‘No entry’, an invitation to intrude,or both? Reflections on a group of anorexic patients

This paper describes the twice‐weekly psychoanalytic psychotherapy of a young woman who had undergone major bowel surgery in her early 20s, with no clear medical indication for the surgery. Whilst the concept of ‘No Entry’ described by Williams ( 1997a , b ) aptly describes many features of more ‘typical’ anorexic patients, this paper describes a particular group of anorexic patients, referred by their physicians for multiple medical procedures; and proposes there is a group of anorexic patients, repeatedly referred for medical investigations, into whom particular types of entries occur. These are entries into the body ‘legitimized’ as medical, with a trajectory towards multiple procedures, examinations and surgical operations. Other entries (outside the medical setting) may occur in a state of altered consciousness, under the influence of alcohol or drugs, such that any wish for intrusion is disowned and denied. In both sets of events, intrusion is both invited, and consciously denied. The case example illuminates some of these features, and aspects of the countertransference are also described. Attention is drawn to relevant research focusing on surgical intrusion. Finally, there is an exploration as to how such patients may invite intrusions into the body through surgery and medical procedures.     

The Innate Bases of Fear

This study addressed the effects of children's understanding of social learning principles on divergent areas of behavior: two indices of self-control, grade scores, personality and conduct problems, immaturity, and subcultural delinquency. Using an orthogonal 2 × 2 (Understanding of Social Learning Principles × Age) multivariate analysis of variance on 44 children, we found no significant interaction or a knowledge of social learning principles main effect.     

Philosophical Autobiography

An examination of the genre of philosophical autobiography sheds light on the role of personal judgment alongside objective rationality in philosophy. Building on Monk's conception of philosophical biography, philosophical autobiography can be seen as any autobiography that reveals some interplay between life and thought. It is argued that almost all autobiographies by philosophers are philosophical because the recounting of one's own life is almost invariably a form of extended speech act of self-revelation. When a philosopher is the autobiographer, this self-revelation illuminates the interplay between thought, life, and personality. Understanding how this works allows us to address three problems of biography raised by Honderich: how to give an account of something as large and complex as a human life; how a life-story is also a judgment; and how we can justify identifying one part of a causal circumstance as 'the cause'. There is also a new ethical problem raised about the autobiographer's right to make public details of a shared private life.     

Wiederkehrende,primäre Kopfschmerzen im Jugendalter

Background

Recurrent pain, especially primary headache, is a serious health problem in adolescents. Music therapy in the treatment of children with migraine has already been evaluated. The aim of this pilot study was to adopt this treatment manual for adolescent patients with recurrent primary headache in preparation for the main randomized controlled trial.

Patients and methods

In this pilot study two different modes of treatment (standard and compact treatment) were tested in an outpatient setting with 19 patients. Frequency and intensity of headache symptoms were evaluated using pain diaries for 8 weeks in a pre-post design.

Results

The pilot study showed good feasibility of both treatment conditions in outpatient practice. Patients reported a reduction of pain frequency and intensity in both groups. The evaluation of the clinical relevance of these effects remains the objective for the main trial.

Conclusions

The music therapeutic treatment plan for children with migraine is even feasible in the treatment of adolescents with recurrent, primary headache. Further evidence questioning the effectiveness of the treatment under controlled conditions is needed.

     

Relationship between heart rate variability and cognitive function during threat of shock

Abstract

The aim of the present study was to investigate the relationship between resting heart rate variability (HRV) and cognitive functions during threat of shock. A Continuous Performance Task and a Working Memory Task were used to measure cognitive functions. Sixty-five male participants from the Royal Norwegian Navy participated. HRV was measured during baseline, test conditions and recovery. Participants were randomly assigned into non-threat and threat groups. Based on the median split of the high frequency (HF) spectral power, groups were divided into two additional groups. Overall, the high HRV participants showed superior performance on cognitive tasks independent of non-threat or threat conditions. During threat condition the low HRV group showed improved performance. Thus, individuals with high HRV were more stress tolerant and resilient in the face of environmental changes. The results from the study might have implications with regard to performance in operational settings, but also for other fields of psychological research such as individual differences, anxiety and coping.     

Vitamin D and executive function: a preliminary report

The aim of this study was to investigate the relationship between vitamin D levels and cognition, both executive and nonexecutive functions, in men incarcerated in a Norwegian prison. Participants were divided into high vitamin D and low vitamin D groups based on established criteria (high level > or = 50 nmol/L; low level < 50 nmol/L). The mean vitamin D concentration was 69 (SD = 12) and 38 (SD = 9) nmol/L in the high-level group (n = 14) and the low level group (n = 11), respectively. Results revealed that the high vitamin D group had significantly more correct responses than the low vitamin D group on the executive function task. There was no difference between the groups on the nonexecutive function task. The reaction time data indicated that the high levels of correct responses in the high vitamin D group on the executive function tasks were not due to a speed-accuracy trade-off.     

A randomized clinical trial comparing affect regulation and social problem-solving psychotherapies for mothers with victimization-related PTSD

Addressing affect dysregulation may provide a complementary alternative or adjunctive approach to the empirically supported trauma memory processing models of cognitive behavior therapy (CBT) for posttraumatic stress disorder (PTSD). A CBT designed to enhance affect regulation without trauma memory processing—trauma affect regulation: guide for education and therapy (TARGET)—was compared to present centered therapy (PCT) and wait-list (WL) conditions in a randomized clinical trial with 146 primarily low-income and ethnoracial minority mothers with PTSD. TARGET achieved statistically and clinically significant improvement on PTSD and affect regulation measures compared to WL, with more consistent and sustained (over a 6-month follow-up period) evidence of improvement than PCT. Drop-out rates (~ 25%) were comparable in TARGET and PCT, similar to those previously reported for trauma memory processing CBTs. Symptom worsening was rare (2–8%) and transient. Affect regulation-based CBT without trauma memory processing warrants further research as a potentially efficacious therapy for victimization-related PTSD.