An examination of some common denominators in the borderline syndrome

Commonalities in borderline patients are examined in an empirical study of three such cases in long-term psychoanalytic treatment with the author. Each case shows the preoedipal feature of a need to repeat the early maternal environment sensed as both deadly and indispensable. These mutually exclusive polarities continued to be experienced as co-existent through a significant degree of primary process functioning. Separation-individuation was arrested and self-object transferences and persecutory anxiety were evidenced. Some ego growth occurred concomitant with therapy and ongoing life circumstances. More reality life forces were released as opposed to unconscious victimization in life-death trap experiences.     

Morality and Interpretation: Commentary on Jonathan Glover's Alien Landscapes?

What is required of the interpreter of disordered minds and what can we learn from the process? Jonathan Glover's book focuses on human interpretation and its role in psychiatry. His hope is that a more careful and sensitive exploration of minds that are very different from our own, will assist us to answer a range of important questions about human agency, identity and responsibility. In this commentary I will focus on the process and purpose of interpretation and expand on some of the moral issues that arise out of the interpretive challenges posed by mental disorders.     

EFFECTS OF ALCOHOL INTOXICATION AND VICTIMIZATION HISTORY ON WOMEN'S SEXUAL ASSAULT RESISTANCE INTENTIONS: THE ROLE OF SECONDARY COGNITIVE APPRAISALS

This study used an experimental paradigm to investigate the role of secondary cognitive appraisals in women's sexual assault resistance and whether these appraisals mediated influences of alcohol and prior victimization. After consuming a beverage (control, placebo, moderate, or high dose), 351 women projected themselves into a simulated interaction with a sexually aggressive man. Four types of secondary appraisals (shock at the man's behavior, concern about his feelings, uncertainty in the situation, conflict about what to do) and three resistance strategies (assertive, polite, passive) were examined. Path modeling revealed that, as expected, intoxication and prior sexual victimization influenced secondary appraisals, which in turn influenced intended resistance. Prior adult sexual assault (ASA) and childhood sexual abuse (CSA) also had direct effects: ASA negatively predicted assertive resistance and CSA positively predicted passivity. Findings suggest that secondary appraisals are key targets for intervention to facilitate effective resistance, thereby reducing the risk of adult sexual victimization.     

Hormonal regulation of delta opioid receptor immunoreactivity in interneurons and pyramidal cells in the rat hippocampus

Clinical and preclinical studies indicate that women and men differ in relapse vulnerability to drug-seeking behavior during abstinence periods. As relapse is frequently triggered by exposure of the recovered addict to objects previously associated with drug use and the formation of these associations requires memory systems engaged by the hippocampal formation (HF), studies exploring ovarian hormone modulation of hippocampal function are warranted. Previous studies revealed that ovarian steroids alter endogenous opioid peptide levels and trafficking of mu opioid receptors in the HF, suggesting cooperative interaction between opioids and estrogens in modulating hippocampal excitability. However, whether ovarian steroids affect the levels or trafficking of delta opioid receptors (DORs) in the HF is unknown. Here, hippocampal sections of adult male and normal cycling female Sprague-Dawley rats were processed for quantitative immunoperoxidase light microscopy and dual label fluorescence or immunoelectron microscopy using antisera directed against the DOR and neuropeptide Y (NPY). Consistent with previous studies in males, DOR-immunoreactivity (-ir) localized to select interneurons and principal cells in the female HF. In comparison to males, females, regardless of estrous cycle phase, show reduced DOR-ir in the granule cell layer of the dentate gyrus and proestrus (high estrogen) females, in particular, display reduced DOR-ir in the CA1 pyramidal cell layer. Ultrastructural analysis of DOR-labeled profiles in CA1 revealed that while females generally show fewer DORs in the distal apical dendrites of pyramidal cells, proestrus females, in particular, exhibit DOR internalization and trafficking towards the soma. Dual label studies revealed that DORs are found in NPY-labeled interneurons in the hilus, CA3, and CA1. While DOR colocalization frequency in NPY-labeled neuron somata was similar between animals in the hilus, proestrus females had fewer NPY-labeled neurons that co-labeled with DOR in stratum oriens of CA1 and CA3 when compared to males. Ultrastructural analysis of NPY-labeled axon terminals within stratum radiatum of CA1 revealed that NPY-labeled axon terminals contain DORs that are frequently found at or near the plasma membrane. As no differences were noted by sex or estrous cycle phase, DOR activation on NPY-labeled axon terminals would inhibit GABA release probability equally in males and females. Taken together, these findings suggest that ovarian steroids can impact hippocampal function through direct effects on DOR levels and trafficking in principal cells and broad indirect effects through reductions in DOR-ir in NPY-labeled interneurons, particularly in CA1.     

