Stakeholder Opinions and Ethical Perspectives Support Complete Disclosure of Incidental Findings in MRI Research

How far does a researcher’s responsibility extend when an incidental finding is identified? Balancing pertinent ethical principles such as beneficence, respect for persons, and duty to rescue is not always straightforward, particularly in neuroimaging research where empirical data that might help guide decision making are lacking. We conducted a systematic survey of perceptions and preferences of 396 investigators, research participants, and Institutional Review Board members at our institution. Using the partial entrustment model as described by Richardson, we argue that our data supports universal reading by a neuroradiologist of all research MRI scans for incidental findings and providing full disclosure to all participants.     

Reply to Commentary

This commentary is a response to questions and discussion points raised by Peter Fonagy and Mary Target in “Playing with the Reality of Analytic Love.” It includes a discussion of the relationship between attachment and sexuality, in addition to issues concerning seductiveness, sadomasochism and therapeutic change.     

The “Rituals” of the Relational Perspective: Theoretical Shifts and Clinical Implications

This paper attempts a closer look at the theoretical foundations for some of the clinical shifts that underlie a relational psychoanalytic approach. It also posits that what unites relational writers who come from different psychoanalytic traditions—that is, Freudian, Kleinian, Object Relations, Self Psychology—has more to do with the kinds of questions asked than with the particular answers that are offered. Specifically these questions have to do with the epistemological basis for how we know what we know as analysts, the model of mind we employ to understand our patients, and the mode of therapeutic action that evolves from these two earlier shifts. Several clinical examples are offered.     

“The Queering of the Oedipus Complex”: A Response to Diane Elise and Noah S. Glassman

This is a response to discussions by Diane Elise and Noah S. Glassman. The response emphasizes how each of us has attempted, in a somewhat different way, to open up the historical concept of the Oedipus complex to a more contemporary appreciation of changing familial patterns and always evolving sexualities and erotic potentials.     

From Oedipus Complex to Oedipal Complexity: Reconfiguring (Pardon the Expression) the Negative Oedipus Complex and the Disowned Erotics of Disowned Sexualities

This paper proposes a contemporary rendering of the Oedipus Complex as key to understanding an individual’s unique erotic signature. Conceived in terms of its complexity as opposed to a fixed and rigid complex and ridded of its hetereonormative biases, Oedipal complexity becomes a royal road to unlocking erotic inhibitions and potentiating sensual expansiveness. The theory is rooted in a multiple self state model of mind with an emphasis on conflicting systems of early internalized object relations. Two extended clinical examples are offered in an attempt to further explicate this point of view.     

Desirable responding mediates the relationship between emotion regulation and anxiety

Reappraisal and suppression are two commonly studied emotion regulation (ER) strategies. Their trait expression is often assessed through self-report questionnaires. Recent work suggests that trait-reappraisal is generally associated with lower levels of psychopathology while trait-suppression is linked to greater psychopathology. We propose here that the reappraisal construct represents a set of highly desirable traits, whereas suppression represents unwanted characteristics. If this were true, relationships between self-reported ER traits and psychopathology, such as anxiety, might be systematically biased. To test this hypothesis, we examined whether desirable responding (self-deceptive enhancement and impression management) mediated the link between self-reported emotion regulation traits (reappraisal and suppression) and anxiety in a sample of over 4000 college students, controlling for gender and ethnicity. Our findings show support for this hypothesis. Desirable responding, especially self-deceptive enhancement, mediated the effects of ER traits on anxiety. Our findings recommend caution in the use of self-reported ER traits when assessing links to psychopathology and underscore the influence of self-deception in subjective well-being.     

Stability and change in temperament during adolescence

This study assessed genetic and environmental contributions to temperament during adolescence within the Nonshared Environment and Adolescent Development project (NEAD; D. Reiss, J. M. Neiderhiser, E. M. Hetherington, & R. Plomin, 2000). NEAD is a national study that includes twins and other sibling types who vary in regard to genetic relatedness. Seven hundred twenty sibling pairs (aged 12.1-13.5 years) participated at Time 1, and 395 sibling pairs (aged 14.7-16.2 years) participated again at Time 2. At both Times, mothers and fathers rated their children's temperament (emotionality, activity, sociability, and shyness). At Times 1 and 2, genetic and nonshared environmental factors accounted for variance in temperament, whereas shared environmental contributions were negligible. However, at Time 1, genetic contributions were inflated, and shared environmental contributions were masked if sibling contrast effects were not taken into account. At Time 2, sibling interaction effects had little impact on estimates of genetic and environmental contributions to temperament. Last, temperament stability was primarily explained by genetic factors, whereas both genetic and nonshared environmental factors accounted for change.