Construct Validity of the Need to Belong Scale: Mapping the Nomological Network

Nine studies examined the construct validity of the Need to Belong Scale. The desire for acceptance and belonging correlated with, but was distinct from, variables that involve a desire for social contact, such as extraversion and affiliation motivation. Furthermore, need to belong scores were not related to insecure attachment or unfulfilled needs for acceptance. Need to belong was positively correlated with extraversion, agreeableness, and neuroticism and with having an identity that is defined in terms of social attributes. Need to belong was associated with emotional reactions to rejection, values involving interpersonal relationships, and subclinical manifestations of certain personality disorders.     

Negro Responses to Certain Intelligence Test Items

Fifty-eight female undergraduate students were administered the Torrance Tests of Creative Thinking (TTCT), Figural form B, and the Washington Sentence Completion Test in order to investigate the hypothesis of a positive relationship between creativity and ego development. A Spearman rank order correlation coefficient was computed for ego development and each TTCT creativity factor (fluency, flexibility, originality, and elaboration), as well as a total composite creativity score. All creativity scores correlated with ego development at the .01 level, except for originality, which correlated at the .05 level. Results were discussed in terms of Maslow's theories concerning highly developed persons, and possible preconscious aspects of the creative process. Conclusions were drawn, and recommendations for further research were made.     

Religion and United States Physicians’ Opinions and Self-Predicted Practices Concerning Artificial Nutrition and Hydration

This study surveyed 1,156 practicing US physicians to examine the relationship between physicians’ religious characteristics and their approaches to artificial nutrition and hydration (ANH). Forty percent of physicians believed that unless a patient is imminently dying, the patient should always receive nutrition and fluids; 75 % believed that it is ethically permissible for doctors to withdraw ANH. The least religious physicians were less likely to oppose withholding or withdrawing ANH. Compared to non-evangelical Protestant physicians, Jews and Muslims were significantly more likely to oppose withholding ANH, and Muslims were significantly more likely to oppose withdrawing ANH.     

Increased forefoot loading is associated with an increased plantar flexion moment

The aim of this study was to identify the cascade of effects leading from alterations in force generation around the ankle joint to increased plantar pressures under the forefoot. Gait analysis including plantar pressure measurement was performed at an individually preferred and a standardized, imposed gait velocity in diabetic subjects with polyneuropathy (n = 94), without polyneuropathy (n = 39) and healthy elderly (n = 19). The plantar flexion moment at 40% of the stance phase was negatively correlated with the displacement rate of center of pressure (r = ?.749, p < .001 at the imposed, and r = ?.693, p < .001 at the preferred gait velocity). Displacement rate of center of pressure was strongly correlated with forefoot loading (r = ?.837, p < .001 at the imposed, and r = ?.731, p < .001 at the preferred gait velocity). People with a relatively high plantar flexion moment at 40% of the stance phase, have a faster forward transfer of center of pressure and consequently higher loading of the forefoot. This indicates that interventions aimed at increasing the control of the roll-off of the foot may contribute to a better plantar pressure distribution.     

Using art for comparison and distraction: Effects on negative emotions and judgements of satisfaction

Abstract

Two studies examined whether emotional comparison and distraction with emotion congruent and incongruent art would improve the well-being of dysphoric undergraduates. In both studies, subjects: (1) imagined a sad event; (2) compared their mood to that expressed by incongruent art (upward comparison) or congruent art (downward comparison); or focused on technical features of incongruent art (incongruent distraction) or congruent art (congruent distraction); and (3) rated their emotions and life satisfaction. The incongruent distraction group reported feeling more positive and more satisfied, and the downward comparison group reported feeling more satisfied, than the upward comparison or congruent distraction groups. Thus, comparison and distraction can improve well-being when directed towards emotion congruent and incongruent art, respectively.     

Ending With Options

No matter what has come before, if the ending of the analytic relationship is not managed sensitively, much good may be undone. Analytic endings are emotionally challenging for analysts as well as patients. What was missing from the classical approach, at least as interpreted by Freud's American disciples, was appreciation of the personal relationship (Flank, 2006 Frank, K. A. 2006. Toward conceptualizing the personal relationship in therapeutic action: Beyond the “real” relationship.. Psychoanal. Perspectives, 3: 6–43.  [Google Scholar]). In a relational view, the ending must be considered uniquely and mutually negotiated as part of a relationship that is both technical and personal. Accordingly, both permanent separation and separation with possible return are seen as just two of many possibilities for ending that the pair may co-create. Other options must also be considered.     

Transference Focused Psychotherapy for Patients with Comorbid Narcissistic and Borderline Personality Disorder

Clinical experience involving the treatment of patients with comorbid borderline and narcissistic personality disorders suggests that this patient population is among the more difficult to treat within the personality disorder spectrum. In this article, we present refinements of Transference Focused Psychotherapy (TFP) based on our clinical experience with and research data on patients with comorbid narcissistic personality disorder/borderline personality disorder (NPD/BPD). We briefly review object relations formulations of severe narcissistic pathology, as well as recent research in attachment and the allied concept of mentalization, which have provided a new lens through which to view narcissistic disorders. The research findings from two randomized clinical trials demonstrating the efficacy and effectiveness of TFP are presented. The data from the two Randomized Clinical Trials (RCT) allowed for the study of the characteristics of the subgroup of borderline personality disorder patients who have comorbid NPD/BPD. Findings on comorbidity, attachment status, capacity for mentalization, and level of personality organization of borderline patients with comorbid NPD/BPD, compared with borderline patients without comorbid narcissistic pathology (BPD), are presented. Clinical implications of the observed group differences are discussed, with a focus on refinements in the technique of TFP. Clinical case material is presented to illustrate the specific challenges posed by narcissistic patients to carrying out TFP in each phase of treatment.     