Use of the Brazelton neonatal assessment scale to educate parents of high-risk infants

This article describes how the Brazelton Neonatal Assessment Scale might be used to assist parents in recognizing their infant's cues and capabilities. Infants to whom the scale as administered were high-risk babies requiring care in an intensivecare unit. The scale can be a useful component of an educational program for parents of newborns.     

Six year follow-up of health status changes in Danish adults with suicide tendency in 1994

The purpose of this study was to determine whether suicidal ideation and/ or suicide attempts have any long-term health effects. The relationship between suicidal thoughts and/or a previous suicide attempt in 1994 and the presence of suicidal ideation in 2000 was analyzed. We found that health status in 1994 differed significantly between the groups with and without suicidal ideation or a previous suicide attempt and that the differences persisted or even deepened (not significant) after 6 years. Further, people who had suicidal ideation or a suicide attempt in 1994 had a significantly greater risk (OR = 7.4) of having suicidal ideation in 2000 than people who had not.     

Daily Goals, Life Goals, and Worst Fears: Means, Ends, and Subjective Well-Being

This study addressed the relations among personal strivings (daily goals) and future life goals and worst fears. Eighty undergraduate participants (62 women, 18 men) listed their daily goals, their ultimate life goals, and their worst fears, and completed questionnaire measures of subjective well-being. Daily goals were content-analyzed for relevance to attaining life goals or avoiding worst fears. Daily goals that were instrumental to life goals or that avoided worst fears were rated as more important but also more difficult by participants. Working on daily goals avoiding one's worst fears was negatively related to measures of subjective well-being, controlling for daily goal progress, difficulty, ambivalence, and importance. Working on daily goals that were instrumental to one's life goals only weakly predicted well-being. The avoidance of worst fears interacted with daily goal appraisals such that individuals who experienced little progress at daily goals that served to avoid their "worst case scenario" experienced the lowest levels of subjective well-being. In addition, progress at daily goals that were relevant to accomplishing one's life goals was significantly more strongly related to subjective well-being than progress at daily goals that were unrelated to one's life goals. Results indicate that daily goals are used to enact life goals and avoid worst fears and that these means–end relations have implications for well-being.     

Novel popout without novelty

Localization of a novel word in an array with several familiar words is typically enhanced relative to localization in an all-novel array (between-array novel popout) and sometimes enhanced relative to familiar words in one-novel arrays (within-array novel popout). Christie and Klein (1996) have questioned the reality of the latter effect, suggesting that it may be an artifact of guessing bias. The present Experiment 1 replicated within-array novel popout with the novel word probed at chance (i.e., on only one quarter of trials). Experiments 2 and 3 demonstrated a similar popout effect for a categorically unrelated word among three categorically related words, despite superior performance on all-related arrays relative to all-unrelated arrays. Repetition of constant sets of words within the experimental context is therefore unnecessary for a popout effect, contrary to assertions by Johnston and Hawley (1994). Interitem associations appear to be sufficient to produce a popout effect; as such, “novel popout” appears to be a misnomer for a phenomenon that does not depend on novelty.     

The “New” democratic woman of modernity: Georgia O’Keeffe and Melanie Klein

Summary O’Keeffe put into visual language the psychic splitting that had occurred between the sexes in the United States, attempting to integrate what had formerly been separated as feminine and masculine into the female psyche. In her most important contribution, she explored presence rather than absence and opened up possibilities for thinking about openings. The concept of the female opening in particular had heretofore been assigned a negative meaning, signifying more often than not a gaping wound rather than a space and place of possibilities. Klein’s complex and evocative understanding of some of the earliest mental processes of life enabled researchers to delve into the meanings made of the presence of the mother and father and baby, in the context of the baby’s body-mind. Klein’s female or male baby desires to know from the beginning. She discovered splitting and projective identification, the development of anxiety and guilt under the aegis of these mental processes, the multiple meanings of aggression, and, significantly, she permitted the female baby’s body to have its own language. The answers provided by O’Keeffe and Klein bequeathed new possibilities for women’s self-invention and remain pivot points for female identity throughout the century, to be confronted again by the second wave of feminism beginning in the late 1960s, by ‘postfeminist’ debates, and by a challenged psychoanalysis. A more careful probing of these issues may help us to better understand our past so as to have greater resources for a more comprehensive reading of our present.