The cognitive effects of trauma: reversal of alpha function and the formation of a beta screen

Following a brief review of Freud's writings on trauma, the author discusses relevant theories of Bion, and in particular the concepts of the alpha function and the beta screen. A clinical example is presented in which the patient's relatively recent trauma in adulthood had become fused with prior related experiences, leading to a propensity for repeated enactments in analysis and a failure to learn from experience. Drawing on the analyst's alpha function, the patient was gradually able to use mentalization to transform her rigidly structured traumatic organization. The author highlights the roles of dreams/dream associations and of screen memories in the patient's analysis.     

Developing a Community Science Research Agenda for Building Community Capacity for Effective Preventive Interventions

Research has shown that prevention programming can improve community health when implemented well. There are examples of successful prevention in local communities, however many continue to face significant challenges, demonstrating a gap between science and practice. Common strategies within the United States to address this gap are available (e.g., trainings), but lack outcomes. Building community capacity to implement high quality prevention can help communities achieve positive health outcomes, thereby narrowing the gap. While there is ample research on the efficacy of evidence-based programs, there is little on how to improve community capacity to improve prevention quality. In order to narrow the gap, a new model of research—one based in Community Science—is suggested that improves the latest theoretical understanding of community capacity and evaluates technologies designed to enhance it. In this article, we describe this model and suggest a research agenda that can lead to improved outcomes at the local level.     

Suicide compared to other causes of mortality in physicians

Physicians frequently are early adopters of healthy behaviors based on their knowledge and economic resources. The mortality patterns of physicians in the United States, particularly suicide, have not been rigorously described for over a decade. Previous studies have shown lower all-cause mortality among physicians yet reported conflicting results about cause-specific mortality such as suicide. In this study, we compared all-cause and cause-specific mortality in a sample of physicians to the age-gender matched general U.S. population from 1948 through 1998. We also compared the mortality experience across medical specialties. The risk of all-cause mortality was 56% lower than expected in men, and 26% lower in women, compared to the general population. Standardized mortality ratios (SMRs) were markedly lower for diseases strongly linked to smoking, e.g., cardiovascular diseases, respiratory diseases, and lung cancer. Suicide was the only cause of death where risk was greater than the general population. Overall, we found that physicians are at substantially lower risk of dying compared to the general population for all causes of death except suicide. The findings for suicide are strikingly different than other causes of death and should provide impetus for new research on the mental health of physicians.     

Greed, death, and values: from terror management to transcendence management theory

Research supporting terror management theory has shown that participants facing their death (via mortality salience) exhibit more greed than do control participants. The present research attempts to distinguish mortality salience from other forms of mortality awareness. Specifically, the authors look to reports of near-death experiences and posttraumatic growth which reveal that many people who nearly die come to view seeking wealth and possession as empty and meaningless. Guided by these reports, a manipulation called death reflection was generated. In Study 1, highly extrinsic participants who experienced death reflection exhibited intrinsic behavior. In Study 2, the manipulation was validated, and in Study 3, death reflection and mortality salience manipulations were compared. Results showed that mortality salience led highly extrinsic participants to manifest greed, whereas death reflection again generated intrinsic, unselfish behavior. The construct of value orientation is discussed along with the contrast between death reflection manipulation and mortality salience.     

Sensorimotor simulations underlie conceptual representations: Modality-specific effects of prior activation

According to the perceptual symbols theory (Barsalou, 1999), sensorimotor simulations underlie the representation of concepts. Simulations are componential in the sense that they vary with the context in which the concept is presented. In the present study, we investigated whether representations are affected by recent experiences with a concept. Concept names (e.g., APPLE) were presented twice in a property verification task with a different property on each occasion. The two properties were either from the same perceptual modality (e.g.,green, shiny) or from different modalities (e.g.,tart, shiny). All stimuli were words. There was a lag of several intervening trials between the first and second presentation. Verification times and error rates for the second presentation of the concept were higher if the properties were from different modalities than if they were from the same modality.     

An application of item response theory analysis to alcohol, cannabis, and cocaine criteria in DSM-IV

Item response theory (IRT) is supplanting classical test theory as the basis for measures development. This study demonstrated the utility of IRT for evaluating DSM-IV diagnostic criteria. Data on alcohol, cannabis, and cocaine symptoms from 372 adult clinical participants interviewed with the Composite International Diagnostic Interview--Expanded Substance Abuse Module (CIDI-SAM) were analyzed with Mplus (B. Muthen & L. Muthen, 1998) and MULTILOG (D. Thissen, 1991) software. Tolerance and legal problems criteria were dropped because of poor fit with a unidimensional model. Item response curves, test information curves, and testing of variously constrained models suggested that DSM-IV criteria in the CIDI-SAM discriminate between only impaired and less impaired cases and may not be useful to scale case severity. IRT can be used to study the construct validity of DSM-IV diagnoses and to identify diagnostic criteria with poor performance.     

Assessing the causal structure of function

Theories typically emphasize affordances or intentions as the primary determinant of an object's perceived function. The HIPE theory assumes that people integrate both into causal models that produce functional attributions. In these models, an object's physical structure and an agent's action specify an affordance jointly, constituting the immediate causes of a perceived function. The object's design history and an agent's goal in using it constitute distant causes. When specified fully, the immediate causes are sufficient for determining the perceived function--distant causes have no effect (the causal proximity principle). When the immediate causes are ambiguous or unknown, distant causes produce inferences about the immediate causes, thereby affecting functional attributions indirectly (the causal updating principle). Seven experiments supported HIPE's predictions.