Physician,Divest Thyself

Responses to public health emergencies can entail difficult decisions about restricting individual liberties to prevent the spread of disease. The quintessential example is quarantine. While isolating sick patients tends not to provoke much concern, quarantine of healthy people who only might be infected often is controversial. In fact, as the experience with severe acute respiratory syndrome (SARS) shows, the vast majority of those placed under quarantine typically don't become ill. Efforts to enforce involuntary quarantine through military or police powers also can backfire, stoking both panic and disease spread. Yet quarantine is part of a limited arsenal of options when effective treatment or prophylaxis is not available, and some evidence suggests it can be effective, especially when it is voluntary, home-based and accompanied by extensive outreach, communication and education efforts. Even assuming that quarantine is medically effective, however, it still must be ethically justified because it creates harms for many of those affected. Moreover, ethical principles of reciprocity, transparency, non-discrimination and accountability should guide any implementation of quarantine.     

Interior experience within analytic process

In this paper, I consider the feeling of interiority as it evolves within the treatment relationship. A capacity to access and sustain one's interiority reflects a sense of personal solidity within which the validity of subjective process and privacy is taken for granted. When this capacity is relatively undeveloped, individuals rely on the “other”; (including the analyst) to help them contact, elaborate, or manage their affective experience. Quite paradoxically, the analyst's active investigation of dynamic or intersubjective process may obfuscate rather than clarify this core difficulty. I suggest two alternative approaches to the treatment situation that stand in some tension and yet also complement each other. One emphasizes the “active”; investigation of dynamic and dyadic process, wherein the analyst works interpretively and/or around relational issues. The other is organized around the “interior”; dimension of the treatment experience, emphasizing the patient's need to develop or manage her affective process in the relative absence of input from the analyst. Two clinical situations are described, the first illustrating the use of silence with a patient whose difficulties involved affect articulation, and the second involving a patient whose need for affect regulation made her highly dependent on the analyst for soothing.     

The Effect of Response Bias on the Personality Inventory for DSM–5 (PID–5)

Valid self-report assessment of psychopathology relies on accurate and credible responses to test questions. There are some individuals who, in certain assessment contexts, cannot or choose not to answer in a manner typically representative of their traits or symptoms. This is referred to, most broadly, as test response bias. In this investigation, we explore the effect of response bias on the Personality Inventory for DSM–5 (PID–5; Krueger, Derringer, Markon, Watson, & Skodol, 2013 Krueger, R. F., Derringer, J., Markon, K. E., Watson, D., & Skodol, A. E. (2013). The Personality Inventory for DSM–5 (PID–5)–Adult (Full version). Washington, DC: American Psychiatric Association. [Google Scholar]), a self-report instrument designed to assess the pathological personality traits used to inform diagnosis of the personality disorders in Section III of DSM–5. A set of Minnesota Multiphasic Personality Inventory Restructured Form (MMPI–2–RF; Ben-Porath & Tellegen, 2008 Tellegen, A., & Ben-Porath, Y. S (2008). MMPI–2–RF technical manual. Minneapolis: University of Minnesota Press. [Google Scholar]/2011 Ben-Porath, Y. S., & Tellegen, A. (2011). MMPI–2–RF manual for administration, scoring, and interpretation. Minneapolis: University of Minnesota Press. (Original work published 2008) [Google Scholar]) validity scales, which are used to assess and identify response bias, were employed to identify individuals who engaged in either noncredible overreporting (OR) or underreporting (UR), or who were deemed to be reporting or responding to the items in a “credible” manner—credible responding (CR). A total of 2,022 research participants (1,587 students, 435 psychiatric patients) completed the MMPI–2–RF and PID–5; following protocol screening, these participants were classified into OR, UR, or CR response groups based on MMPI–2–RF validity scale scores. Groups of students and patients in the OR group scored significantly higher on the PID–5 than those students and patients in the CR group, whereas those in the UR group scored significantly lower than those in the CR group. Although future research is needed to explore the effects of response bias on the PID–5, results from this investigation provide initial evidence suggesting that response bias influences scale elevations on this instrument.     

Military Marriages: The Aftermath of Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF) Deployments

An examination of how members of military marriages were affected by and adapted to OIF/OEF deployment found three themes: communicating to stay connected, emotional and marital intimacy, and managing change. The findings demonstrate the nuanced and subtle nature of deployment-related challenges. While open and frequent communication was important in the adaptation process, communication was not synonymous with transparency. Unshared stories created a void that prevented couples from confiding in and supporting their partners. Although wives maintained their marriages by restraining sexual desires and over-extending their responsibilities post-deployment, these behaviors had a negative effect on marital quality. Clinical and research implications are discussed.     

Under threat of social exclusion, females exclude more than males

Theoretical analyses and studies with children suggest that females are more likely than males to respond to threats of social exclusion with exclusion. Here we present a series of studies using a modified version of a computerized competitive game that participants play against two fictitious opponents. In previous studies, females and males have typically made identical strategy choices when playing this game. We show that when players are told that the two fictitious opponents may form an exclusionary alliance against them, females modify their competitive strategies by forming more preventive exclusionary alliances than males do. These results support the idea that adult females are more likely than males to form preventive exclusionary alliances when faced with a social threat. The results further suggest that females and males compete in different ways.