confused with no acceptability, nor moderate level of evidence with none.     

Preventing Contagion With Avian Influenza: Disease Salience,Attitudes Toward Foreigners,and Avoidance Beliefs1

Building on an evolutionary approach to out‐group avoidance, this study showed relations between perceived disease salience and beliefs in the efficacy of avoiding foreigners as protective measures in the context of a real‐life pandemic risk; i.e., avian influenza. People for whom avian influenza was salient and who held unfavorable attitudes toward foreigners were more likely to believe that avoiding contact with foreigners protects against infection. This finding suggests that individual differences in social attitudes moderate evolved mechanisms relating threat of disease to out‐group avoidance.     

Managing motivational conflict: How self-esteem and executive resources influence self-regulatory responses to risk

This article explores how self-esteem and executive resources interact to determine responses to motivational conflict. One correlational and 3 experimental studies investigated the hypothesis that high and low self-esteem people undertake different self-regulatory strategies in "risky" situations that afford opportunity to pursue competing goals and that carrying out these strategies requires executive resources. When such resources are available, high self-esteem people respond to risk by prioritizing and pursuing approach goals, whereas low self-esteem people prioritize avoidance goals. However, self-esteem does not influence responses to risk when executive resources are impaired. In these studies, risk was operationalized by exposing participants to a relationship threat (Studies 1 and 2), by using participants' self-reported marital conflict (Study 3), and by threatening academic competence (Study 4). Executive resources were operationalized as cognitive load (Studies 1 and 2), working memory capacity (Study 3), and resource depletion (Study 4). When executive resources were ample, high self-esteem people responded to interpersonal risk by making more positive relationship evaluations (Studies 1, 2, and 3) and making more risky social comparisons following a personal failure (Study 4) than did low self-esteem people. Self-esteem did not predict participants' responses when executive resources were impaired or when risk was absent. The regulatory function of self-esteem may be more resource-dependent than has been previously theorized. (PsycINFO Database Record (c) 2012 APA, all rights reserved).     

Divergent effects of activating thoughts of God on self-regulation

Despite the cultural ubiquity of ideas and images related to God, relatively little is known about the effects of exposure to God representations on behavior. Specific depictions of God differ across religions, but common to most is that God is (a) an omnipotent, controlling force and (b) an omniscient, all-knowing being. Given these 2 characteristic features, how might exposure to the concept of God influence behavior? Leveraging classic and recent theorizing on self-regulation and social cognition, we predict and test for 2 divergent effects of exposure to notions of God on self-regulatory processes. Specifically, we show that participants reminded of God (vs. neutral or positive concepts) demonstrate both decreased active goal pursuit (Studies 1, 2, and 5) and increased temptation resistance (Studies 3, 4, and 5). These findings provide the first experimental evidence that exposure to God influences goal pursuit and suggest that the ever-present cultural reminders of God can be both burden and benefit for self-regulation.     

Community implementation of PMTO™: Impacts on referrals to specialist services and schools

Sigmarsdóttir, M. & Björnsdóttir, A. (2012). Community implementation of PMTO?: Impacts on referrals to specialist services and schools. Scandinavian Journal of Psychology 53, 506–511. In 2000, the city of Hafnarfjörður, Iceland, implemented Parent Management Training – Oregon Model (PMTO^?) to prevent and treat behavioral problems among children. This paper describes the implementation and findings regarding impacts in the community. As hypothesized, findings showed that the number of referrals to specialist services decreased in Hafnarfjörður following PMTO implementation and increased in two comparison communities not implementing the method. Within the Hafnarfjörður community, recorded instances of behavior problems reduced in elementary schools working in line with PMTO. The results presented are the first such findings in Iceland and suggest the kinds of systematic changes communities may experience following the implementation of an evidence‐based program.     

