Trauma and processes of separation from parental figures

Abstract

Extreme conditions in some young persons' life-experiences might postpone or even hinder the natural process of mourning of lost childhood omnipotence, ambivalent feelings towards and separation from parental figures. The psychic mechanisms behind these youngsters' flight from the loving grip of their parents to the conflicting situations which later traumatise them are described. The traumatic events following their choice of leaving the parental home were later unconsciously experienced as punishment—a direct consequence of the forbidden separation. Guilt problems otherwise within the normal range of development, here get a special colouring which can be recognised among others in the difficulties to establish a working-alliance with the therapist and problems in establishing intimate relationships later in life.     

The framework of psychoanalytically oriented psychotherapy with traumatised patients and the institution

Abstract

Lindbom-Jakobson M, Lindgren L. The Framework of Psychoanalytically Oriented Psychotherapy with Traumatised Patients and the Institution. Int Forum Psychoanal 1997;6:217-224. ISSN 0803-706X.

Psychotherapies performed at multidisciplinary institutions will be influenced by the ongoing dynamics and inevitable group processes of the institution. The difficulties of these processes become extremely hard to handle when the patient category is a severely traumatised one. The prerequisite of psychoanalytically oriented psychotherapy, the illusion of the sealed room and fixed framework, gets disturbed by the information flow in an institution. The institutions for these patients tend to become stages on which the patients as well as staff can perform and repeat their intrapsychic and interpersonal conflicts, non-adaptive defences and disturbed object relations. The predominant dynamic that arises around tortured refugees as a patient category is sado-masochistic relating.     

Effects of Age on the Temporal Organization of Working Memory in Deaf Signers

ABSTRACT

Deaf native signers have a general working memory (WM) capacity similar to that of hearing non-signers but are less sensitive to the temporal order of stored items at retrieval. General WM capacity declines with age, but little is known of how cognitive aging affects WM function in deaf signers. We investigated WM function in elderly deaf signers (EDS) and an age-matched comparison group of hearing non-signers (EHN) using a paradigm designed to highlight differences in temporal and spatial processing of item and order information. EDS performed worse than EHN on both item and order recognition using a temporal style of presentation. Reanalysis together with earlier data showed that with the temporal style of presentation, order recognition performance for EDS was also lower than for young adult deaf signers. Older participants responded more slowly than younger participants. These findings suggest that apart from age-related slowing irrespective of sensory and language status, there is an age-related difference specific to deaf signers in the ability to retain order information in WM when temporal processing demands are high. This may be due to neural reorganisation arising from sign language use. Concurrent spatial information with the Mixed style of presentation resulted in enhanced order processing for all groups, suggesting that concurrent temporal and spatial cues may enhance learning for both deaf and hearing groups. These findings support and extend the WM model for Ease of Language Understanding.     

Between uncertainty and certainty

In this study, 10 hematologists and 10 lung oncologists were interviewed regarding the information they provide to patients in four situations of uncertainty: determining the treatment that is in the patient's best interest; recurrence or progression of the patient's disease; determining when to withdraw life-prolonging treatment; discussing death, addressing questions such as whether the patient will die from the disease, and when. The primary finding is that delivery of information to patients with low survival rates can be improved by more and better disclosure by physicians at an earlier stage. The crucial point for physicians is to ascertain the wishes of patients, to learn what to reveal about what patients should expect, short term and long term, as death approaches.     

Cognitive processes in implicit attitude tasks: An experimental validation of the Trip Model

Implicit attitude tasks have become very popular in various areas of psychology. However, little is known about the cognitive processes they involve. To address this issue, we investigated the underlying processes of the Go/No‐go Association Task (GNAT), a go/no‐go variant of the well‐known Implicit Association Test (IAT). More precisely, we tested two alternative multinomial processing tree (MPT) models of GNAT performance, the Trip Model and the generalized Quad Model. Both models assume that GNAT performance is influenced not only by automatic associations but also by response biases and a controlled discrimination process. However, the two models differ with respect to an additional overcoming bias process. In contrast to the Quad Model, the Trip Model assumes that overcoming bias does not play a major role in GNAT performance. Instead, the Trip Model emphasizes the role of response biases. We report three experiments that demonstrate the validity of the Trip Model for GNAT data. Copyright © 2010 John Wiley & Sons, Ltd.     

Does personality disorder co-morbidity impact treatment outcome for patients with major depression? A multi-level analysis

In literature, there exists disagreement regarding the impact of comorbid personality disorder(s) (PD[s]) on treatment outcome for patients with major depressive disorder (MDD). The aim of this paper was to investigate whether statistical heterogeneity and inter-dependency are potential moderators of the effect of co-morbid PDs on outcome for patients with MDD. Clinician-rated MADRS scores and DSM-IV Axis II personality disorder diagnoses were obtained from 562 outpatients with MDD who received 6 months of combined psycho- and pharmacotherapy. Single-level regression showed significantly worse treatment outcome among patients with co-morbid PD, as compared to patients with no PD. After controlling for statistical heterogeneity and interdependency, treatment outcome was no longer significantly worse for patients with co-morbid PD. In conclusion, heteroscedasticity and inter-dependency should be considered as potentially compelling explanations for inconsistencies in findings on treatment outcome for depressed patients with co-morbid PDs.     

The Illness/Injury Sensitivity Index: Validation of a German Version of the ISI-R

Three fundamental fears-anxiety sensitivity, fear of negative evaluation, and illness/injury sensitivity-are considered integral components of anxiety-related psychopathology and also bear connections with chronic pain. Scales measuring the first two fears, the Anxiety Sensitivity Index and the Fear of Negative Evaluation Scale, have been translated into German; however, the nine-item Illness/Injury Sensitivity Index-Revised (ISI-R) that measures fears of injury and illness has not been available in German language yet. The aim of this study therefore was a translation of the ISI-R into German language and an initial validation of the translated scale in two different samples. The German ISI-R was translated by both professionals and laypersons, and a final version was decided on by consensus. In Study 1, participants included 96 undergraduate students (85% women) who completed the German version of the ISI as part of a larger study. An exploratory factor analysis with oblique rotation was conducted and suggested a two-factor-solution with one factor representing fears of illness and the other fears of injury. This factor structure was confirmed via a confirmatory factor analysis (CFA) in Study 2. Participants included 117 community members (79% women). Convergent validity was supported using a visual analogue scale for fear of illness in both samples and the German translation of the Whiteley Index in Study. Overall, the results supported the German translation of the ISI-R. Comprehensive results, limitations, and directions for future research are discussed.     

Language, moral order and political praxis

The paper argues that the debate between objectivist criticism and postmodern critique represents a fracturing of the modes of mundane social and linguistic practice. The two together miss the open-textured character of language-in-use and the reflexive properties of situated human practice. Both difference and agreement are grounded in the multiplicity of criteria that are a feature of the logical grammar of language, and therefore of everyday praxis, including that of critique. To escape the duality of foundationalism on the one hand, and radical relativism on the other, attention to the praxiological details of human action and reasoning is needed. The paper draws on Wittgensteinian philosophy and ethnomethodological studies of reasoning to make its case.