Addressing Challenges in Individual Psychotherapy with Delusional Patients: A Case Study

Although cognitive-behavioral treatments for schizophrenia and other psychotic disorders demonstrate strong results in clinical trials, not all patients respond to these treatments. Common challenges in psychotherapy with delusional patients include a mismatch between the therapist’s and the patient’s expectations about the purpose of therapy, the patient’s lack of motivation to reduce delusional beliefs in service of other goals, and the patient’s dependence on the delusions in order to preserve an intact sense of self. This case highlights the value of integrating a psychodynamic perspective with cognitive-behavioral interventions to address challenges in psychotherapy with chronically delusional patients.     

Process timing and its relation to the coding of tonal harmony

Advances in auditory research suggest that gamma-band synchronization of frequency-specific cortical loci could be responsible for the integration of pure tones (harmonics) into harmonic complex tones. Thus far, evidence for such a mechanism has been revealed in neurophysiological studies, with little corroborative psychophysical evidence. In six experiments, we observed a rate- and time-specific response-time advantage for a sequence of target pips when the defining frequency of the target was a fractional multiple of a priming frequency. The effect was only observed when the prime and target sequences were presented at 33 pips per second and when the interstimulus interval was approximately 100 and 250 ms. This evidence implicates oscillatory gamma-band activity in the representation of harmonic complex tones and suggests that synchronization with precise temporal characteristics is important for disambiguating related harmonic templates. An outline of a model is presented, which accounts for these findings in terms of fast resynchronization of relevant neuronal assemblies.     

Mindfulness predicts less texting while driving among young adults: Examining attention- and emotion-regulation motives as potential mediators

Many young adult drivers read and send text messages while driving despite clear safety risks. Understanding predictors of texting-while-driving may help to indentify relevant targets for interventions to reduce this dangerous behavior. The present study examined whether individual differences in mindfulness are associated with texting-while-driving in a sample of young-adult drivers. Using path analysis, we tested whether this relationship would be mediated by the degree to which individuals use text-messaging as a means of reducing unpleasant emotions (emotion-regulation motives) and the degree to which individuals limit texting in order to focus on present-moment experiences (attention-regulation motives). Individuals lower in mindfulness reported more frequent texting-while-driving and this relationship appeared to be mediated primarily by emotion-regulation motives. Results may help inform the development of mindfulness-based interventions to prevent texting-while-driving.     

Nurturing Faith for Action: Theological Education and Global Responsibility

Ghana hopes to parlay the financial promises of oil recovery into a better life for its people. If Ghana succeeds, it would be a model for the developing world. But Ghana's capacity to overcome poverty and support human dignity will be stronger if the rest of us who also hold that value commit more truly to it. As people of faith, as leaders of institutions, as educators, we face substantive questions about how our own actions, business decisions, and consumptive practices contribute to the larger issues of oil, consumerism, and planetary health. A course that asks not just Christian scholars and clergy, but leaders of theological institutions, church bodies, businesses, and others, to consider an ethical, paradigmatic shift toward a whole‐world ethic of well‐being is in order.     

Autonomy,Reciprocity, and Responsibility: Darwall and Levinas on the Second Person

Abstract

Stephen Darwall’s The Second‐Person Standpoint converges with Emmanuel Levinas’s concern about the role of the second‐person relationship in ethics. This paper contrasts their methodologies (regressive analysis of presuppositions versus phenomenology) to explain Darwall’s narrower view of ethical experience in terms of expressed reactive attitudes. It delineates Darwall’s overall justificatory strategy and the centrality of autonomy and reciprocity within it, in contrast to Levinas’s emphasis on the experience of responsibility. Asymmetrical responsibility plays a more foundational role as a critical counterpoint to ‘mean‐spirited’ reciprocity than Darwall’s laudable distinction between accountability and revenge, and responsibility even founds this distinction. The experience of being summoned to asymmetrical responsibility amplifies the meaning of ‘authority’, which is a presupposition for Darwall. Finally, asymmetrical responsibility helps develop decentred reasoning, invites risk beyond the boundaries of reciprocity at moments when autonomy appears endangered, reconciles respect and care at the experiential level, and presses to extend the scope of moral obligation.     