TO HAVE DONE (TRULY) WITH METAPHYSICS

One cannot consider the future of continental philosophy without accounting for its specific “hermeneutic situation.” It seems to us that the state of continental philosophy today returns us to metaphysics and to the possibility of truly having done with it. Continental philosophy, in reality, does not cease to live metaphysically, because by asserting the end of metaphysics, it still continues to think according to the topos of the here‐and‐now and the beyond: that which seeks the ruin of the heavens continues to obsess over the heavens; the cult of immanence can only understand itself in opposition to the other world, therefore in constant reference to it; insufficiently radical, the critique, in the words of Karl‐Otto Apel, is but an “inverted metaphysics.” Our inversions of the for and against (the sensible vs. the intelligible, the body vs. the soul, the empirical vs. the transcendental, and more recently, the multiple vs. the one) still belong to the landscape of metaphysics. How do we imagine what comes after metaphysics? Can philosophy think according to a topos other than the one of the world above and the world below? Can it respatialize itself in a new way? Put more precisely, can we accept what science tells us about the world and about humanity in any other way than as the deposing of the other world? Can science provide us with anything other than weapons against metaphysics; in other words, can science give us anything other than metaphysics? As a response to these questions, we imagine an alternative scenario tied to the (scientifically attested) fact of our animal origin. Our animal origin can be, for philosophy and more specifically for phenomenology, the chance for a new beginning. But it can do so only on the condition that it does not follow the current method of evolutionary psychology. If it is true that we can be metaphysicians while being reductionistic, because we thus preserve the “old schema,” then evolutionary psychology is today, in virtue of its very reductionism, one of the more metaphysical currents of thought. Conversely, if phenomenology decides to face the fact of evolution and to confront its estrangement, we think that it possesses all the resources to invent a new intellectual landscape.     

Long-term effects of footshock and social defeat on anxiety-like behaviours in rats: Relationships to pre-stressor plasma corticosterone concentration

We compared the consequences of two stressors, 'unnatural' inescapable footshocks (IFSs) and 'natural' social defeat (SD), on behaviours typically sensitive to stress [sucrose preference, open field (OF), elevated plus maze (EPM) and acoustic startle responses (ASRs)] and the association with pre-stressor plasma corticosterone concentration. After initial blood sampling, rats (n?=?20 per group) were exposed to either 10 IFSs (1?mA intensity, 5?s duration each) or to 1?h SD (defeat by an aggressive resident male rat and further exposure but separated in a small cage) or to control procedures (handling). Rats were tested once for ASR (day 19), while the other behavioural tests were applied once weekly for 3 weeks. Both stress groups showed short-lasting lowered sucrose preference, and in the EPM they showed shorter total distance moved, shorter distance moved on open arms and less time on open arms compared to controls. In the OF test, IFS rats showed shorter total distance moved up to 2 weeks after stress. The SD group showed shorter total distance moved in the OF, which was only significant 2 weeks after stress. Low pre-stressor plasma corticosterone concentration was only associated with defecation (IFS rats) and latency to enter open arms in the EPM (all low corticosterone subgroups, n?=?10 per subgroup). SD rats with high initial plasma corticosterone concentration showed enhanced ASR compared to the other subgroups with high initial plasma corticosterone concentration (n?=?9 per subgroup). The results indicate that footshock and SD, while generally leading to an increase in anxiety behaviours, represent qualitatively different stressors.     

Hand preference and its flexibility according to the position of the object: a study in cercopithecines examining spontaneous behaviour and an experimental task (the Bishop QHP task)

The extant literature on manual laterality in non-human primates is inconclusive, plagued by inconsistent or contradictory findings and by disturbing methodological issues (e.g. uncontrolled influential factors, comparability issues). The present study examined hand preference and its flexibility in 15 red-capped mangabeys (C. t. torquatus) and 13 Campbell's monkeys (C. c. campbelli), two species that differ in their degree of arboreality. We investigated the influence of the spatial position of the object on hand preference for reaching. We considered spontaneous behaviour (reaching for food during daily feeding) and an experimental task: the QHP task. The QHP is a task that is used in humans. This is a simple reaching task that involves high spatial constraints on hand use. In our study, the subject had to reach for items that were placed on a semi-circle in front of it on five positions, including in the centre position, in the ipsilateral space and in the contralateral space. We assessed hand preference for reaching in front (baseline condition), and we examined how this preference changed when reaching in lateral positions. For reaching in front, about half of the subjects were lateralized and no group-level bias occurred, for both spontaneous and experimental conditions. When considering reaching in the lateral positions, we observed that the position of the object influenced hand use: individuals used the hand that was closest to the object. The results are discussed in relation to previous findings in humans and in non-human primates and regarding theories on handedness and flexibility of hand preference.