The Effects of Childhood ADHD Symptoms on Early-onset Substance Use: A Swedish Twin Study

Research has documented that children and adolescents with attention-deficit/hyperactivity disorder (ADHD) are at increased risk of substance use problems. Few studies, however, have focused on early-onset substance use. This study therefore investigated how the two symptom dimensions of ADHD (hyperactivity/impulsivity and inattention) are associated with early-onset substance use, the role of persistent ADHD for the association, and to what extent the association is influenced by genetic and environmental factors. Twins (1,480 pairs) in the Swedish Twin Study of Child and Adolescent Development were followed from childhood to adolescence. ADHD symptoms were measured at age 8–9 and age 13–14 via parent-report, whereas substance use was assessed at age 13–14 via self-report. Results revealed that hyperactive/impulsive symptoms predicted early-onset “sometimes” tobacco use (adjusted odds ratios, 1.12, for one symptom count), controlling for inattentive symptoms and conduct problem behaviors. There is no independent effect of inattentive symptoms on early-onset substance use. Children with persistent hyperactivity/impulsivity (defined as scoring above the 75th percentile at both time points) had a pronounced risk of both early-onset tobacco and alcohol use (adjusted odds ratios from 1.86 to 3.35, compared to the reference group). The associations between hyperactivity/impulsivity and early-onset substance use were primarily influenced by genetic factors. Our results indicated that hyperactivity/impulsivity, but not inattention, is an important early predictor for early-onset substance use, and a shared genetic susceptibility is suggested to explain this association.     

Predictors of Boys’ ADHD Symptoms from Early to Middle Childhood: The Role of Father–Child and Mother–Child Interactions

This prospective 3 year longitudinal study investigated preschool paternal and maternal parenting predictors of Attention-Deficit/Hyperactivity Disorder(ADHD) in a community sample of 93 school-age boys. Participants were recruited on the basis of inattention-hyperactivity at age 4 and fathers and mothers were observed interacting with their sons. Teachers, fathers, and mothers reported children's ADHD symptoms and impairment. Results from dimensional analysis showed that less observed paternal sensitivity and maternal positive regard predicted higher levels of inattentiveness in middle childhood, and that intrusive paternal behavior was predictive of hyperactive-impulsive behavior at school. In categorical analysis, less maternal warmth and sensitivity were predictive of later ADHD. These predictions held after statistical adjustment for the effects of preschool ADHD behaviors and conduct problems. At follow-up, parents of boys with ADHD reported more negative child-parent relationship perceptions than comparison parents. Findings highlight the importance of examining responsive parenting behaviors of both fathers and mothers in relation to multi-informant ratings of ADHD symptoms.     

Salience modulation in serial preexposure: implications for perceptual learning

In three experiments rats were given serial preexposure to two flavor stimuli. In Experiment 1, some animals were given exposure to AX followed by the presentation of BX, a forward schedule; the others were given backward preexposure (BX→AX). Conditioning and test trials with the A element showed that salience or effectiveness of A was better protected in the forward than in the backward condition. Experiments 2 and 3 assessed the relevance of this salience modulation mechanism for perceptual learning. In these experiments, generalization of a conditioned aversion from AX to BX was reduced in the forward (but not in the backward) condition only after prolonged exposure, indicating that the establishment of an inhibitory link from B to A is required for successful discrimination. However, generalization to a novel compound stimulus, NX, was reduced in the forward group both after short and long preexposure, suggesting the existence of salience modulation processes that work in parallel with associative inhibition. These results seem to support the existence of a salience modulation mechanism that seems to be beyond the scope of current theories of perceptual learning.     

Sándor Ferenczi: From Clinical Turmoil to Theoretical Articulations

The article deals with concepts proposed by Sándor Ferenczi: confusion of tongues, disavowal and progressive trauma, illustrated by a clinical example, in which excessive life experiences deeply determined the psychic construction, compromising the integrity of the self-image and the potentiality of egoic capacities. We attempt to understand the uniqueness of the patient's history, and the ethical practice of deep analytic listening.     

No More Away: Techno-Attachments and the Relational Future

This paper speculates about the impact of techno-connectedness on our children, ourselves, our grandchildren. Triggered by recollections from Victorian novels that describe European summers “away” from home, a concern about loss of opportunity, the “space” for self-discovery in this young generation will be explored in a relational context. Brought about by pervasive dependence upon computer technology, is self-experience fragmented and attachment changed by the ubiquitous technological presence and is the more isolated, reflective experience being eroded?     

Psychosis: A Synthesis of Motivational and Defect Perspectives

Based on the evolution of human intelligence and the tremendous cognitive capacities arising from it, we have an innate tendency for the extreme thought content, thought form, and sensory perceptions of psychosis. During the conscious and awake state, cognitive regulatory control processes block these more extreme variants to facilitate reality congruency necessary for adaptive functioning. While asleep there is no need for reality congruency and the cognitive regulatory control processes are deactivated allowing psychotic equivalents to be expressed in dreams. This paper helps synthesize the two dominant perspectives regarding the etiology of psychosis: the neuroscience defect perspective and the psychoanalytic motivational perspective. Regarding the former, defective cognitive regulation arising from certain conditions, such as the deficit state of schizophrenia, allows extreme cognitive distortions, thought form variants, and sensory perceptual experiences to intrude into the conscious and awake state, thereby producing psychosis. Consistent with the psychoanalytic motivational perspective, defensive processes can motivate extreme cognitive distortions, thought form variants and sensory perceptual experiences, and also facilitate their expression by deactivating the relevant cognitive regulatory control processes.     

Critical Transference in a Case of Severe Epilepsy

In this paper, the author presents a summary of a brief treatment with a young woman, suffering from severe epileptic illness, which describes the mutuality of cross-transferences of deep and intense feelings and the unorthodox way to receive, to take in persons affected with critical phenomena. This treatment was deeply influenced by the traumatic triad, borrowed from Ferenczi: "amnesia, anaesthesia, aboulia," the ways of forgetting (or erasing) the past/the present/the future. The investigation led us to clarify, on the one hand, the incestophilic-or perhaps incestuous-source in the family, and on the other, the burdensome and tragic genealogy and history of each parent. At the end of this short treatment, which took place at a frequency of one session a week (with the patient sitting, standing, lying on the floor; with sometimes severe fits, deliria, threats; bringing of letters, texts, drawings; and a few phone calls), there was an alleviation of the critical phenomena and revival.