Pragmatic Psychodynamic Psychotherapy—Bridging Contemporary Psychoanalytic Clinical Practice and Evidence-Based Psychodynamic Practice

Pragmatic psychodynamic psychotherapy (PPP; Summers & Barber, 2009 Barber, J. P. 2009. Toward a working through of some core conflicts in psychotherapy research. Psychother. Res, 19(1): 1–12. [Taylor & Francis Online], [Web of Science ®] , [Google Scholar]) describes the therapeutic principles and approaches found in many forms of manualized psychodynamic psychotherapies, which are being used in research studies with the aim of building an evidence-based psychodynamic practice. This article focuses on one such treatment, Supportive-expressive psychotherapy (SEP; Luborsky 1984), which employs the Core Conflictual Relationship Theme (CCRT) method to formulate core interpersonal problems and treatment goals and identify therapeutic interventions. To illustrate SEP, we describe the 40-session treatment of a patient who met diagnostic criteria for several personality disorders. The case illustrates how complex ego-syntonic character pathology is expressed in CCRT terms and worked through in the transference, gradually becoming ego-dystonic and amenable to modification. In this case, the patient became more aware of his interpersonal wishes and vulnerability. Although his anxiety increased somewhat, he had an improvement in psychosocial functioning.     

The Protestant work ethic,religious beliefs,and homonegative attitudes

The purpose of this study was to examine the influence of the Protestant Work Ethic (PWE) on negative attitudes towards gay men and lesbian women (homonegativity). The influence of religious beliefs and the notion of homosexuality as a choice were also examined in combination with PWE in regards to homonegativity. Previous research suggested that those who subscribe to the PWE have more negative attitudes towards societal out-groups (e.g., African–Americans). Thus, it was hypothesized that those with high PWE scores would display more homonegative attitudes. A significant correlation between PWE and homonegativity supported this hypothesis. Multiple regression analyses revealed that PWE interacted with religious beliefs, and religious beliefs interacted marginally with the idea of homosexuality as a choice. Those with high religious beliefs and who strongly believed that homosexuality was a choice were more likely to have negative attitudes towards homosexuals. The implications of these findings are discussed, with particular respect to reducing homonegative attitudes.     

Adult age differences in subjective and objective measures of strategy use on a sequentially cued prediction task

Differences in strategy use are thought to underlie age-related performance deficits on many learning and decision-making tasks. Recently, age-related differences in learning to make predictions were reported on the Triplets Prediction Task (TPT). Notably, deficits appeared early in training and continued with experience. To assess if age differences were due to early strategy use, neural networks were used to objectively assess the strategies implemented by participants during Session 1. Then, the relationship between these strategies and performance was examined. Results revealed that older adults were more likely to implement a disadvantageous strategy early in learning, and this led to poorer task performance. Importantly, the relationship between age and task performance was partially mediated by early strategy use, suggesting that early strategy selection played a role in the lower quality of predictions in older adults.     

Parent-Adolescent Relationship and Adolescent Psychological Functioning among African-American Female Adolescents: Self-Esteem as a Mediator

African-American female adolescents living in urban areas are at increased risk for adverse adjustment outcomes. The present study accomplished two goals. First, the quality of the parent-adolescent relationship across age groups was examined for differences among younger (i.e., 12'14) versus mid-range (i.e., 15'16) versus older (i.e., 17'18) adolescents. Second, self-esteem was examined as a possible mediator of the relationship between the quality of the parent-adolescent relationship and adolescent psychological functioning in a sample of 608 African-American urban adolescent females. With regard to developmental shifts in the quality of the parent-adolescent relationship, midrange adolescents reported a significantly poorer relationship with their mother than older adolescents. Results also indicated that self-esteem partially mediated the relationship between parent-child relationship and adolescent psychological functioning. Mental health professionals can broaden their interventions that aim to improve adolescent psychological functioning by either focusing on the quality of the parent-adolescent relationship or adolescent self-esteem.