Commentary: “A Fundamental Polarity in Psychoanalysis: Implications for Personality Development,Psychopathology, and the Therapeutic Process” by Sidney J. Blatt

A commentary on Dr. Sidney J. Blatt's article, “A Fundamental Polarity in Psychoanalysis: Implications for Personality Development, Psycho-pathology, and the Therapeutic Process” is presented by articulating Dr. Blatt's significant contribution to psychoanalysis, developmental and attachment theory, and therapeutic process research. According to Blatt's theory, normal maturation involves a complex reciprocal transaction between two developmental lines throughout the life cycle: (a) the establishment of stable, enduring, mutually satisfying interpersonal relationships and (b) the achievement of a differentiated, stable, and cohesive identity. He has applied this theory to understand both normal and pathological psychological phenomena, the latter resulting from disruptions in these developmental lines, resulting in an overemphasis on relational (anaclitic) or self-definitional (introjective) issues. Further, Dr. Blatt has evaluated his theoretical model through empirical study and demonstrated that relationally oriented and self-definitionally oriented persons have differential responses to psychotherapy. Finally, areas of question and potential for future research are outlined. Specifically, it is argued that although anaclitic and introjective configurations are easy to discuss as distinct types, relevant evidence from attachment theory raises the issue of whether these types may be better conceptualized as dimensions, with different configurations located within two-dimensional space. Further, findings of a group evidencing mixed anaclitic and introjective features raise additional questions about how these configurations relate to one another, and evidence from the attachment literature is used to shed light on this issue.     

Attachment Theory,Psychoanalysis, Personality Development,and Psychopathology

Blatt and Levy place attachment theory and research in a broad theoretical matrix by considering the relationship of attachment patterns to personality development and to different types of psychopathology in adults. Thus Blatt and Levy construct conceptual bridges between the two configurations of personality development and psychopathology that Blatt and colleagues have developed over the past quarter century (e.g., Behrends and Blatt, 1985; Blatt, 1974, 1995; Blatt and Behrends, 1987; Blatt and Blass, 1990, 1996; Blatt and Shichman, 1983) and attachment theory and research. Blatt and Levy identify a polarity that is central to attachment theory and research, the polarity of attachment and separation, and they note that this polarity has also been central in much of classic psychoanalytic theory (e.g., Freud, 1930; Loewald, 1962). This polarity is expressed in attachment theory and research in the differences between avoidant and anxious-preoccupied insecure attachment patterns as well in the distinction between two types of disorganized attachment, helpless-withdrawn and negative intrusive, identified by Lyons-Ruth (1999, 2001).

This polarity of attachment and separation, or relatedness and self-definition is also fundamental to personality development that occurs in the hierarchical dialectic transaction of two basic developmental lines—interpersonal relatedness and self-definition (Blatt and Blass, 1990, 1996). This polarity is also inherent in the conception of two fundamental configurations of psychopathology—anaclitic psychopathology, the dependent (or infantile) and hysterical personality disorders—that are preoccupied with issues of interpersonal relatedness, and introjective psychopathology, the paranoid, obsessive-compulsive and depressive personality disorders, in which issues of self-definition and self-worth are dominant (Blatt, 1974, 1995; Blatt and Shichman, 1983). Thus, the identification of this fundamental polarity provides the basis for establishing links between attachment patterns, personality development, and adult psychopathology. Blatt and Levy also attempt to integrate psychoanalytic concepts of the representational world (e.g., Sandler and Rosenblatt, 1965)—the development of concepts of self and significant others—with the internal working models (IWMs) of attachment relationships. This integration enabled Blatt and Levy to bring a fuller developmental perspective to the IWMs of attachment theory and to note that, based on differences in the content and structural organization of the IWMs or mental representation of self and significant others, several developmental levels can be identified in both avoidant and anxious preoccupied attachment. These developmental levels within each attachment style also identifies less and more adaptive forms of both types of insecure attachment. Thus, the integration of the psychoanalytic concepts of mental representation with concepts of the IWM of attachment theory and research enables Blatt and Levy to create a fuller developmental perspective in the study of insecure attachment patterns.     

Psychoanalytic Training: The “Faculty System”

The primary and ideal version of the task faced by training institutes is simple: to help aspiring candidates become competent. Candidates receive assistance in developing their knowledge and skills as practitioners. But to look at training more closely is to see a far more complex set of demands and expectations. Indeed, training as it is actually conducted in most institutes can easily seem inconsistent, contradictory, and, at times, self-defeating. Moreover, in the golden age of psychoanalysis, training was considerably more haphazard and casual than it has become, but our efforts to become more systematic and thoughtful about training coincide with a general decline in our level of originality. Why has training, the development of competence, seemingly so clear and simple a task, become so complex and confusing?